Additional Restrictions Grant Fund Application
Please ensure you have read the
Additional Restrictions Grant Fund Guidance
before completing this form.
I have read and understand the Additional Restrictions Grant Fund for businesses and can confirm that my business is suffering significant loss of income as a result of COVID-19
My business was trading on 04/11/2020
Business rates account number
If none please enter N/A
Business address including postcode
The address in Peterborough your application is for
Proof of business ID
Company Registration Number
VAT Registration Number
Self Assessment / Partnership Number
National Insurance Number
Unique Taxpayer Reference
Registered Charity Number
Enter your unique reference here
Full name of business owner
Address of business owner
As registered with companies house
Name of company
As shown on companies house
Full name of all business owners
Home address of all business owners
Full name of treasurer or secretary
Home address of treasurer or secretary
Trading name of organisation
This is the trading name of your business eg the name of your shop or salon
Wholesale & Retail
Transport and Storage
Hotels & Catering
Finance & Insurance
Professional, scientific & technical
Recreation & Culture
Size of Business
Micro 0-9 employees
Small 10-49 employees
Medium 50-249 employees
Large 250+ employees
Nature of Business
Please provide a short description of what your business does
Please indicate which of the following criteria your business falls under
Businesses with a RV above £51,000;
Indoor soft-play centres and similar leisure businesses;
Businesses without non domestic property costs, if they can demonstrate a significant COVID Impact;
The leisure and hospitality supply chain: e.g. Wedding Venues and their suppliers;
Any business who can demonstrate a significant fall in turnover;
Support for Day Nurseries;
Support for the beauty, performing arts and crafts sector;
Rent support for single owned businesses for a single month;
Support for independents, freelancers and businesses in the “live events” sector.
Please outline below the fixed business related costs your organisation is liable for
You will need to provide supporting evidence for these
Please specify "other"
Please provide further detail of the costs referred to above , such as amounts, frequency of payments etc.
Please provide a summary as to how the current crisis has significantly affected your income
Please provide details of any other grant income you have received in respect of this property
Grant payments will be paid by BACS.
Please provide the following data and email a copy of the header page from your last bank statement to firstname.lastname@example.org along with your supporting evidence as detailed below. This statement must be in the same name as the business rates account.
Business Bank Account Number
Bank Sort Code
Name of Business Bank Account Holder
Applications will be assessed on a first received first paid basis and will not be treated as 'received' until all supporting information has been received.
I understand that I will be required to provide the information below in support of my application and I understand that the Council will not be able to assess my application until this has been received.
Evidence of rent/mortgage payments and a copy of your lease
Evidence of other property and business related costs
Evidence to support how your income has been affected (for example, full trading accounts, turnover / orders received for a comparable trading period showing a decline)
We will also require additional information to support your claim. Please also provide evidence to show you were in occupation of the property on 4th November unless you have a live business rates account
I have a live business rates account from 4th November
I will provide evidence to show occupation at 4th November
Please also provide your latest accounts and balance sheet, unless you have been trading for less than 1 year.
I will provide my latest accounts and balance sheet
I have been trading for less than one year
Please provide the evidence stated above along with any other documents you wish to provide to support your claim to email@example.com. Please put the word "
", the business name and business rates account number (if applicable) in the subject heading.
I acknowledge the requirement to provide the additional information
Before you can proceed, you must confirm the following:
This award shall comply with the EU law on State Aid on the basis that, including this award, I the applicant shall not receive more than €800,000 in total of aid within any given 3-year period under the European Commission's Temporary Framework for State Aid including the COVID-19 Temporary Framework scheme for the UK.
I declare that as at 4 November 2020 that the applicant's undertaking was not in the financial difficulties. (For the avoidance of doubt, businesses that were in administration, are insolvent or where a striking-off notice has been made at the date of the local lockdown are not eligible for funding under this scheme).
I understand that knowingly providing incorrect information, or knowingly making a false declaration, could lead to a prosecution under the Fraud Act 2006. I claim the grant, and declare that I am authorised to act on behalf of the above named account holder and are entitled to the grant.
This grant is for the ratepayer only, and may be liable for recovery if the recipient was not the ratepayer on the eligible date.
Tick to agree with the above statements
Title of applicant
Full name of applicant
Position within the business
Comments box - for any other details you may wish to make us aware of