This document is not an application form; it is a replica of the application in the Investment Management System (IMS) Portal and is intended for use in preparation of your Callaghan Innovation R&D Grant application. Before completing all sections please take time to read the funding agreement which is available from your account manager. When you are ready to apply, cut and paste the information into IMS under the relevant sections – please do not submit or upload this form. Before you submit your proposal check you have completed all sections that appear in the side bar in IMS. If you have any questions please ask for assistance. G E N ER AL IN FO RM AT IO N Print and submit First talk to us Callaghan Innovation strongly advises Applicants to discuss their proposed R&D Getting Started Grant BEFORE preparing an Application to ensure that they are eligible for funding. Contact your Callaghan Innovation Account Manager or phone Callaghan Innovation on 0800 4 CALLAGHAN. The Ministerial Direction sets out the rules for Business R&D Grants. Refer to the Ministerial Direction 7 December 2015. https://www.callaghaninnovation.govt.nz/grants/faqs Funding Contract Your Application will form part of your Funding Agreement with Callaghan Innovation. We advise that you read the Funding Agreement before you submit your Application. https://www.callaghaninnovation.govt.nz/grants/faqs Need help? For information about your Application please discuss with your Account Manager. For technical support relating to the portal phone 0800 477 8326 or email [email protected], between Monday and Friday from 8:30am to 4:30pm. Next steps For additional information and forms, please visit our website https://www.callaghaninnovation.govt.nz/grants R&D GETTING STARTED GRANT > NOV 2015 / 1.0 S ECT IO N 1: AP P L IC ANT INF O RM AT IO N 1.1 Application Summary Investment area: R&D Getting Started Contracting organisation: The contracting organisation is the Applicant Business ("Business"), who will be responsible for signing the Funding Agreement, should this Application be successful. Enter text here Postal and Courier address: Enter text here New Zealand Business Number: Enter text here Total External project costs: Please enter your Total Project Cost (excl. GST) Enter text here Project Title: Please use a brief project title that is not commercially sensitive. If your Application is approved, project title, business name, funding type and value will become public information. Enter text here Proposed start and end dates: Please enter the proposed start and end dates for the R&D Project. These dates will be confirmed at time of contracting should your Application be successful. (They may be different from the dates recorded here). Costs will not be claimable before or after the contract start and end dates. Enter text here Statistics New Zealand Industry Code (ANZSIC06V1.0): Please provide the most appropriate Industry Code for your business. Refer to www.stats.govt.nz/tools_and_services/ClassificationCodeFin der Enter text here R&D GETTING STARTED GRANT > NOV 2015 / 1.0 1.2 Key Contacts Please list the key people who are assigned to this project. A key person is one who may have a significant impact on the project if they were not available. You must include the external parties you are seeking funding for. NOTE: There must be at least one contact person and one Project Manager (These can be the same person). Enter text here 1.3 Bank Account Please enter your Bank Account details and provide evidence of the bank account information you have entered. e.g. scanned bank deposit slip or screenshot form online banking. Please ensure that the bank account name and detail can be clearly seen on the documentation provided. Enter text here 1.4 Business Background a) Business background: Provide a brief overview of your business including the products/services you sell and markets you service. Enter text here S ECT IO N 2: B US IN E S S E LIG IB ILIT Y 2.1 Business Eligibility a) Please confirm that your business is an eligible business entity. A Company registered under the Companies Act 1993 A Limited Partnership registered under the Limited Partnerships Act 2008 A Maori incorporation or a trust established under Te Ture Whenua Maori Act 1993 A trust established on behalf of Maori claimants to receive and manage assets as part of the settlement of a claim under the Treaty of Waitangi. A Maori statutory body. A business that is controlled by one or more of these types of Maori entities. Enter text here R&D GETTING STARTED GRANT > NOV 2015 / 1.0 b) If your business is a Māori Trust or a Māori statutory body, please identify the Act under which your business was established. Enter text here c) Are you aware of any issues (past, current or potential) relating to your business, its Owners or Directors (or equivalent), or your products or services that could bring New Zealand's or Callaghan Innovation’s reputation into disrepute? If yes, outline the issues: Enter text here S ECT IO N 3: AP P L IC AT I O N D ET AI L S 3.1 Financial Information Table Please enter the last two years of financial information for the Applicant entity in $NZD (excl. GST). Financial Year Total revenue: Net profit before taxation (NPBT): Exports revenue: R&D spend: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 R&D FTE: FTE: Comment on your business' revenue for the last two financial years. Please note any significant issues or changes (both positive and negative) within your business that have affected these figures. Maximum of 50 words, bullet points preferred. Enter text here 3.2 R&D Project R&D Getting Started grants cover work undertaken in New Zealand. The funding cannot be used for any overseas activity. a) R&D Project: What product, process or services are you developing? What work do you want funding for? Enter text here R&D GETTING STARTED GRANT > NOV 2015 / 1.0 b) Expertise: What expertise is needed for your project? Why did you select your specific experts? Any work undertaken overseas is not an eligible project cost. Enter text here c) Next steps: What happens after you complete this project? Identify the next steps and the timing. Enter text here 3.3 Commercial Results a) Commercial result: What is the commercial potential of your new product, process or service? Estimate your future revenues. Enter text here b) Customers: Who will buy you new product/service or what you produce from your new/enhanced process? Are any customers signed up? Enter text here c) Funding: Do you have the funds to cover your share of this project? How will you fund the next steps you identified in the previous section? Enter text here 3.4 Upload Section In this section, please upload the quotes you are seeking funding for and a profile of the experts that will do the project work. You can also upload any other relevant information you feel would support your application for funding. Enter text here R&D GETTING STARTED GRANT > NOV 2015 / 1.0 S ECT IO N 4: F E ED B ACK S E CT IO N 4.1 Feedback Questions Assistance with your R&D application: How did your Callaghan Innovation Investment Manager or Regional Business Partner – help your company with Business R&D funding? Information on R&D grants schemes Access to expertise at a R&D organisation Advice on doing R&D projects Advice on business case Introductions to companies that can assist with the R&D project And/or commercialisation Enter text here R&D grants process: Did you get external assistance to complete your proposal? Enter text here R&D grants process: How could Callaghan Innovation improve our processes? Enter text here R&D grants process: Would you refer Callaghan Innovation to other businesses? Enter text here DE CL AR AT I O N The information below is a copy of the formal declaration that will appear when you submit your application. You agree that by submitting this application to Callaghan Innovation, you declare and acknowledge the following: I am authorised to submit the application on behalf of the applicant; The applicant is a legal entity capable of entering into a contract with Callaghan Innovation; The information in the application is true and correct; Information received and generated by Callaghan Innovation in relation to this application may be released by Callaghan Innovation in accordance with Callaghan Innovation’s external reporting requirements or if required by law, including in accordance with the requirements of the Official Information Act 1982 or the Privacy Act 1993. Consent to the disclosure of this application and all information relating to this application, to New Zealand Trade and Enterprises and regional business partners of Callaghan Innovation, for the purpose of improving the quality of shared customer engagement and service provision. To submit your application, click the 'Submit to IMS' button in the 'Print and submit' section. R&D GETTING STARTED GRANT > NOV 2015 / 1.0
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