CRL Targeted Hardship Re-Application Form

Targeted Hardship Fund Re-application Form Kia ora So we can assess your Targeted Hardship Fund (THF) application for the next tranche as quickly as possible, please carefully read all information at CityRailLink.co.nz/targetedhardshipfund Please make sure to read this document carefully and answer honestly. All applications must be submitted using this form and include supporting documents as listed on page 3.

Please note that THF applications are processed and administered by TSA Management.

You can send your application by: Email: Post: Delivery/courier:

C3Hardship@tsamgt.com PO Box 26433, Epsom, Auckland 1344 Level 2, 88 Broadway, Newmarket, 1023

If you have any questions please contact TSA Management at C3Hardship@tsamgt.com or phone 021 169 4149.

Applicant contact details FIRST NAME LAST NAME BUSINESS NAME

Application period Tick all that apply.

n Tranche 3 - 01 January 2022 to 31 March 2022 n Tranche 4 - 01 April 2022 to 30 June 2022 Eligibility criteria To be eligible for the THF your business must be immediately adjacent to, and impacted by, major and sustained CRL construction disruption.

Has the address of your leased premises changed since you applied for the THF previously?

To be eligible, your business must be in the C3 Affected Area.

n Yes n No If you answered yes to the above question, please provide the new business address and date that your business moved.

1 | Targeted Hardship Fund Re-application form

Briefly outline how City Rail Link C3 construction has directly caused your business genuine financial hardship during the application period/s selected.

Has your annual rental amount payable and/or OPEX changed since you applied for the previous THF tranche?

n Yes n No Evidence required: If you answered yes to the above question, please attach relevant supporting documentation.

Have you received any assistance, such as a rent decrease or rent rebate, from your landlord since you applied for the THF previously? *CRL will take into account a business’ financial position. If no such assistance has been offered to date, CRL will seek a meaningful contribution towards the level of financial support offered to a successful applicant from their landlord - in line with CRL Sponsor’s high-level guidelines.

n Yes n No If you answered yes to the above question, please detail the assistance provided from your landlord below. *Please include when such support started, and for how long. Evidence required: Please attach any relevant supporting documentation.

Financial & legal viability You are required to declare whether your business is financially and legally viable. This includes all required statutory and regulatory approvals under the relevant laws, including planning, licensing, and building approvals.

Is your business currently legally compliant?

n Yes n No Are there any current legal proceedings being brought against your business?

n Yes n No Is your business still operating?

n Yes n No If you answered no to the above, what date did your business stop operating?

DATE

2 | Targeted Hardship Fund Re-application form

Declaration I/We do solemnly and sincerely declare that the business in this application has suffered sustained City Rail Link disruption resulting in genuine financial hardship, and that the information contained in this application, together with all supporting information, is true and correct.

I/We do understand that my application may be subject to audit, and that action may be taken if deemed to be fraudulent.

DATE

SIGNATURE

Checklist Please include the following supporting documents with your application. You do not need to supply any documents that you have already supplied as part of a previous THF application.

n n n n

Completed Targeted Hardship Fund re-application form Copy of renewal of lease or new rent review and/or OPEX (if applicable) Copy of signed rent review (if applicable) Evidence of rent paid e.g. invoices or statement from the landlord, bank statements or rent receipts

Annual accounts or tax returns for:

n n n n

2018/2019 2019/2020 2020/2021 2021/2022 (a draft format will be accepted)

When your application is submitted you will receive an automatic confirmation email that your correspondence has been received by TSA Management. If you do not receive an email confirmation, please check to see if the email has been treated as spam.

If you need assistance please contact TSA Management at C3Hardship@tsamgt.com or phone 021 169 4149.

3 | Targeted Hardship Fund Re-application form