ࡱ> WYV_ Nbjbj .Xbb\\\\\pppp<pXnnnnI> ${-!Q\II\\nnK\n\n(tn}!e@a0H,!{!t!\tLu:! ": De Minimis Aid Declaration  You are being offered assistance under the European Commission s State Aid Regulations. This allows a company to receive up to 200,000 (at applicable exchange rate) of De Minimis state aid over a rolling three-year period. The following requested information is a mandatory requirement to enable you to receive the support offered. To be completed by aid recipient:Name of OrganisationAddress (incl. post code)Main ContactPosition:E-mail AddressTelephone No. To confirm that you are able to receive this assistance you must declare the full amount of De Minimis aid you have already received over the last 3 fiscal years. The following is not a comprehensive list of the possible forms of aid. However it should give an indication of the most common forms of aid, which you may have been given over the past three years. Potentially any assistance from a public body might be an aid. Should you have any doubts on this matter, please contact the body from which the assistance was received. Grants from public bodies Loans from public bodies at favourable rates Loan guarantees from public bodies Differential tax benefits Grants from an investment trust (including charities) which may themselves have received the funds from a public body Grants from a part publicly funded venture capital fund Publicly administered funds, even if the funds were originally not public such as the national lottery Waiving or deferral of fees or interest normally due to a public body such as the waiving or deferral of rent or waiver of interest normally due on late payment of taxation or other costs to a public body Monopoly licences or guarantees of market share Advertising via a public channel such as a tourist board or state owned television Consultancy advice provided either free or at a reduced rate Training provided either free or at a reduced rate Aid for investment in environmental projects Provision of a free or reduced rate feasibility study for research and development or other assistance with research and development Purchase of public land or property at a less than market rate Benefiting from the provision of infrastructure where your organisation was pre-identified as a beneficiary These types of aid may have been provided under De Minimis (as De Minimis aid) or under another State Aid regulation. If you are in any doubt whether aid received was De Minimis aid or about its value, check with the organisation, which provided it. If they are unable to say or there is any uncertainty, assume that it was De Minimis aid unless its value exceeded 200,000 in which case it cannot have been De Minimis. Any De Minimis state aid awarded to you under this project will have to be declared if you apply, or have applied, for any other De Minimis aid. I declare that the amount of De Minimis aid received by the company / organisation over the last three years is: Organisation Who Provided The Aid*Date Aid Approved(Estimated Value ()Estimated Value ( )#* Add or delete rows as necessary ( This should be the date the aid was approved, not the date the aid was received # This should be the Official EU Accounting Exchange Rate from the date that the aid was approved not received:  HYPERLINK "http://ec.europa.eu/budget/contracts_grants/info_contracts/inforeuro/inforeuro_en.cfm" http://ec.europa.eu/budget/contracts_grants/info_contracts/inforeuro/inforeuro_en.cfm Data Protection The data contained in this De Minimis Record is a mandatory requirement to enable support to be provided by this 468:<>@@ B n q r ʾէ}hVhVh}VhVh;4htUhI 5B*CJOJQJ^JaJmH phsH "hI 56>*B* CJ\]ph(hhI 56>*B* CJ\]ph(htUhI 56>*B* CJ\]ph)htUhI B* CJOJQJmH phsH ,h-hI 5B* CJOJQJ^JaJphhGhI 5CJaJhGhI CJaJ,hGhI 5B* CJOJQJ^JaJph&hI 5B* CJ0OJQJ^JaJ0ph68<>@q r s w$<<$Ifa$gdI $a$gdI gdI Ukd$$Ifl70 E t644 la $$Ifa$gdI $IfgdI r s    վ짒지ii쀾U&hI 5B* CJOJQJ^JaJph,hKQhI 5B*CJOJQJ^JaJph#hI B* CJOJQJ^JaJph)h-hI B* CJOJQJ^JaJph,h{\hI 5B*CJOJQJ^JaJph,h-hI 5B* CJOJQJ^JaJph,hD hI 5B*CJOJQJ^JaJph&hI 5B*CJOJQJ^JaJph yy <<$IfgdI ykdY$$Ifl '   t 0644 lap  sff <<$IfgdI kd$$Ifl0  l   t 0644 lap  sffff <<$IfgdI kd$$Ifl0  l   t 0644 lap   7*** <<$IfgdI kdL$$Ifl\ s    t0644 lap    *%gdI kdM$$Ifl\c sR    t0644 lap <<$IfgdI    8 e PDw)hv$ & Fe^e`a$gdI $ & Fa$gdI $a$gdI $a$gdI  lpx468NvDzǢǢt\I6I%h:khjB* CJOJQJ^Jph%h:khI B* CJOJQJ^Jph/h:khI 5B*CJH*OJQJ^JaJph1 jh:khI 5B*CJH*OJQJ^Jph(h:khI 5B*CJOJQJ^JphhI B* CJOJQJ^Jph(hhI 5B* CJOJQJ^Jph%hhI B* CJOJQJ^JphhhI B* CJ^Jph,hhI 56>*B* CJ\]^Jphvx.8$xx$Ifa$gd:k$a$gdI 8:<- xx$Ifgd:kkdN$$Ifl\   z H      t(0644 lap(yt:k<>@BD8kdN$$Ifl\   z H t0644 lap(yt:k$xx$Ifa$gd:kDFHJL$xx$Ifa$gd:k xx$Ifgd:kLNPRTH;++$xx$Ifa$gd:k xx$Ifgd:kkd$$Ifl\   z H t0644 lap(yt:kTVXZ\8+ xx$Ifgd:kkd$$Ifl\   z H t0644 lap(yt:k$xx$Ifa$gd:k\^`bd8+ xx$Ifgd:kkd$$Ifl\   z H t0644 lap(yt:k$xx$Ifa$gd:kdfhjl8kdv$$Ifl\   z H t0644 lap(yt:k$xx$Ifa$gd:klnprt$xx$Ifa$gd:k xx$Ifgd:ktvxz|H;++$xx$Ifa$gd:k xx$Ifgd:kkd@ $$Ifl\   z H t0644 lap(yt:k|~4b8333gdI kd $$Ifl\   z H t0644 lap(yt:k$xx$Ifa$gd:k345I؄mXAX,jhI B* CJOJQJU^JaJph)h*hI B* CJOJQJ^JaJph,h*hI B* CJH*OJQJ^JaJph"hI B* CJH*OJQJ^Jph)hNn"hI B* CJOJQJ^JaJph(hNn"hI B* CJH*OJQJ^Jph. jhNn"hI B* CJH*OJQJ^Jph#hI B* CJOJQJ^JaJph)hUIjhI B* CJOJQJ^JaJph  _`abtL/M^MaMkM̧̹~lXVlA,A)hhB* CJOJQJ^JaJph)hhI B* CJOJQJ^JaJphU&hI 6B* CJOJQJ^JaJph#hI B* CJOJQJ^JaJph&hI 5B* CJOJQJ^JaJph)h*hI B* CJOJQJ^JaJph#hI B* CJOJQJ^JaJph$h{hI 0JCJOJQJ^JaJ,jhI B* CJOJQJU^JaJph8j h{hI B* CJOJQJU^JaJphbcstMMNNNNNNtykd $$Ifl `'   t 0644 lap xx$IfgdI gdI funded project. As well as being a record of the support provided, the data may be used to for reporting purposes (e.g. to the European Commission) and also for subsequent evaluation of the project (e.g. to contact beneficiaries to understand their views on how they have benefited from the project). The data may be used by the project deliverer, BIS, or DCLGs appointed agent (e.g. an external consultant appointed to evaluate the project), for the purposes outlined above. Signatory of beneficiary, confirming the details contained in this De Minimis declaration are true and accurate, and agreement that the data can be used as per the Data Protection statement.Name:Signature:Position:Date: kMlMMMMMMNNNNN®lW@.#h!hI 5CJOJQJ^JaJ,h!hI 5B* CJOJQJ^JaJph)h-hI B* CJOJQJ^JaJph,h-hI 5B*CJOJQJ^JaJph,hD8hI 5B*CJOJQJ^JaJph&hI 5B*CJOJQJ^JaJph&hI 5B* CJOJQJ^JaJph#hI B* CJOJQJ^JaJph)hhI B* CJOJQJ^JaJph,hhI 6B* CJOJQJ^JaJph NNNNNNNNNNNֿց}h^X)h-hI B* CJOJQJ^JaJph,h!hI 5B* CJOJQJ^JaJph#h-hI 5CJOJQJ^JaJ,h-hI 5B* CJOJQJ^JaJph&hI 5B* CJOJQJ^JaJph)hFhI B* CJOJQJ^JaJph NNNNNN\OOOO xx$IfgdI kdP $$Ifl\2s X t0644 laNNN\Zkd $$Ifl\2s X t0644 la,1h. 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