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Coronavirus - business support additional restrictions grant form

Coronavirus - additional restrictions grant form phase 2

Do not use this application form for Tier 4 grant applications - use our Tier 4 business rates grant form instead.

Applications for the Additional Restrictions Grant (including supporting evidence) must be received by 2 April 2021.

If you still see the form and not an acknowledgement message, when you press submit check each field for a red error message and amend where required before re-submitting.

We are doing everything we can to ensure that grants are administered as quickly as possible.

Important

Please make sure you have all relevant information / documents to hand before completing the form.

Indicates mandatory fields

Coronavirus additional restrictions grant form

Additional Restrictions Grant Form

I confirm that this business has not received grant funding via the ‘Mandatory’ Local Restrictions Support Grant schemes that would make this application ineligible:

Read our  privacy statement

I have read the Council's privacy statement (above):
Eligibility for Grant:

*Businesses that have chosen to close but not been required to will not be eligible for this grant, unless they can demonstrate significant impact on their trading through cancelled orders for products and services to closed businesses which supply the retail, hospitality, and leisure sectors, or businesses in the events sector.

Do you have your own Business Rates assessment?
This reference number is my:

Cost evidence 

To receive the Additional Restrictions Grant fund, your business must evidence ongoing fixed building-related costs. Examples of proof include, but are not limited to: business rates bill, rent agreement, mortgage statement, lease documents / licensing agreement, number of staff. 

Please supply the following to support your claim:

• Lease documents / Licencing agreement 

• Summary of your monthly fixed outgoings 

• Number of staff 

• Bank statements, for the last 3 months 

• What support have you already received 

• What steps have you taken to minimise your outgoings – agreed rent reductions etc. 

• Have you seen a reduction in your operating costs – if so please clarify in comments box below




Have you seen a significant impact by the restrictions on your trading through cancelled orders for products and services?

Please provide evidence to demonstrate actual loss of demand due to restrictions. As a minimum, a statement of circumstances will be required and ideally supported by additional documentation including details of contracts lost or cancelled booking diaries/work schedules or cancelled customer bookings.




Business and contact details

 

Business bank account details

 

Declaration

Before you can proceed, you must confirm the following:

I confirm that the information I have provided is correct. I understand that knowingly providing incorrect or false information, could lead to a prosecution under the Fraud Act 2006. I claim the discretionary grant, and declare that I am authorised to act on behalf of the above named account holder and am entitled to the grant.

Tick to agree with above statement:

This grant is for the business in question, and may be liable for recovery if not in business on the eligible date. 
     
The government will not accept deliberate manipulation and fraud - any business found to be falsifying information to gain funding will face prosecution and any grant issued will be subject to recovery, as may any grants paid in error. 
     
I declare that as at the 3 December 2020 that the applicants undertaking was not in financial difficulties (For the avoidance of doubt, businesses that were in administration, are insolvent or where a striking-off notice has been made at the date of the local lockdown are not eligible for funding under this scheme.)

Tick to agree with above statement:

This award shall comply with the EU law on State Aid on the basis that, including this award, I the applicant shall not receive more than €800,000 in total of aid within any given 3-year period under Section 3.1 of the European Commission’s Temporary Framework for State Aid including the COVID-19 Temporary Framework scheme for the UK. For aid for uncovered fixed costs under Section 3.12 of the Temporary Framework, the maximum level of aid is €3 million. 

 
Tick to agree with above statement:

I understand that the Council will not share personal information with any other parties, except where required to carry out its statutory duties and functions, where required by law, or by consent from me. I further understand information provided will also be used internally to analyse the impact of COVID-19 across the Borough and support businesses and that we may will retain their contact details on file to keep in touch in the future.

Tick to agree with above statement:

The information provided in this form may be shared with the Department for Business, Energy and Industrial Strategy for monitoring and evaluation purposes only. To find out more about how we use personal information see our  privacy statement.  

 

Important:

Please supply as much evidence and information as possible with your application to avoid any unnecessary delays in processing your funding request. Please ensure that you have completed all the mandatory fields (marked with a red star) above before  clicking on the 'submit' button.

 

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