New - FA4JR

MINISTRY OF FINANCE, TRADE, INVESTMENT AND ECONOMIC PLANNING

FINANCIAL ASSISTANCE FOR JOB RETENTION

APPLICATION FORM 2

APPLICATION FORM FOR THE FINANCIAL ASSISTANCE OF SELF-EMPLOYED

This application form is for completion by self-employed individuals who are NOT on a payroll. You must be registered with SRC and/or appropriately licensed in order to apply.

Note to Applicants:

All sections which have an asterix (*) are compulsory. Other sections are to be filled in based on its applicability to your business

Have you requested assistance through Government's Salary Assistance for the salaries of your staff?

Yes No

Bank Details for Payment of Support

Bank Name *

Bank Address *

Account Name *

Bank Account Number *

Supporting Documents

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Max file size: 10MB

Allowed file types: Excel (xls,xlsx,xml), Word (docx), PDF (pdf), Image (jpg, png), Text (txt), Zip (zip)

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Description

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You are required to provide satisfactory evidence of these items, and claims made hereunder, to the satisfaction of the FA4JR Committee. In the event of eligibility but the inability to appropriately prove extent of prior income, the maximum provided hereunder will be SCR 5,804.00

I declare that the particulars shown herein and evidence provided supplementary hereto, are true and correct in every particular.

I am aware that any misleading statement or misrepresentation made may result in penalties including liability for full return of all payroll assistance provided.

I am aware that the information provided within this application form and any documents and information supplementary thereto may be utilized by the Seychelles Revenue Commission and the Ministry responsible for Finance as is necessary for their assessment and follow up analytics.

I hereby authorize the Ministry responsible for Finance to request information from third parties as they may deem necessary for their assessment of the request for payroll assistance being provided hereunder.

I am aware that subject to approval of payroll assistance hereunder, the business name hereunder will be published as having been approved or such payroll assistance via such media as the Ministry responsible for Finance deems appropriate.

I, , declare that I am duly authorized to make this declaration. By submitting this application electronically, this qualifies as my signature. If there is a co-applicant to this application, that co-applicant has authorised the submission of this application.

(Kindly insert your name in the space provided)

MINISTRY OF FINANCE, TRADE, INVESTMENT AND ECONOMIC PLANNING

FINANCIAL ASSISTANCE FOR JOB RETENTION

APPLICATION FORM 2

APPLICATION FORM FOR THE FINANCIAL ASSISTANCE OF SELF-EMPLOYED

This application form is for completion by self-employed individuals who are NOT on a payroll. You must be registered with SRC and/or appropriately licensed in order to apply.

Business Information

Employees Information

How many staff do you employ?

Financial Details

Financial Assistance Details

Bank Details for Payment of Support

Supporting Documents

Required documents for Income Assistance application checklist

Attach if applicable

Declaration *

Partner

Bank Details for Payment of Support