Local Lockdown Business Support Grant Application

All fields with * are mandatory, and should be completed in full.

Applicant Details

Title

First Name

Last Name

Business Details

Business Rates reference (12 digits long, starts with a 5 and is on your bill)

Business Name

Nature of Business

Which of the following statements describes the circumstances of your business – Tick any and all that apply

A business in the Hospitality or Leisure sectors whose income was being affected by COVID on 1st August
A business forced to closed due to Tier 3 COVID restrictions on 23rd October
A business forced to close by National Lockdown on 5th November
A nightclub or sexual entertainment venue forced to close due to National Lockdown in March

Business Email

Telephone Number

Position In Company

Companies House Number (if applicable)

VAT Registration Number (if applicable)

Was your business in liquidation or dissolved on the date of the Local Lockdown? Yes No

By making this application you are confirming that you have not reached the limit of permissible payments under the State Aid De Minimis limit or COVID-19 UK Temporary State Aid Framework.

Business Address

Search for a Wigan address by street / postcode

Bank Details

The name on your Business Bank Account

Bank Sort Code (6 digits, no dashes or spaces)

Bank Account Number (8 digits)

Evidence Upload

No grant award will be made without a business first providing their latest business bank statement as proof of eligibility and to protect against fraudulent claims. You must therefore provide your business bank statement below.

Business Bank Statement (Accepted file formats are PDF, JPG, PNG. Maximum file size is 5MB)

Declaration

I declare that the information on this form is correct and complete to the best of my knowledge and belief. I understand that it is a criminal offence to make a statement or representation that I know to be incorrect or to provide documentation that is false or I fail to disclose information to the authority where the law requires it, after this form is complete. If I do so I may be prosecuted. I understand Wigan Borough Council is under a duty to protect the public funds it administers and to this end may verify the information I have provided on this form with other internal departments, government agencies, local authorities and private sector organisations for the purpose of billing, collection and recovery of business rates and for the prevention and detective of fraud. Wigan Borough Council may also share this information with these agencies and other bodies' responsibilities for auditing or administrating public funds for these purposes.

I Agree