Department of Economic Development Rheynn Lhiasaghey Tarmaynagh
Business Support Scheme Application Form Please complete in BLOCK CAPITALS and in black ink. Send completed form to:
Business Support Scheme, Department of Economic Development, St George’s Court, Upper Church Street, Douglas, Isle of Man, IM1 1EX Telephone: +44 1624 682326
Business details Business name Business address
Telephone number
Email address
Market sector
Number of Employees
What are your main business activities?
Export related activities?
Please state discipline of project
(if known)
Your application I/We confirm that, with the exception of information listed separately, all appropriate returns have been made to Treasury by the due date, that there are no outstanding statutory payments, such as I.T.I.P., Company Tax, National Insurance Contributions or V.A.T., currently due to the Isle of Man Government and that I/we are in no other way indebted to the Isle of Man Government. I/We authorise the Department of Economic Development (a Department of the Isle of Man Government), (“the Department”) to seek and obtain any necessary information for verification purposes. I/We understand that the Business Development Consultants to the Business Support Scheme do not offer advice. They may however make suggestions or offer guidance on how the business might progress, and it is then up to the business to seek its own advice and/or make its own decisions. I/We agree to supply information for a Post Completion Review Questionnaire which is designed to monitor effectiveness and will take place approximately one year after project completion. Note: The Business Development Consultant and any Project Consultant subsequently appointed are independent contractors and are not employees of the Department. The Department will not be a party to any subsequent contract entered into between the business and Project Consultant. To the fullest extent permitted by law, neither the Department or the Business Development Consultants accept any liability for any loss suffered by the business as a result of any action or inaction taken by the business as a result of any guidance offered by the Business Development Consultant and/or any Project Consultant subsequently appointed. The liability of the Project Consultant to the business must be addressed in the contract between them. I confirm that I am an authorised person to make this application and that this business is trading lawfully and is not operating in contravention of any statutory requirement relating to this trade or business.
Signature
Position in Company Date
Print name BSS Project Number (Official Use Only)