Grant for Research and Development Application Form
Research Projects, Development Projects, Exceptional Development Projects, Micro Projects
For office use only Date received Reference Project Officer
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Please read the Guidance Notes carefully before you fill in this form.
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Please type your answers, or write in black ink using CAPITAL LETTERS.
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You must fill in the application form and provide a detailed project proposal, as set out in the Guidance Notes.
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Where boxes are provided, click on the correct box and a cross will appear.
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Regional Development Agencies (RDAs) are responsible for appraising applications and deciding which projects to support in their region.
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Please submit your completed application to the RDA responsible for the area where you intend to carry out the project.
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You should contact your RDA to establish any closing dates for applications in your region.
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Applications received after any deadline which has been set, even if clearly postmarked earlier, will not be accepted.
Grant for Research and Development Application Form – A DTI business support solution.
4 1 Business name and address You must either plan to start up or be operating a business in England. Business name:
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): Turnover (in your most recent annual accounts):
Business address:
£
as at:
Balance sheet total (total assets net of depreciation): £ Postcode Website:
Is your business part of a group? No
(Go to Question 5)
Yes
(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:
as at:
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 DTI business support solution.
5
Do you or any other partner, member or director of your business have any interests in, or control over any other business? 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).
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
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
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
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
If YES, please give details within the proposal.
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. 8
What type of project do you plan to carry out? Research Project Development Project Exceptional Development Project Micro Project
8a Grant applied for £ 8b Total project costs £ 8c Project title
Grant for Research and Development Application Form – A DTI business support solution.
9
Who should we contact to discuss your proposal? Name: Position: Telephone:
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
Fax: Email:
Name of Organisation:
1 0
1 1
Number of jobs created and/or safeguarded as a result of your proposal
Nature of Collaboration:
Please give details of any new jobs that will be created in your business as a result of this project.
Job Titles:
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.
This application form must be
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.
Grant for Research and Development Application Form – A DTI business support solution.
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)
Part D: Business development plan (one to three pages)
Project aims and deliverables
History of your business
Reasons for the work
Business cash flow (see appendices)
Project cost and length
History of public support
Project location(s) (where the work is to be done)
How you plan to develop your wider business
Why you need the grant and what would happen to the project without the grant
The effect of the project on the wider business operations and development
How you plan to fund your share of the project costs
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
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 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 DTI business support solution.
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. Your Regional Development Agency 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 controller is the Regional Development Agency 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. Your Regional Development Agency 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, your Regional Development Agency 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 your Regional Development Agency. 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 DTI business support solution.
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: 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 DTI business support solution.