GOVERNMENT OF GRENADA'S GRANT ASSISTANCE - COVID

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GOVERNMENT OF GRENADA'S GRANT ASSISTANCE - COVID - 19

PURPOSE: TO PROMOTE BUSINESS SUSTAINABILITY AND PROVIDE FINANCIAL ASSISTANCE TO BUSINESSES DIRECTLY AFFECTED BY THE COVID PANDEMIC.

1. NAME OF ESTABLISHMENT: *

2. TYPE OF BUSINESS: *

3. ADDRESS:

4. CONTACT DETAILS:

a. TELEPHONE *

b. FAX

c. EMAIL *

5. TAX IDENTIFICATION NUMBER *

6. ARE YOU REGISTERED WITH GTA (where applicable) *

Yes

7. NUMBER OF EMPLOYEES FOR WHOM SUPPORT IS REQUIRED

8. NUMBER OF NEW EMPLOYEES HIRED AFTER JULY 1ST 2021 *

9. VACATION EARNED BY EMPLOYEES FOR WHOM THIS SUPPORT IS BEING REQUESTED HAVE UTILIZED THEIR LEAVE TO DATE *

Yes

10. WHERE VACATION LEAVE HAS NOT BEEN FULLY UTILIZED, THE EMPLOYEE HAS BEEN PAID FOR SUCH LEAVE AT THE TIME OF THIS APPLICATION *

Yes

14. BANKING DETAILS (FOR DEPOSIT OF GRANT SUPPORT):

A. NAME OF BANK: *

B. NAME OF ACCOUNT: *

C. ACCOUNT NUMBER: *

D. FINANCIAL INSTITUTION *

E. STATE ANY SIGNIFICANT ACCOUNTING ACTIVITY WITHIN THE LAST 6-13 MONTHS *

9. COMMENTS:

10. TOTAL GRANT REQUEST (COMPLETE APPENDIX 1 WITH THE SUPPORTING DETAILS):

A. AMOUNT: *

B. PERIOD: (Month) *

DECLARATION:

I (your name) being duly authorized to act on behalf of the Applicant hereby declares that the information submitted is true and covenants on behalf of the Applicant that the Applicant will observe and perform in accordance with the purpose(s) stated in Item 1.0 in this Application form which purpose(s) restricts the use of the grant to the Applicant once approved and imposes obligations on the Applicant to act solely in accordance with the purpose(s) stated in Item [add item number]. The Applicant covenants that if it fails to utilise the grant for the purpose(s) stated in Item 1.0 that it/he/she is to be deemed to be in breach of the stated purpose(s) in Item [add item number] and is therefore liable to repay the value received and not used for the stated purpose(s) in Item 1.0 and on demand promises to pay to the Government of Grenada any and all sums not used for the purpose(s) stated in Item 1.0 and associated expenses incurred by the Government of Grenada to recover sums. The approval of this Application shall not be deemed to constitute a partnership or agency or fiduciary relationship and the Applicant has no right to make commitments for or on behalf of the Government of Grenada and or otherwise hold the Government liable sums granted.

DO YOU ACCEPT? *

YES

Required

DATE: *

YYYY

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