Application Form: Exceptional Fund

Applicants can only claim for a maximum of two fixed costs.

Upload bank statement evidence as required to evidence trading pre lockdown. For those businesses trading pre-lockdown three months of consecutive bank statements (business choice dated no later than 1st April 2019 - 22nd March 2020) to show pre-pandemic trading.

For those businesses that began trading on or after the 23rd March 2020. Business are required to submit two bank statements to cover the April and May 2021 period.

Applicant businesses are required to submit bank statements which cover July, August and September 2021. Applicants should ensure that the most recent bank statement includes the business address, sort and account codes for the purposes of checks and processing.

Please upload evidence of the fixed costs for which are being claimed i.e. property rent/lease payments; mortgage payments; equipment lease or loan payments; utilities.

Applicants should provide further evidence that demonstrates the turnover reduction here such as year-end accounts, management accounts, sales systems reports etc. Max or two files to cover the pre and post lock down spells. The evidence should correspond with the bank statements provided.

This is where funds will be paid if the grant application is successful. Complete the fields fully and double check ahead of submission. If successful, incorrect data will lead to delays with payments. Fully complete the sort code and account number fields.

If your sort or account code includes zero ahead of numbers i.e. 002278 or 03456789, please ensure it is input correctly.

I understand that if I give information that is incorrect or incomplete the grant may be withdrawn or reclaimed and action may be taken against me. I declare that the information I have given in this form is correct and complete. I will inform Telford & Wrekin Council if there are any changes in circumstances. I also confirm I have read both the scheme criteria, associated guidance and FAQs. The General Data Protection Regulation The data we collect is for the purposes of managing and reporting against the success of the scheme. The programme requires your data to be added to the Telford & Wrekin Evolutive CRM Database called Evolutive and other internal storage mechanisms. We will use the information you supply:

• Telford & Wrekin Council use in its role of accountable Body
• to provide business support to you and make referrals to partners and other providers of relevant services as appropriate;
• Ministry MHCLG (or their sub-contractors), BEIS or other Government departments as required.
• This information will be used to evaluate this project and to report to Government Departments for monitoring and evaluation purposes.

Your details will be stored securely and retained in compliance with internal, requirements and the General Data Protection Regulation. We will only use your data for this programme and not for marketing or commercial purposes.