Grant for Research and Development Application Form
Proof of Market, Research Projects, Micro Projects, Development Projects, Exceptional Research or Development Projects.
For office use only Date received Reference Project Officer
Full GR&D details are available at www.financesoutheast.com under Business Grants. Please read the Guidance Notes carefully before you fill in this form. If you have not already done so, please submit a pre-application summary (from our website) prior to submitting a full application. Please type your answers, or write in black ink using CAPITAL LETTERS. You must fill in the application form and provide a detailed project proposal, as set out in the Guidance Notes. Where boxes are provided, click on the correct box and a cross will appear. Finance South East, on behalf of SEEDA, is responsible for appraising applications and deciding which projects to support in the SEEDA region. Please send a director-signed unbound, hard copy of this application form and all supporting documents by post to the address below, together with : An electronic copy of your application form and all supporting documents by email to businessgrants@financesoutheast.com. Each item of your application is to be emailed as a separate attachment, in Microsoft Office format.
Postal Address : Business Grants Team, Finance South East Ltd., Riverside House, 4 Meadows Business Park, Station Approach, Blackwater, Surrey GU17 9AB.
Grant for Research and Development Application Form – A DIUS Solutions for Business Product May 2009
1 Business name and address You must either plan to start up or be operating a business in England. Business name:
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Business details You will need to provide details of the financial position of your business as part of your proposal. Number of employees (including Directors):
Business address:
Turnover (in your most recent annual accounts): £ as at:
Balance sheet total (total assets net of depreciation): Postcode Website: £ as at:
Is your business part of a group? No Yes (Go to Question 4a) (Answer the questions below)
2 In what role are you applying? You will need to explain the business background in your proposal. Limited company Sole trader or individual Partnership Limited liability partnership 3 Business registration number and date of registration. Registration number:
Number of group employees (including the number of company employees shown above):
Turnover (in their most recent annual accounts): £ as at:
Balance sheet total (total assets net of depreciation): £ as at:
4a Business Sector and (2003) SIC code: Date of registration:
Find your SIC code at www.statistics.gov.uk/methods_quality/sic/contents.asp
Grant for Research and Development Application Form – A DIUS Solutions for Business Product May 2009
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Do you or any other partner, member or director of your business have any interests in, or control over any other business? Yes No
7a Have you or any other partner, member or director of your business ever been prosecuted for fraud or disqualified from becoming a director? Yes No
If YES, please give details within the proposal. You must provide background detail to cover all directorships and shareholdings in other businesses in relation to all directors and shareholders (that is, the number of directorships, names of businesses and shareholding percentages). By ‘partner’, we mean a legal partner within a business. By ‘member’, we mean a member belonging to a limited liability partnership. By ‘director’, we mean a director of a company. 6a Have you or your business previously applied, or been connected with an application, for other public sector help? (For example, local authority grants, grants from other Government Departments, NESTA, any Regional Development Agency financial support and so on.) Yes No
7b Have you or any other partner, member or director of your business ever been an owner, partner or director of a business which went into bankruptcy, liquidation or receivership? Yes No
If you have answered YES to either 7a or 7b, please give details on a separate sheet as an annex to your proposal. (You will not necessarily be disqualified from claiming an award if you say ‘Yes’.) By ‘partner’, we mean a legal partner within a business. By ‘member’, we mean a member belonging to a limited liability partnership. By ‘director’, we mean a director of a company.
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What type of project do you plan to carry out? Proof of Market Research Project
If YES, please give details within the proposal. 6b Have you applied for support for this project from any other public sector source of help? (For example, local authority grants, NESTA, any Regional Development Agency financial support and so on.) Yes No
Exceptional Research Micro Project Development Project Exceptional Development 8a Grant applied for £ 8b Total project costs £
If YES, please give details within the proposal.
Grant for Research and Development Application Form – A DIUS Solutions for Business Product May 2009
8c Project title 11 Collaboration with: Research and Technology Organisation; Higher Education Institute; Further Education Institute; UK Public Sector Research Establishment; or Research and Development Organisation If your project will involve collaboration with any of the organisations listed above please give brief details below Name of Organisation:
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Who should we contact to discuss your proposal? Name:
Position:
Telephone:
Fax:
Email:
Nature of Collaboration:
10 Number of jobs created and/or safeguarded as a result of your proposal Please give details of any new jobs that will be created in your business as a result of this project. Number Full-time (ie 30 or more hrs/week) Number Part-time (ie 15 or more hrs/week)
* Only include collaborations formed for the purpose of completing this proposed project. Do not include any prior or existing collaborations formed for any other purpose.
Job Titles:
This application form must be supported by a detailed project proposal that clearly deals with the selection criteria. Our Guidance Notes tell you what information you need to provide. You should follow the headings of the preferred format, but at the very least you must make sure that your proposal covers the conditions. A properly focused proposal will help us make a quick decision – it will also help you plan and manage your project.
If you do not fill in this application in full or you do not give us the information we need, it will take us longer to make a decision on your project or we may reject your Grant for Research and Development Application Form – A application. for Business Product DIUS Solutions
May 2009
The information in this section helps us to measure the wider impact of Grant for Research and Development in the region. You will need to provide this information, but it will not affect your chance of securing a grant.
You are required to notify the RDA of any material information in relation to
Checklist
All of the following areas should be covered in your project proposal. Please tick to confirm that you have covered each area. (The written proposal should not be more than 10 pages long if it is properly focused.)
Part C: Marketability (one to three pages)
The market and market potential and the exploitation routes you will use The competitive edge over competing products and competitors Intellectual property rights (IPR) The potential sales over a three-year period after the project has finished
Part A: Introduction – the general overview (one page)
Project aims and deliverables Reasons for the work Project cost and length Project location(s) (where the work is to be done) Why you need the grant and what would happen to the project without the grant How you plan to fund your share of the project costs
Part D: Business development plan (one to three pages)
History of your business Business cash flow (see appendices) History of public support How you plan to develop your wider business The effect of the project on the wider business operations and development If you have a business plan, please provide it. If you need help to prepare a business plan, you can contact your local Business Link operator.
Part B: Technical work plan (two to three pages)
Tasks and technical risks Proposed methodology A work plan (see appendices*) Project costs (see appendices*) Project cash flow (see appendices*) The project team’s CVs * A set of the financial appendices to be completed are downloadable from www.financesoutheast.com under Business Grants.
Part E: Supporting documents
Last two years’ accounts (if you have been trading for at least two years) Latest management accounts Evidence of funding Details of company structure, all shareholders (and their percentage holding) and names of the company’s officers. Please send any other information that you want to support your proposal (for example, letters of support, letters of interest, patent searches, company brochures and so on).
Grant for Research and Development Application Form – A DIUS Solutions for Business Product May 2009
Declaration – please read this carefully before signing
To the extent that this form contains information which is personal data for the purposes of the Data Protection Act 1998 (DPA), any personal data you provide will be processed in accordance with the DPA. Regional Development Agencies are primarily responsible for the delivery of Grant for Research and Development. GR&D is funded by SEEDA and delivered by Finance South East (FSE) in the South East region. FSE will process your personal data as indicated in paragraphs 1 to 5 below and for the purposes of detecting or preventing fraud may also disclose data to other Regional Development Agencies around the UK. The data controllers are SEEDA and Finance South East, to which you submit your completed application. The information you provide will be used for the following purposes. 1. Processing and assessing your application and proposal. FSE may refer your proposal to other Government Departments or outside organisations that are contracted to provide technical expertise in confidence. 2. Your name and address (but not the details of your project proposal) may be passed to other organisations who are delivering Business Link services or other support schemes and initiatives. 3. If you are successful in gaining a grant, SEEDA and/or FSE may publish business and project details within a directory. The directory will be publicly available and aims to publicise projects and the Grant for Research and Development product.
4. Data may be used for statistical and performance reporting and evaluation. 5. For the purpose of detecting or preventing fraud, data may be disclosed to (i) subcontractors employed by the Department of Trade and Industry for this purpose, (ii) Departments (and their subcontractors) responsible for the provision and delivery of grant support in the UK devolved administrations, (iii) Regional Development Agencies and their equivalents (the Welsh Development Agency, Invest Northern Ireland), (iv) other Government Departments, and (v) law enforcement agencies. You have a right to request a copy of your personal details at any time to check the accuracy of the information held. If you want to do this, you should write to Finance South East. You must sign and date this form. This form must be signed by someone with the legal authority to bind the business to the terms and conditions of the application assessment process. If you are a registered company, an executive director must sign. If you are a sole trader, the owner must sign. If you are a partnership, a partner with authority to obligate the other partners must sign. If you give information which you know or suspect is untrue or misleading, you may be prosecuted. If you email your project application, you do so at your own risk. Emailed applications and all other information given to support the application will be treated as correct.
Grant for Research and Development Application Form – A DIUS Solutions for Business Product May 2009
As far as I know, the information on this form and all other information given in support of this application is correct. I authorise any enquiries necessary to be made (including checks with credit reference agencies) to confirm the information and assess the proposed work. I confirm that I understand the purpose of this form and the reasons for the collection of my personal data (to the extent that this form contains information which is personal data for the purposes of the Data Protection Act 1998) and that I agree to my personal data being used as stated. Signature:
IMPORTANT You must not start your project before receiving a formal decision. Grants are paid in instalments in arrears against project expenditure defrayed. GR&D is governed by strict sets of criteria, which must be at least met for an application to be eligible. There is no automatic entitlement. The grants are discretionary and are assessed and selected on an individual basis against the grant criteria, SEEDA’s Regional Economic Strategy and value for money to the public purse. Grant for Research & Development is funded by SEEDA and delivered by Finance South East.
Electronic signatures will not be accepted. A signed hard copy of your application must be submitted before a formal offer of grant can be made.
Date:
Name (CAPITAL LETTERS):
Position in your organisation:
Who helped you prepare this application (for example, Business Link Operator, accountant, consultant and so on)?
Grant for Research and Development Application Form – A DIUS Solutions for Business Product May 2009