Tandridge District Council Forms

Your Contact Details

First name

Last name

E-mail address

Primary contact telephone number

Contact mobile phone number

Business Details

Business rates account reference

(Will be on your recent 2020/21 Demand, if you do not know it, you need to find your recent bill before we are able to apply grant)

Which period are you applying for the grant for:

5th November to 2nd December 20202nd December to 16th December 2020

Are you a Limited Company?

YesNo

VAT registration number

(As registered with HMRC)

Company number

(As registered with Companies House * If not a Ltd Company straight to Title of Applicant)

Business name

(As registered with Companies House)

Search postcode

Address

Address not found

Address not found on address search

uprn

Please enter your address

What sector does your business operate in

Do you offer a take away or click & collect service?

YesNo

Please tell us what the property is used for and the nature of the business

Number of employees

Bank Details

Bank sort code

Bank account number

Name of bank account holder

Name of bank

(if bank account name differs from the business rate payer’s name, please explain why name is different below)

Reason for difference between bank account name and rate payers name

State Aid Declaration

I confirm that I have read and understood the relevant information and State Aid de minimis regulations available at: www.gov.uk/state-aid

I confirm that I represent the business and that the information provided is accurate for the purpose of the exemption.

I understand that if I claim incorrectly, any relief awarded will be recovered by the Council.

I can confirm that the business is not covered by the exclusions as covered below:

Enterprises in road haulage operations for the acquisition of road freight transport vehicles.
Enterprises in the agriculture sector (with the exception of those active in processing and marketing of agricultural products).
Enterprises active in the coal sector, undertakings in difficulty, or for directly export-related activities.
The same costs that are being supported under another block exemption or notified scheme. It is unlawful to provide de minimis for costs being funded under the State Aid cover of an exemption or notified scheme if it means the specific allowable aid intensity will be exceeded.
For the setting up of distribution networks or export and the business is not in difficulty as defined by ‘This is defined’ in section 2.1 of the Community Guidelines and State Aid for Rescuing and Restructuring Firms in Difficulty (2004/C22/02).

Name

Role in company

Date

State aid de minimis exemption

Has the business, or any holding or subsidiary companies, received state aid during the previous three fiscal years not exceeding 200,000 euros (this being the current fiscal year and the previous two fiscal years)?

Please tick

YesNo

Declaration

I declare that to the best of my knowledge, the particulars given on this form are true, accurate and complete.

I understand that this information will be checked.

I declare that the business provides non-essential goods or services.

I undertake to notify Tandridge District Council of any changes in circumstances, which will affect my Business Rates liability.

I understand that this grant is for the business rates payer, if the recipient of the grant is not the ratepayer on 4th November 2020, Tandridge District Council may take action to recover the amount of the grant.

Local Restriction Support Grant

Your Contact Details

Business Details

Bank Details

State Aid Declaration

Declaration