Tax Credits for Micro Enterprises and the Self Employed APPLICATION FORM. Version 2.03

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1 Ministry of Finance, the Economy & Investment Industrial Estate San Gwann SGN Malta Tel: Fax: tax.credits@maltaenterprise.com Tax Credits for Micro Enterprises and the Self Employed APPLICATION FORM Version 2.03 Personal Data Protection Any personal information collected in this form will be used for establishing the aid which may be granted to the applicant. All information will be processed in accordance with the Data Protection Act, Cap 440 of the Laws of Malta and shall be treated in confidence. The information contained in this application form will be processed by Malta Enterprise and may be forwarded to third parties appointed by Malta Enterprise to administer, implement, monitor or audit any part of this incentive. You have the right to access, rectify, and, where applicable, the right to erase personal data concerning you. Malta Enterprise guarantees fair processing in respect of your personal information. Malta Enterprise will solely send you information related to the Corporation s services. 1 This assistance is granted in line with Commission Regulation (EC) No 1998/2006 of 15 December 2006 on the application of Articles 87 and 88 of the Treaty to de minimis aid, Official Journal L379 of In terms of this State Aid regulation, an enterprise may receive a total amount of aid up to 200,000 over a rolling three fiscal year period. This maximum threshold includes all de minimis aid granted to the beneficiary including that received from any entity other than Malta Enterprise.

2 APPLICATION FORM Part 1 Business Details a) Applicant s business name, address and contact details: Registered Name 1 Registration Number 2 Registered Address Contact Person Telephone Number Fax Number Mobile Number Web Address Address Income Tax Number VAT Number b) Premises where project has been undertaken This is only required if different from (a) above Address 1 2 Registered Name: The registered name of a company is the named specified in the Memorandum and Articles of Association registered with the Malta Financial Services Authority. Partnerships and co-operative societies should enter the name as specified in a valid deed of partnership. Self Employed persons should list the full name (first name and surname) as listed on their official identification document. Registration Number: The registration number is the official registration number of the company or partnership is in terms of the Companies Act, Chapter 386 of the Laws of Malta. Co-operative societies should enter their official registration number in terms of the Co-operatives Societies Act, Chapter 442 of the Laws of Malta. Self Employed should enter their Identity Card Number

3 APPLICATION FORM Part 1 Business Details c) Business Activity Describe the current business activity clearly identifying key products and services provided. d) Business Size Declaration Number of Full Time Employees Number of Part Time Employees working 20hrs or more per week Number of Part Time Employees working less than 20hrs per week Is the applicant linked or partnered with another business As at: 9 th November 2009 date of Application Yes / No (Please delete as required) If the applicant is linked 3 or partnered 4 to another business, the applicant must submit the Enterprise Size Declaration which can be downloaded from Has your annual turnover exceeded 2,000,000 in any of the last 2 years? Yes / No (Please delete as required) d) Other State Aid Attach the de minimis Aid Declaration form to this application. The template of this declaration can be downloaded from Has the applicant applied or been granted any aid for the cost items listed in this application? Yes / No (Please delete as required) 3 4 Linked undertakings are undertakings which form a group through the direct or indirect control of majority of voting rights of an undertaking by another or through the ability to exercise a dominant influence on an undertaking. Undertakings may be linked through a natural person or a group of natural persons acting jointly if they engage in their activity or in part of their activity in the same relevant market or in adjacent markets. A partner undertaking is an undertaking (upstream undertaking) which holds, either solely or jointly with one or more linked undertakings 25% or more of the capital or voting rights of another undertaking (downstream undertaking).

4 APPLICATION FORM Part 2 Claimed Expenses Furbishing and Investment Costs List the costs being claimed (excluding VAT) and attach original fiscal/vat invoices or fiscal/vat receipts. Invoices and receipts in which the name and details of the supplier or the cost item details are not clearly listed will not be considered. Invoice / Receipt No. Date dd/mm/yyyy Supplier Category (choose from the dropdown menu) Description Total Costs (excl. VAT) Number of Invoices / receipts included in this application (If you have more items please reprint sheet and attach to application form.) TOTAL 0.00

5 APPLICATION FORM Part 2 Claimed Expenses Wages (newly engaged additional employees) Attach a copy of the FS3 and FS4 for each new additional employee, the FS5 Return for November 2009 and FS5 Return for the month in which this application is submitted. ID Card number Name Date Employed Date of Termination (if applicable) Average hours per week Number of Months Monthly Wage Total Wage Costs Total 0.00 Commercial Vehicle Attach a copy of the vehicle s log book, the original fiscal invoices or VAT receipts. Invoices and receipts on which the name and details of the supplier or the cost item details are not clearly listed will not be considered. Licence Plate number Registration Date Make Model Year of Manufacture Costs excluding VAT / / 0.00

6 APPLICATION FORM Part 4 Declaration Declaration of Conformity I, the undersigned, do hereby declare that I am an authorised signatory of the applicant undertaking and that the information being submitted with regards to this application is correct. I also confirm that: a) the costs on which the tax credit is being claimed are not recoverable in any way; b) there are no arrears with respect to VAT, Income Tax, Social Security and rental payments to Government in relation to this business activity; c) the undertaking is not engaged in primary production activities (such as agriculture and aquaculture) d) I have read and understood the MicroInvest Incentive Guidelines. The undersigned, grants authorization to Malta Enterprise, as the administrator of the scheme, to process the data contained in this form for the purpose stated below, and to disclose to the Commissioner of Inland Revenue or his representative any information, documents and records which the Corporation may have obtained in connection with this application. Date / / Full Name Position in Undertaking Signature 11 th April Version 2.02

7 APPLICATION FORM Annex I Documentation Check The following check list many be used to help you confirm that all the required documentation has been attached to this application form. Copy of the licence for the business premises where the costs have been undertaken and a receipt showing the last payment of the relevant licence. Warranted professionals must submit a copy of their warrant and the MEPA permit relevant to the business premises (where applicable). If the applicant s commercial activity is not carried out from established premises, the applicant should present a copy of the registration issued by the Commerce Department. In such a case, if the applicant is a company, include documentation showing that the person in favour of whom the registration has been issued is a director OR shareholder in the applicant company. Copy of VAT Certificate FS5 Return for November 2009 FS5 Return for the month in which the application is submitted Original Fiscal Invoices or VAT receipts for all claimed costs (excluding wages). Invoices and receipts in which the name and details of the supplier or the cost item details are not clearly listed will not be considered. Receipts issued from persons that are not registered with the VAT department should contain: the date of supply; the name, address and ID number of supplier; the name, address and V.A.T. registration number (if applicable) of customer; details of the supply made; the price before and after any discount (clearly showing final price); and a note indicating that the issuer of the receipt is not V.A.T registered in line with LN500 of FS3 and FS4 forms for each employee on which wages are claimed Vehicle log book (if costs of a vehicle are being claim) de minimis Declaration - The template of this declaration can be downloaded from Enterprise Size Declaration - If the applicant is part of a group (linked or partnered to another business), the applicant must submit the enterprise size declaration which can be downloaded from 11 th April Version 2.02