Start-up Finance Application Form (Version 1.1)

Start-up Finance
Application Form
Version 1.1
Start-Up Finance
Notes to Applicants

This form is to be used by eligible undertakings that wish to benefit from the Start-up
Finance Scheme

Start-ups may apply prior to registering with the MFSA. Nevertheless, prior to the signing of
the Letter of Approval/Incentive Entitlement Certificate, the applicant must be registered as
a limited liability company with the MFSA as per Section 3.1 of the Incentive Guidelines.

In view that VAT is an ineligible cost, any value entered should exclude VAT.

This Application Form and any attached documents will be treated as confidential
throughout and after the project evaluation process.

All replies must be clearly explained and substantiated.

Only electronically filled in application forms will be accepted. Should the application be
hand-written or should the format of the application form be altered, the application form
will not be evaluated.

Further information, as well as information and guidance on the filling in of this application
form may be obtained by contacting Malta Enterprise during office hour or by calling 144 or
via email on [email protected]

Undertakings seeking support through this measure should submit to Business First the
following documentation by not later than 31st October 2016 (noon)

On an annual basis, if the interest payable to the Corporation exceeds 50% of the total
profits of the beneficiary for the year in review, the Corporation may approve that the value
in excess of 50% of the total profits (pre-tax) shall be added to the outstanding value of the
repayable grant.

With regards to support for procurement of tangible assets, the equipment needs to be
insured. The interest needs to be noted on the insurance policy. The tangible assets
purchased by the beneficiary shall be considered as security against the repayment of the
grant and hence cannot be used as collateral for any other financial instrument.

The assistance provided is in a form of a repayable assistance.

Malta Enterprise may request further information.
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1.
Applicant Details
1.1
Name of Applicant:
This section should specify the legal name of the
enterprise as defined in the Memorandum of Articles.
1.2
Address of Applicant:
This section should specify the address of the Applicant.
The address inserted here will be used to address any
mail correspondence to the Applicant.
1.3
Applicant’s Telephone Number/s:
The Applicant’s general telephone number/s.
1.4
Applicant’s e-mail:
The Applicant’s general e-mail address.
1.5
Website (URL):
The Applicant’s website address.
VAT Number1:
1.6
The Applicant’s VAT Number, as per VAT Certificate,
relating to the activities funded under the proposed
project.
Registration Number2:
1.7
The registration number is the official registration
number of the co-operative, company or partnership as
defined in the Companies Act – Chapter 387 of the Laws
of Malta.
1
If a VAT Number is not yet available it will need to be presented prior to the signing of the Letter of Approval or Incentive
Entitlement Certificate
2
If this information is not yet available it will need to be presented prior to the signing of the Letter of Approval or Incentive
Entitlement Certificate
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1.8
Start-up Date:
This is the date, the undertaking was first established. In
:order to be eligible for assistance, the applicant is
required to submit the application form within thirty
(30) months from the start-up date:
1.9
Click here to enter a date.
NACE Code (if applicable)
As registered with the National Statistics Office.
:
1.10
Business Synopsis
Provide an overview of the business activity in terms of the undertaking’s products, services, and markets.
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2. Request for Financial Assistance
2.1 Type of Assistance Requested (tick where appropriate)
Support as co-investment linked to private equity
Amount of Assistance Requested:
€
Amount of Private Equity
€
Provide details on the how the funds are
expected to be raised
Provide a detailed account of the assistance
needed
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Support for the procurement of tangible assets
Amount of Assistance Requested:
€
Provide a detailed account of the tangible assets
due to be purchased
Is the undertaking an innovative or Knowledge
Based Technology Start-up as defined within Choose an item.
Section 2 of the Incentive Guidelines?
If yes, kindly provide the following information:
a) A brief description of the products, services or processes that are new or substantially improved
compared to the state of the art in its industry, and which carry a risk of technological or
industrial failure;
OR
b) The percentage amount of R&D costs in comparison to the total operating costs:
Year
2015
%
2014
2013
OR
c) Provide information of the Key Promoter
Name & Surname
Designation
Telephone Number
Mobile Number
Email Address
Background, Experience, and
the role within the start-up
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Support linked to Crowdfunding
Campaign 1
Amount requested through a crowdfunding
campaign:
Assistance requested through Start-Up Finance:
€
€
Crowdfunding Platform to be utilised
Provide a detailed account of the assistance
needed
Campaign 2
Amount requested through a crowdfunding
campaign:
Assistance requested through Start-Up Finance:
€
€
Crowdfunding Platform to be utilised
Provide a detailed account of the assistance
needed
Campaign 3
Amount requested through a crowdfunding
campaign:
Assistance requested through Start-Up Finance:
€
€
Crowdfunding Platform to be utilised
Provide a detailed account of the assistance
needed
Campaign 4
Amount requested through a crowdfunding
campaign:
Assistance requested through Start-Up Finance:
€
€
Crowdfunding Platform to be utilised
Provide a detailed account of the assistance
needed
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2.2 Other National/ European funding for this project?
a. Has an application been made for assistance from any other National/
European funding program for this project?
Choose an item.
b. Has any assistance requested been approved?
Choose an item.
2.2. 1 If an application has been made for assistance kindly list down the name of the programme or
scheme.
2.3 Start-up Financing
Explain how the start-up is being financed. This may include funding from own financial resources,
new bank loans, and/ or State funding. The total of the table below should be equal to the
investment costs quoted in Annex 3 - Investment Cost Breakdown.
Source
Value
Own financial resources
€0
New bank loans
€0
Other sources*
€0
Total Investment
€ 0
c. The applicant should highlight any other National and/ or European funding applied for in relation
to any part of this project. The information provided should give details of the approving Body,
any application reference number/s, application date/s, financial instrument concerned, and
funding requested and approved.
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3. Checklist of Documents
Kindly use the following checklist of required documents to ensure that you enclose all the necessary
documents. Kindly tick all the documents that you will be submitting together with this Application
Form.
The applicant will be required to deliver a presentation to the Corporation explaining the proposed
operation and justifying the viability of the venture.
Application Form completely filled in and duly signed
Annex 1: Business Plan in line with the parameters set in Section 5.2 of the Incentive Guidelines
Annex 2: Enterprise Size Declaration
Annex 3: Investment Cost Breakdown
Annex 4: Profit & Loss
Annex 5: Balance Sheet
Annex 6: VAT compliance certificate – Enterprises established in Malta for more than twelve
(12) months, should attach a VAT compliance certificates issued by the VAT department not
more than six (6) months before of the submission of this application form.
Annex 7: Income Tax compliance certificate – Enterprises established in Malta for more than
twelve (12) months should attach a certificate issued by the Inland Revenue Department
confirming that the applicant has no liabilities in respect of Income tax or is otherwise honouring
an agreement for setting any outstanding amounts. The certification should have been issued in
the six months preceding the submission of this application form.
Annex 8: Final Settlement and of Social Security Contributions compliance certificate –
Enterprises established in Malta for more than twelve (12) months should attach a certificate
issued by the Inland Revenue Department confirming that the applicant has no liabilities in
respect of the Final Settlement System (FSS) and of Social Security Contributions (SSC) or is
honouring an agreement for setting any outstanding amounts. The certification should have been
issued in the six months preceding the submission of this application form.
Annex 9: Memorandum and Articles of association. (Enterprises established in Malta for less
than twelve (12) months may submit a draft version of the Memorandum and Articles)
Annex 10: In case of Support for the procurement of tangible assets, for any procurement above
€25,000, three (3) quotations from three (3) independent suppliers are required to be submitted.
Annex 11: In case of innovative undertakings:
1.
an evaluation carried out by an external expert that it will in the foreseeable future develop
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products, services or processes which are new or substantially improved compared to the state of
the art in its industry, and which carry a risk of technological or industrial failure.
The external expert must be independent, holds a degree relevant to the start-up’s remit and who
has at least five (5) years work experience in a similar sector similar.
Or
2. A declaration by an external auditor stating that the research and development costs in at least
one (1) of the three (3) years preceding the granting of the aid represent at least 10 % of its total
operating costs, or in the case of a start-up undertaking without any financial history, in the audit
of its current fiscal period, as certified by an external auditor.
Annex 12: In case of Knowledge Based Start-ups, certified true copy of the doctoral degree
certificate of the promoter identified in Section 2, or a declaration by the tutor that the promoter
identified in Section 2 is pursuing a doctoral degree.
Annex 13: Cumulation of Aid Declaration
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4. Declaration
4.1 Personal Data Protection
Personal information provided in this form will be processed in accordance with the Data Protection Act, Cap 440 of the
Laws of Malta and shall be treated in the strictest confidence.
Information provided in this form will be processed by Malta Enterprise to assess the applicant’s eligibility, for the approval
or otherwise of assistance under this scheme, for monitoring implementation of aid granted.
The undersigned consents Malta Enterprise to share information provided in this application with Government Entities or
the European Commission where this is strictly necessary for the proper administration of this incentive or where legally
required.
The undersigned hereby authorises Malta Enterprise Corporation to process the data contained in this form for the
purpose stated above and declare that the information on this form and any other supporting documents given with this
application is correct to the best of the undersigned’s knowledge.
4.2 Cumulation of Aid
The undersigned declares that aid approved under this incentive is in line with the terms and conditions set out in the
Incentive Guidelines and in line with Cumulation Article 8 of the Commission Regulation (EU) No 651/2014 of 17 June 2014
declaring certain categories of aid compatible with the internal market in application of Articles 107 and 108 of the Treaty.
4.3 Double Funding
The undersigned confirms that there has not been any approval or has been granted any public funding, financing or fiscal
benefit in respect to the cost items included in this request for aid and will not seek funding or fiscal benefits for these cost
items through other National and/or European Union measures. Such measures may include:

Schemes administered by Malta Enterprise, the Planning and Priorities’ Coordination Division (PPCD), the
Measure and Support Division, the Tourism and Sustainable Development Unit (TSDU), the Employment &
Training Corporation (ETC), the Malta Council for Science & Technology (MCST), the Regulator for Energy and
Water Services (REWS) and government funded schemes operated by other entities (such as JAMIE financial
instrument).

Schemes funded through ERDF, ESF, Cohesion Fund, TEN-T Budget, EAFRD, EFF, LIFE+; Horizon 2020 and other
European Union programmes/instruments.
4.4 Outstanding Recovery Order
The undersigned confirms that the applicant is not subject to an outstanding recovery order following a previous
Commission decision declaring an aid illegal and incompatible with the internal market should be excluded from the
scope of this Regulation.
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5. Signatures
Name of Applicant (full legal name)
Name and Surname of signatory
authorised to represent the Applicant
(CAPITAL LETTERS)
Position in Establishment
Signature & Company Stamp
Date
Click here to enter a date.
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6. Declaration by a Certified Public Accountant (CPA)
I declare that the financial projections attached to this application (Annexes 3, 4 and 5) have been
prepared on the basis of the assumptions stated and in accordance with the requirements of the
International Financial Reporting Standards. In preparing these financial projections, the directors or
otherwise:



presume that the company will continue in business for the foreseeable future;
have made judgments and estimates that are reasonable and prudent; and
have considered the economic and market uncertainties as well as the associated risks
and opportunities in making the financial projections.
The overall capital requirements to carry out the proposed project have been effectively assessed
and the applicant is in a position to meet these requirements.
Name and Surname
Address
Date
Click here to enter a date.
Signature
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