Investment Incentives Application

INVESTMENT INCENTIVES APPLICATION

On completion of this form, please return it to the Economic Development, Tourism and Agriculture Directorate:

Physical Address: 3rd Floor, KwantuTowersBuilding, Vuyisile Mini Square, Port Elizabeth

Postal: P.O. Box 1161, Port Elizabeth, 6000

Fax: 041 503 7520/086 5529 460

For enquiries: please call 041 503 7527 or email:

SECTION 1.APPLICANT DETAILS

Date of application
Name of applicant
(registered business name)
SA business registration number:
Physical address of business
Postal address of business
Contact person(s)
Contact details / Tel:
Cell:
Email:
BBBEE status (points as per DTI BBBEE Scorecard)

Incentive(s) applying for:

Just tick / Complete Sections
Joint financing of feasibility study / Business Plan development / 2 & 3
Rebate on municipal building plan approvalcosts / 2 & 4
Discounts on municipal rates and services / 2 & 5
Discount on municipal land/buildings / 2 & 6
Training grant / 2 & 7

SECTION 2.DESCRIPTION OF INVESTMENT

Brief description of investment:

Location of investment in NelsonMandelaBay:

Physical address / Located in NMBM Priority Development Zone? YES / NO
NMBM erf / Farm / Site No
Industry sector / Priority sector for NMBM? YES / NO
Number of permanent full-time jobs created by investment / More than 20 full-time permanent jobs p.a.? YES / NO

Value of investment

Capital expenditure / Operational expenditure
Year 1: / R / R
Year 2: / R / R
Year 3: / R / R
Year 4: / R / R
Year 5: / R / R
Total value of capital expenditure / R / More than R10 million? YES / NO
Percentage of operational expenditure (of R value) procured from / Outside RSA / %
In RSA: Outside NMB / %
Within NMB / %
100%

SECTION 3.JOINT FINANCING OF FEASIBILITY STUDY/BUSINESS PLAN DEVELOPMENT

Cost of developing Feasibility Study / Business Plan (attach quote from Service Provider)

Rand / % of Cost / Verification
Contribution by investor (applicant) / R
Contribution by other investors/organisations: / R
Contribution by NMBM / R / Max: 50% of cost, up to R50000
YES / NO
Total cost / R / 100%

Service provider details:

Verification
Name of service provider / Is it registered with NMBM?
YES / NO
Physical address / Located in NMBM?
YES / NO
Postal address
Contact details / Tel:
Fax:
Email:
Date of quote / Within three months of application? YES / NO

SECTION 4.REBATE ON BUILDING PLAN APPROVAL COSTS FOR APPROVAL INVESTMENTS:

Verification
Date of building plan submission
Name of applicant
Site (NMBM erf / farm No)
Is applicant the owner of premises? / Yes / NO / If yes, include copy of title deed
If property is leased, when does the lease agreement expire? / Duration of lease agreement: 10+ years? YES / NO
NMBM Reference # for submitted building plan

Costs of approved building plans

Verification
Date of building plan approval
Municipal costs of approved building plans / Excludes any additional penalties
NMBM receipt number:
Date of receipt

SECTION 5.DISCOUNTS ON RATES AND SERVICES

Verification
Is applicant the owner of premises? / Yes / NO / If yes, include copy of title deed
Value of property as per municipal Valuation Roll / R / Confirmed by Valuation Roll
NMBM Utility Services Account Number(s) / Water / Verify account numbers with Finance Department
Electricity
Sewerage
Refuse removal
Property rates
Current / Expected monthlyconsumption / Water / kl / Verified by relevant departments or records of past consumption
Electricity / kWh
Sewerage / kl
Refuse / Tonnes
Total basicservice connection fees
(excl. any additional costs to meet investor specifications) / Water / R / Verifyagainst records of relevantdepartment
Electricity / R
Sewerage / R

SECTION 6.DISCOUNTS ON SELLING/LETTING OF MUNICIPALLAND AND BUILDINGS

Site (NMBM erf / farm number) / Is site in NMBM Priority Development Area? YES / NO
Interested in buying/renting municipal property? / Buying / Renting

Buying municipal property

Verification
Market value of property / R / As per municipal Asset Register/Valuation Roll
Total capital expenditure of investment (excl. cost of property) / R / As per Investment Business Plan/financial records
Net contribution to NMB GGP of capital expenditure (excl. cost of property) / As per Economic Impact Assessment Report

Renting municipal property

Current market rental price / R / Per Month / As per NMBM records
R / Per Annum
Date of last occupancy / As per NMBM records
Date of first rental / Building vacant for more than 12 months? YES / NO
Expiration date of lease / Lease agreement period longer than 10 years? YES / NO

SECTION 7.TRAINING AND SKILLS DEVELOPMENT GRANT

Description of skills required / Number of persons that require training

List other state organisations/institutions applied to for funding (attach proof of rejection of applications)

Organisation / Institution / Date of Application / Verification
Application rejected? YES / NO
Application rejected? YES / NO
Application rejected? YES / NO
Application rejected? YES / NO
Application rejected? YES / NO

Cost of Training of Workers (attached quotes from Service Providers)

Per Worker / Total / Verification
Contribution by Investor (applicant) / R / R
Contribution by NMBM / R / R / Max: 50% of cost, up to R5000/worker
YES / NO
Total Cost / R / R

Service Provider Details:

Verification
Name of Service Provider / Registered with NMBM?
YES / NO
Physical Address / Located in NMBM?
YES / NO
Postal Address
Contact Details / Tel:
Fax:
Email:
Date of Quote / Within three months of application? YES / NO

NelsonMandelaBayMunicipality – Investment Incentive ApplicationPage 1