Select appropriate option

If the project is approved, when do you think the project will start and finish? (Please be realistic)

Private Match funding is required for all Applications for LEADER Funding. For example, if you are applying for funding at a rate of 50%, you must be able to demonstrate how you will match fund the remaining 50% of the cost. Applicants should demonstrate how they intend to provide match funding for their proposed project. Match funding can be in the form of any of the following;

·        Saving reserves amounting to part of the overall funds to match finance the project identified in bank accounts/Bank statements of the promoter.

·        Letter from lending agent, banks, banking institute, etc. confirming details of a loan facility.

·        Letter from investors confirming their commitment to the project and evidence (bank statements) that they have the funds available to match the investment required or identified.            

Please provide a detailed financial breakdown of all elements of the project from the figures provided in your tender report / most competitive quotes / schedules for voluntary labour / contribution in kind etc. and valuations for donations.

Note: All applicants must complete the individual project item cost in the table below.

Please provide details of Funding Sources. Please note if you are registered for VAT, the below costs must be related to EX VAT costs as you can reclaim the VAT and you therefore cannot be funded on it. 

If you are not registered for VAT, please include the values including VAT. 

Total Cost of Project below show be the same as either total cost above ex VAT or inclusive of VAT.

Note: The percentage received will determine the procurement process to be followed.

*e.g. European Programmes, County Council, County Enterprise Board, Fáilte Ireland, Regional Tourism Organisation, National Lottery, Bord Bia, /DSP/Solas/SEAI, Teagasc, Heritage Council, other Semi-State Agencies, Government Departments, Local Development Company.

*e.g. European Programmes, County Council, County Enterprise Board, Fáilte Ireland, Regional Tourism Organisation, National Lottery, Bord Bia, /DSP/Solas/SEAI, Teagasc, Heritage Council, other Semi-State Agencies, Government Departments, Local Development Company.

When procuring works, supplies, goods and services, applicants are expected to conduct the process in a manner which ensures openness, value for money and fairness. There are two procurement categories, those applying for 50% or less funding or those applying for over 50% funding. Please note if you have received other public funds for this specific project already (e.g. Sports Capital Funding) this should be factored into this percentage. 

·        

As you are applying for 50% or less funding for supplies and/or services, please note below the requirements in relation to procurement.

As you are applying for 50% or less funding for works and/or works related services, please note below the requirements in relation to procurement.

As you are applying for more than 50% funding for supplies and/or services, please note below the requirements in relation to procurement.

As you are applying for more than 50% funding for works related services, please note below the requirements in relation to procurement.

As you are applying for more than 50% funding for works, please note below the requirements in relation to procurement.

If applying as an existing business, please confirm the Annual Turnover and Balance Sheet Total:

Please specify number of persons currently employed (if facility/service/business already exists) Please enter 0 if this is a new enterprise.

To what extent will the proposed project help to create jobs (Anticipated Jobs created)?

Personal Data

As the main contact for this Application Form, we will collect and record your name, address, email and telephone contact details. We require this information to correspond with you regarding any queries we have concerning this Application Form and to advise you of the outcome of this Application.

Part of the information you provide in this form will be held on computer and hard copy format. There are robust security protocols in place to protect and secure your data. This information will be used for the administration of Expression of Interest Forms and producing monitoring returns. LAG’s may share information with each other and Government departments/agencies to enable them to prevent fraudulent applications or for detecting crime and to co-ordinate processing of complementary applications.

It may also be subject to meeting obligations under the Freedom of Information Act as amended. The information may be held for as long as required by the Government/European Union under the Operating Rules of the RDP LEADER Programme. This policy does not affect your rights and your information will be held as prescribed under the Data Protection Acts 1998 and 2003 and the EU General Data Protection Regulation (GDPR) which came into force on the 25th May 2018. 

I understand that Leitrim Integrated Development Company CLG endeavors to comply with the Data Protection Acts of 1988 and 2003 and the EU General Data Protection Regulation (GDPR) which came into force on the 25th May 2018.

I understand that Leitrim Integrated Development Company CLG will record my personal information in order to deliver and audit the programmes outlined above and provide a streamlined service.  

-to information about how data is processed;                                                                                                                       

-access to their own data;

-rectification of their data;

-erasure of their data;

-ensure the notification of third parties of the rectification or erasure of personal data;

-right to lodge a complaint with the Supervisory Authority;

-restriction of processing;

-data portability;

-objection to the processing of personal data;

-withdraw consent if they previously gave it in relation to processing their personal data;

-object specifically to the processing of personal data for the purpose of direct  marketing;

-not to be subject to automated decision making  

-not subject to profiling

From 25 May 2018 onwards, all Department of Rural and Community Development, Leitrim Integrated Development Company CLG / Leitrim County Council / Leitrim Local Community Development Committee (Leitrim LAG) customers have the following additional rights:                                                                                                                                                                                   

• restriction of processing;

• data portability;

• objection to processing;

• withdraw consent if they previously gave it in relation to processing of their personal data;

• relating to automated decision making, including profiling.                                                                                       

10. Recipients: When you submit an application for LEADER funding your personal data will be made available to Department of Rural and Community Development, Implementing Partner/Animating Partner/LAG Name and may be made available to those organisations listed below. By signing this application form, the project applicant gives permission that the information contained in this application form, the accompanying documentation and all subsequent documentation submitted regarding this grant application, may be made available to the DRCD, Implementing Partner/Animating Partner/LAG Name and those organisations listed below:

·        Leitrim Local & Community Development Committee;

·        Leitrim County Council;

·        Evaluation Committee of Leitrim LAG;

·        The Department of Agriculture, Food & the Marine (including publication of grant received on DAFM website);

·        Pobal;

·        E.U. Commission and E.U. Court of Auditors;

·        Comptroller and Auditor General and any other Government Department or Agency;

·        Accreditation Body.

but only where there is a valid legal basis to do so. The purpose of this sharing of data is for processing purposes, audit, evaluation purposes, controls relating to the legislation underpinning all Rural Development measures, as required by EU Regulation 1305/2013 and EU Regulation 1306/2013 and EU Regulation 2020/2220 and EU Regulation 2020/2094. Department of Rural and Community Development, Leitrim Integrated Development Company CLG / Leitrim County Council / Leitrim Local Community Development Committee (Leitrim LAG) will not otherwise release any information received as part of this application except as may be required by law, including under the Freedom of Information Act 2014.            

Personal data may be used for statistical, research and analysis purposes in some circumstances, but will only be done so in compliance with the Data Protection legislation in force. Data used for such purposes will be pseudonymised (masked) or anonymised, as appropriate, to protect the security and confidentiality of the data. The use of the data in this way may facilitate DRCD in informing policy decisions into the future.       

The onus is on the applicant to notify Leitrim Integrated Development Company CLG / Leitrim County Council / Leitrim Local Community Development Committee (Leitrim LAG) of any confidential material that it supplies in support of its application for funding, as all material and information provided including this application form will be subject to the Freedom of Information Act 2014.  This includes information provided in its application form for funding and information that it provides subsequent to the application.                          

As part of the LEADER programme, if you are approved into the LEADER programme, you may be requested by DRCD, Leitrim Integrated Development Company CLG / Leitrim County Council / Leitrim Local Community Development Committee (Leitrim LAG), to supply data in relation to your participation in the LEADER programme and facilitate on-site inspections/assessments, where required for the purpose of assessment, verification, evaluation or research purposes as provided for under the Regulations (EU Regulation 1306/2013 and EU Regulation 2020/2220). Not to supply such information may invalidate/cancel your application.        

11. Retention Period: Personal data, data submitted in support of the application by the data subject under the LEADER programme will only be retained by Department of Rural and Community Development, Leitrim Integrated Development Company CLG / Leitrim County Council / Leitrim Local Community Development Committee (Leitrim LAG) for the period necessary for the purposes for which the data was collected and processed, or where subject to statutory requirements. Personal data no longer required will be destroyed or deleted in a secure manner in line with internal guidelines or guidelines for destruction received from the National Archives Office or associated permissions received from them

12. Data provision being statutory or contractual obligation: The data provided for this purpose is being requested under the requirements of EU Regulation 1305/2013 and EU Regulation 1306/2013 and EU Regulation 2020/2220 and EU Regulation 2020/2094 and if the customer chooses not to provide this information, their application for the LEADER programme cannot proceed. 

13. In accordance with EU Regulation 1306/2013 and EU Regulation 2020/2220, the details of all of the beneficiaries of CAP funding, both legal and non-legal persons, are published. In accordance with these Regulations the Department of Agriculture, Food and the Marine must, by 31 May each year, publish the following data:

·        The name of the beneficiary (unless the amount of payment under CAP funds is less than €1,250, in which case the individual will be identified by a code)

·        The municipality where the beneficiary is resident

·        The amount of payment corresponding to each measure received by a beneficiary, and

·        The nature and description of each measure

·        The data contained in this publication may be processed by auditing and investigating bodies of the Communities and the Member States for the purposes of safeguarding the Communities' financial interests.

·        The data therein cannot be used for direct marketing or other purposes and this will be made clear.

WARNING 

To knowingly or recklessly makes a false statement to obtain aid for yourself or anyone else, will lead to disqualification, liability to refund any aid already paid and possible prosecution.

The information made available in this form may be available to other departments/And or Agencies for the purpose of preventing or detecting Crime. 

SELF-INSURANCE AND/OR PUBLIC LIABILITY INSURANCE DECLARATION

The applicant must declare acceptance of, and effect and keep in force, for both the project implementation process and the 5-year durability period, self-insurance arrangements and/or public liability insurance. In this regard the applicant must confirm that they have read and understood Appendix B (page 15) of the application form

DATA PROTECTION & FREEDOM OF INFORMATION ACT 2014 DECLARATION

The applicant must declare acceptance of Data Protection provisions in relation to an application for funding under the LEADER Programme 2014-2022.

Please also refer to Appendix C (page 16) of this Application Form. In this regard the applicant must confirm that they have read and understand Appendix C (page 16) of this Application. 

CONFIRMATION OF ACCURACY OF INFORMATION PROVIDED

·    - The applicant confirms that they agree to be bound by the LEADER Operating Rules of the Rural Development Programme Ireland 2014 - 2022. 

·   - The applicant declares that the particulars supplied in this application are true and correct, and accepts that any false or misleading statements or withholding of information will result in the relevant project being excluded from receiving LEADER support and any amounts paid will be recovered. The applicant will be excluded from receiving any further LEADER support in the relevant EAFRD year and for the following year.

·   - The applicant confirms their understanding that if grant aid is awarded and/or paid in respect of their project, the name of the applicant and the details of the project including the amount awarded may be publicised.  

    -The applicant hereby requests that grant assistance be given in support of the project as outlined and certifies that, if paid, the grant will be solely for the purpose for which it is approved.  

      I confirm I am 18 years old or over

      I am authorised to submit this application

T    To the best of my knowledge all the information provided is true and accurate

      I have read the Application Guidance Notes and the Department statement on Data Protection & Freedom of Information  Act 2014.

I     I have read, understand and declare acceptance of the content of the four declarations outlined below, in relation to:

·        MINIMIS DECLARATION FORM

·        SELF INSURANCE AND/OR PUBLIC LIABILITY INSURANCE

·        DATA PROTECTION & FREEDOM OF INFORMATION ACTS

·        CONFIRMATION OF ACCURACY OF INFORMATION PROVIDED

I have researched the need for this project, expected costs and outcomes in detail and prepared a business

plan to support this application.   

I will facilitate a project site visit and provide additional information within the timescale set by Leitrim Local Action Group's request, as necessary for the assessment of the project application.