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LEADER Project ID

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Section A: Promoter & Project Details

Primary Contact Details

Project Title (please include a clear and concise name that relates directly to your proposed project):

Promoters/Group/Organisation/Business Name (Where promoter is a company or community group, please use the legally constituted name):

Project Address Line 1:

Project Address Line 2 :

Project Address Line 3:

County:

Eircode of project

Website (if applicable):

Main Contact First Name:

Last Name:

Main Contact Telephone No:

Main Contact Email Address:

Main contact postal Address (if different to project address)

Contact Address Line 1

Contact Address Line 2

Contact Address Line 3

County

Proof of Sufficient Insurance for Proposed Project

Where possible, submit a copy of your current insurance policy. Please supply evidence to support that project elements can be insured at the end of the project.

For new projects, evidence of insurance confirmation must be provided. This can be in the form of a confirmation letter from an insurance company stating that they can insure the proposed project items (damage/loss/public liability where applicable) and the proposed cost of such insurance.

Please upload documentation relating to insurance here

Project Type

Project Description

Describe the proposed project (i.e. what you are seeking funding for), the main activities involved to develop it and any other parties involved. (300 word maximum)

Project Timelines

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

Proposed Start Date:

Proposed Finish Date:

Section B: Registration Details of Promoter

Registration Details of Promoter

Please provide relevant registration numbers for your community group, organisation or business below

Tax Registration Number (TRN):

Tax Clearance Access Number (TCAN):

VAT Registration

Where funding is to be paid in respect of non-recoverable VAT, the promoter must provide up to date written confirmation from the Revenue Commissioners that the promoter is not VAT registered.

Are you, your group or your Company VAT Registered?

Yes No

Please ensure you save your Application Form as you go through it

Section D: Financials & Previous Funding (De Minimis Declaration)

Actual Project Costs:

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.

Nature of Contract/ Goods/ Item/Donations/Voluntary Labour	Supplier/Contractor	Cost excluding VAT (€)	Cost including VAT (€)

Total Cost excluding VAT (€)

Total Cost including VAT (€)

Funding Level

What level of funding are you applying for?

50% or less fundingover 50% funding

Sources of Funding:

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.

	Value (€)	Percentage of Cost (%)
LEADER Programme
Donation of Property (where applicable)
Voluntary Labour (where applicable)
Own resources - Cash/savings in account
Own resources: Loans/Bridging Finance
Other: Public Funds from Non EU Source (e.g. Local Authority, Fáilte Ireland, etc.)
Total cost of project

Please confirm the total percentage of public funding this project will receive, i.e. LEADER Funding

%

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

Phased Payments

If your application is successful and, to assist with project cash-flow you may request phase payments of grant aid. This will normally apply to capital projects and is subject to LAG approval.

Please tick the box if you wish to be considered for phase payments for your project

Previous Project Funding

Has another organisation (other than the applicant) previously received public funding for this project*?

YesNo

*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.

If another organisation (other than the applicant) has received public funding for this project, please include details below;

Project name (1):

Name of Organisation (1):

Project Reference Number (1):

Programme applied to (1):

Funding Organisation (1):

Amount approved/received (1):

Date(s) of receipt of funding (1):

Current or Pending Funding Approvals

Have you/your organisation/business applied elsewhere for funding for this project or received funding elsewhere for this project?

YesNo

If you have applied elsewhere for funding for this project, include details. If approval is pending, please provide expected decision date

Project name (1):

Programme applied to (1):

Application Date (1):

Amount applied for (1):

Project Name (2):

Programme applied to (2):

Application Date (2):

Amount applied for (2):

False Declarations & Debt

Has a false declaration finding ever been incurred by you or your organisation for a LEADER Programme 2007-2013 project?

YesNo

If yes, please provide details and project reference

Have you or your organisation/business any outstanding debt for previous LEADER funding?

YesNo

If yes, is there a repayment agreement in place and are you/your organisation actively engaged in repaying this debt?

YesNo

Section E: Enterprise Projects

Revenue Generation

Please provide details of how revenue will be generated and how it will be used to ensure the financial sustainability of your project (Business Plan, Projected Income and Expenditure): (300 word maximum)

Existing Enterprise

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

Reference Accounts and provide copies for previous three years.

Annual Turnover:

Balance Sheet Total:

If the promoter is part of a group of companies please provide details:

If you company is linked or partnered with another company, please provide details (100 word maximum)

Financial Projections

Year	Projected Income(€)	Projected Expenditure (€)	Net Income (€)

Note: For economic projects, these details should match the Income/Expenditure Profile in the Business Plan

Section F: Job Creation

Creating or Sustaining Jobs

Will this project be creating or sustaining jobs?

YesNo

Existing Jobs

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

*FTE = Full Time Equivalent

E.g. If you have 2 part time workers working 2.5 days a week, (2 workers x 2.5 days = 5 days a week = Total Number FTE: is 1

Full Time

Part Time

Seasonal

Total Number FTE*

Impact on Employment

Describe the impact the project will have on sustaining this existing employment?(300 word maximum)

New Jobs

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

*FTE = Full Time Equivalent

E.g. If you are proposing to have 2 part time workers working 2.5 days a week, (2 workers x 2.5 days = 5 days a week = Total Number FTE: is 1

Full Time

Part Time

Seasonal

Total Number FTE*

What type of job roles do you plan to create?

Please use job titles and type of employment. Please also note how long these jobs will be needed for. (200 word maximum)

Section G: Training, Analysis and Development & Marketing (For Training, A&D and Marketing projects only)

Training Course Details:

Course Title:

Course Location:

Course Provider:

Accrediting Body:

(If relevant)

Number of people to be trained:

How will these numbers be achieved: (300 word maximum)

How was the need for this training identified? (300 word maximum)

Course Details:

(no. of modules, assignments, workshops, seminars, examinations and so on) (300 word maximum)

Skills Gained:

Outline how the skills gained through this training will be of benefit (300 word maximum)

A&D Details:

Focus of Study / Research / Plan / Development:

Outline the main focus of the Study / Research / Plan / Development to be carried out (300 word maximum)

How will the findings of the Study / Research / Plan / Development be used?

How will the findings be presented and what will the results be used for on completion (300 word maximum)

Has any analysis been done for a similar purpose by you/your group or another group in the area?

Provide details of similar analysis that have been completed and provide details of whether they are available in the public domain (300 word maximum)

Marketing/Promotion Details:

Who is the Marketing/Promotion targeting and why is it required?

Provide details of the target group(s) (300 word maximum)

Details of Marketing/Promotion to be undertaken

Provide details of the activities to be undertaken (300 word maximum)

How will Marketing/Promotion be recorded/documented?

Provide details of how these activities will be recorded/documented (300 word maximum)