Low Carbon Lake District Grants Registration FormDATA PROTECTION AND FREEDOM OF INFORMATION ACT STATEMENTWe need to store your data on our database in order to give you the full assistance under this scheme. All information given will be held for a period of 7 years and only used in line with the Data Protection Act 2018 and the General Data Protection Regulations 2016. As a requirement of our grant funding, we will need to share your information with our funding providers, the Ministry of Housing, Communities and Local Government, the European Court of Auditors, the European Commission Auditors and the National Audit Office (and if required to their auditors). It may be necessary to share your information within the Low Carbon Lake District project partnership which includes your Local Authority, in order to offer the full support service.Whilst we will use our best endeavours to ensure that commercially sensitive information remains confidential, you should be aware that some information relating to this public funded project may be declared to third parties under the Freedom of Information Act 2000.Agreement for the LDF to hold and share your information.*Please note that if you do not agree to us sharing your information, we will be unable to offer you full assistance under the scheme. I acknowledge and agree for the LDF to hold and share information provided.PRIVATE AND CONFIDENTIAL1. ORGANISATION DETAILSBusiness / Organisation Name*Address* Street Address Address Line 2 City ZIP / Postal Code Local Authority*AllerdaleBarrowCarlisleCopelandEdenSouth LakelandBrief Description of Entity:*Tell us what your business or organisation does.Legal Status* Limited Company Registered Charity Co-operative Partnership Sole Trader Date of Incorporation / Registration:*Company, CIC, charity, or UTR number*VAT Reg No (if applicable)VAT Recovery:* Yes No Please tell us whether you are able to recover VATWebsite*Year of registration or when starting trading*Please enter a number from 0 to 2024.Is this a New Business*e.g. Less than 12 months since registration or not yet trading Yes NoHow did you hear about this grant* Lake District Foundation Cumbria Chamber of Commerce Lake District National Park Authority Cumbria Tourism Press Release Social Media Event 2. FIRST CONTACT DETAILSName* First Last Contact Position in Organisation:*Phone*Email* Would the First Contact like to be added to the Lake District Foundation mailing list and receive communications about future events, funds and opportunities?* Yes No3. SECOND CONTACT DETAILSName* First Last Contact Position in Organisation:*Phone*Email* Would the Second Contact like to be added to the Lake District Foundation mailing list and receive communications about future events, funds and opportunities?* Yes No4. ORGANISATIONAL ELIGIBILITYSector*Please tick all that apply Construction Consultancy Education Energy Food Production Hospitality, Tourism and Leisure Manufacturing Retail Transport OtherDoes your organisation have an Equal Opportunities Policy*If no, please prepare Yes NoNumber of employees*No. of employees less than 250* Yes NoAnnual Turnover (£)*Annual Profit (£)*Turnover is less than €50m, (approx. £46m) or Balance Sheet less than €43m (approx. £39m)* Yes NoIs more than 25% of the business owned by another company / group (some exemptions e.g. VC)* Yes NoIf Yes to the above, do the consolidated accounts of the parent co still meet the SME thresholds or other do other exemptions apply? (If Yes then eligible for support)* Yes No N/AGross spend on wages (£)*Are you ‘Undertaking in Difficulty’ as defined in Article 2 of EC Regulation 651/2014 (please tick accordingly)* Yes NoUndertaking in difficulty means an undertaking in respect of which at least one of the following circumstances occurs: • In the case of a limited liability company (other than an SME that has been in existence for less than three years), where more than half of its subscribed share capital has disappeared as a result of accumulated losses. This is the case when deduction of accumulated losses from reserves (and all other elements generally considered as part of the own funds of the company) leads to a negative cumulative amount that exceeds half of the subscribed share capital. For the purposes of this provision, "limited liability company" refers in particular to the types of company mentioned in Annex I of Directive 2013/34/EU34 and "share capital" includes, where relevant, any share premium. • In the case of a company where at least some members have unlimited liability for the debt of the company (other than an SME that has been in existence for less than three years or, for the purposes of eligibility for risk finance aid, an SME within 7 years from its first commercial sale that qualifies for risk finance investments following due diligence by the selected financial intermediary), where more than half of its capital as shown in the company accounts has disappeared as a result of accumulated losses. For the purposes of this provision, "a company where at least some members have unlimited liability. for the debt of the company" refers in particular to the types of company mentioned in Annex II of Directive 2013/34/EU. • Where the undertaking is subject to collective insolvency proceedings or fulfils the criteria under its domestic law for being placed in collective insolvency proceedings at the request of its creditors. • Where the undertaking has received rescue aid and has not yet reimbursed the loan or terminated the guarantee, or has received restructuring aid and is still subject to a restructuring plan. • In the case of an undertaking that is not an SME, where, for the past two years the undertaking’s book debt to equity ratio has been greater than 7.5 and the undertaking's EBITDA interest coverage ratio has been below 1.0.5. PRELIMINARY PROJECT INFORMATIONPlease let us know the project(s) you would like support for*You may choose more than one. The projects listed here are just examples and this is not an exhaustive list of the projects we can support. Solar PV Solar Thermal Air, Ground or Water Source Heat Pump Biomass Boiler Small hydro power Insulation LED Lighting Energy efficient appliances Variable speed drives Voltage optimisation Infrared heating Electric vehicle charge point Other Don't know yetIf other, please describePlease let us know the estimated cost of your project(s) (excluding VAT)* £0 - £5,000 £5,000 - £15,000 £15,000 - £25,000 Over £25,000 (Please note: additional procurement rules will apply if individual projects exceed £25,000) Don't know yet6. STATE AIDPlease Upload Your State Aid Declaration*In order to avoid public funding distorting competition within the European common market, the European Commission sets limits on the levels of assistance which the public sector can provide to businesses (“the state aid rules”). The assistance provided to you from the Lake District Foundation will comply with the state aid rules by applying De Minimis Exemption, EC Regulation 1407/2013 (24 December 2013) in the first instance, and the General Block Exemption Regulation (GBER), EC Regulation 651/2014 (17 June 2014) may also be applied. You will in due course receive notification of which scheme your support falls under, clarifying any obligations.Max. file size: 64 MB.7. CLIENT DECLARATIONBy entering your name and date here, and submitting this registration form:I confirm that I am authorised to sign this form on behalf of the business.I confirm that I have read and understood the data protection statement and consent to my data being used as described.I confirm that the business / organisation named on the state aid declaration has been awarded the state aid (if applicable). I confirm that I understand the obligations with regard to state aid and acknowledge that in the event of this declaration being made incorrectly, the business / organisation may become liable to repay the full cost of the support received.I confirm that the business satisfies the criteria for an SME: has fewer than 250 full time equivalent employees; has either an annual turnover of less than €50m or a balance sheet of less than €43m, when linked or partner organisations are taken into account (i.e. when more than 25% of the capital or the voting rights of the Company is owned by another enterprise, or you own more than 25% of the capital or voting rights of another enterprise).I agree to provide updated information in the future to enable the full impact of the support received to be evaluated. This may include financial information, information about jobs safeguarded/created or information about carbon and energy savings.I understand the need to retain audit evidence and state aid information in relation to this support.Name*Position*Date*8. Equality and Diversity MonitoringWe want to make sure our grants reach all sections of our community and work hard to make this happen. Details provided here will help us to understand the accessibility of the scheme. They will not be used to assess your eligibility for support. For our confidential records, please can you let us know if your organisation is :Led or managed by someone who is classed as having a disability* Yes No Prefer not to sayLed by someone who is* Male Female Intersex Non-binary Prefer not to say Led by someone who identifies as* White Mixed multiple ethnic group Asian or Asian British Black, African, Caribbean, Black British Prefer not to say Led by someone who is aged* 16-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+ Prefer not to sayHow long did it take you to complete this form (minutes)Please tell us approximately how long it took to complete this form so that we can continue to improve the application process.EmailThis field is for validation purposes and should be left unchanged.