We understand that the impacts have been felt across a wide geographical area but we may not be able to support all applications.

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1 Somerset Micro-Business Flood Relief Grants Guidelines and Application Form Somerset Community Foundation recognises the value and importance of micro-businesses in the rural economy and the broader community. We are seeking applications from micro-businesses that have been impacted by the floods. If you are unsure about the eligibility of your application you can, in the first instance, We understand that the impacts have been felt across a wide geographical area but we may not be able to support all applications. Our priorities are: Applications from micro-businesses that are operating in the flooded areas. Priority will be given to those hit hardest financially. Applications from micro-businesses where our grants could make a significant difference in terms of the broader benefits to the local community (e.g. those that employ local people or provide an essential local service to the community). We define micro-businesses as having 5 employees or less, but please contact us if you think we should consider your case. Small charities or social enterprises may also apply if their day to day activity has been affected by the flooding. For example, a community shop experiencing loss of income due to the floods. However, to apply for funding for work to directly assist in relief or recovery efforts please apply using our Foundation Grants form, available on our website. We are not inviting applications from agricultural businesses. Please contact RABI, the Addington Fund or DEFRA for support to farm-related enterprises. Grants to alleviate financial hardship within households are available through a separate application process, using Phase 1 and Phase 2 application forms, available on our website.

2 What can we support? We have a flexible approach to supporting businesses, but we will aim to provide essential support not covered by other funds. The nature of the grants may change depending on the wider range of support available. However we may support: Income replacement to maintain cash flow and ensure business survival Repair to premises Replacement of damaged equipment and stock Re-establishment costs Please note we will not fund anything covered by insurance, but we will take into account the level of excess payments on your insurance. In some cases we may consider making temporary loans until insurance is received or cash-flow has recovered. How to apply Complete the application form for a Somerset Micro Businesses Flood Relief Grant and return it to: Somerset Community Foundation, Yeoman House, Bath and West Showground, Shepton Mallet, Somerset BA4 6QN What happens next? If we believe we may be able to support your business we will probably contact, or possibly visit, you to discuss your application in more detail. At this stage grants will usually be between 1,000 and 3,000. Decisions will be based on the information provided to us and any subsequent discussions or documents submitted to us. The decision of Somerset Community Foundation will be final, although if more information is made available to us we will review grant awards at our discretion.

3 Somerset Micro-Business Flood Relief Grants Application Form About you and your business Name of Business Address Website Legal Structure: Sole-trader/Partnership/Limited Company/Other Registered Address (if different) Registered Company No. (if applicable) Names of Directors (if applicable) Names of Shareholders (if applicable) Which year was your business established? Your name Position: Owner/Director/Manager/Other (Please state) Tel. No. Total No. of employees Full time Part Time

4 What does your business do? Can you estimate your normal turnover in the Jan-Mar quarter? If requested, could you or your accountant provide monthly income and expenditure statements for the Jan-Mar quarter from 2012 & 2013, or other financial information about business? Yes/No If applicable, please provide your accountant s contact details: Name Address Tel No

5 Impact of the flooding Are you able to trade at present? Fully / Partially / Not at all Is the flooding placing your business under threat of permanent closure now or in the foreseeable future? Yes/No Please describe the impact of the flooding on your business How has flooding impacted upon the financial position of your business? Estimated amount (to Covered by Insurance? date) Loss of Income Yes/No Yes / No Additional operating costs Yes/No Yes / No Damage to premises Yes/No Yes / No Loss or damage to equipment Yes/No Yes / No Loss or damage to stock Yes/No Yes / No Other (please state) Yes / No Yes / No If any of these are covered by insurance, what is the excess payment? What do you predict your turnover in the 2014 Jan-Mar quarter to be?

6 Is there any further information you wish us to take into consideration? Have you applied for any other funding or loans? Yes / No If Yes, please give details here: Name of funder/lender Amount requested/received Bank Details If your application is successful we will pay the grant by BACS. Please provide your account details here: Name of Bank Acct Name Sort Code Acct Number Declaration 1. I am authorised to make this application. 2. I certify that the information provided in this application is correct to the best of my knowledge. 3. I give permission for the organisations involved in providing this funding to record the information in this form electronically. 4. I understand that I may be asked to participate in publicity but I am under no obligation to participate - and evaluation activities related to these funds. 5. I understand the Somerset Community Foundation may make enquiries for verification purposes.

7 The Somerset Community Foundation reserves the right to reclaim any money which has been paid as a result of fraudulent or misleading claims. Person completing the application form Signature Date Confidentiality Personal information recorded on this form will be treated confidentially by Somerset Community Foundation, although we may need to share data with our partners in order to achieve swift and timely response to your needs. In such cases, we will require our partners to also respect your confidentiality. Date may be used for monitoring purposes.