2SD V11 Self Declaration Form

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SELF-DECLARATION FORM FOR ENHANCED ISPRINT PACKAGED SOLUTION (SECTOR SCALE UP)
A. Please submit this Self-declaration Form and the required supporting documents to apply for financial assistance under Enhanced ISPRINT (the “Scheme”) from the Info communications Development Authority of Singapore (“IDA”). Refer to Explanatory Notes of the Self-declaration Form for eligibility criteria.

B. Please retain a photocopy of the submitted Self-declaration Form for future reference and application for fibre connectivity and Wireless@SG.

C. The Start Date of the Participating SME’s Qualifying Period for the ICT Packaged Solution is the date when the Participating SME accepted and signed the quotation for the ICT Packaged Solution(s).

D. The End Date of the Participating SME’s Qualifying Period for
On-premise ICT Packaged Solution (Sector Scale-Up), is SIX (6) months from the Start Date;
Software-as-a-Service (SaaS) ICT Packaged Solution (Sector Scale Up), is THIRTY (30) months from the Start Date;

E. The ICT Solution Provider shall submit the ORIGINAL Self-declaration Form and supporting documents to IDA within TWO (2) weeks from the Start Date.

F. The ICT Packaged Solution must be completely implemented and used by the Participating SME from the Start Date to End Date.

G. The approved grant amount will be disbursed through payment to the ICT Solution Provider if the conditions for the application and the claim are met.

H. For final claims, claims form, together with all supporting documents, must be submitted to IDA upon complete implementation and usage, and within THREE (3) months from the End Date of the Participating SME’s Qualifying Period.

I. You can provide feedback on the ICT Solution Provider who has engaged you on Enhanced ISPRINT at ida_isprint@ida.gov.sg.

1. Registered Name of Participating SME
Business sector(s) (please select one only)

Accounting Practice

Services

Media

Landscape

Design

Retail

Maritime

Real Estate

Construction

Tourism

Others

Manufacturing

Food & Beverages

Others, Please specify

3. Registered Name of ICT Solution Provider

4. Name of Packaged Solution/ Project Name

Address of Site # where Packaged Solution is to be used

# “Site” refers to a location of the Participating SME’s business that will perform all or part of the core function(s)/activities of its business for a minimum of 1 year from the start of the Participating SME’s Qualification Period. The core function(s)/activities carried out at the Site must be related to the principal activities of the Participating SME as shown in the ACRA records. The location of the Site must be evidenced by submission of such documents as may be required by IDA in its discretion, such as a tenancy agreement entered into by the Participating SME, for the location.

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Declaration by Participating SME

IMPORTANT; If “NO” is selected for any one of the following questions, DO NOT proceed with the purchase; email this Self- declaration Form to IDA (ida_isprint@ida.gov.sg) for advice on your company’s eligibility status.

I DECLARE THAT AS AT THE START DATE OF THE PARTICIPATING SME’S QUALIFYING PERIOD

6. My company/firm does NOT have any corporate shareholder holding more than 50% of the total shareholding in my company/firm.

Yes

7. My company/firm does NOT hold more than 50% of the total shareholding of any subsidiary company.

Yes

8. My company/firm is a business registered in Singapore and has at least 30% local equity.

Yes

9. My Group annual sales turnover does NOT exceed S$100 million. (Refer to “Explanatory Notes” for Definition of Group)

Yes

10. My Group employment size does NOT exceed 200 workers. (Refer to “Explanatory Notes” for Definition of Group)

Yes

11. My company/firm has NEVER applied for; or claimed any financial assistance under Enhanced ISPRINT (incl. ISPRINT), SME Infocomm Package (SIP) or Accounting Software Assistance Scheme (ASAS).

Yes

12. My company/firm at the Site does NOT own/ use any software or IT system that performs a similar set of functions as the Packaged Solution(s) that I/we are now purchasing.

Yes

13. I understand that the items procured using the financial assistance from Enhanced ISPRINT is meant to be used by my company/firm at the Site only and I will strictly abide by this requirement.

Yes

14. I understand that my company/firm shall require prior written consent of IDA for the transfer of the Packaged Solution(s) from the Site where I have declared the Packaged Solution(s) is to be used, to another Site which fulfils eligibility criteria.

Yes

15. I understand that the grant of this financial assistance is subject to the availability of funds, my compliance with the terms and conditions in this Self-declaration Form and the approval of IDA, which may be withheld at its sole discretion.

Yes

16. My company/firm at present is not engaged whether as plaintiff or defendant or otherwise in any claim, legal action, proceeding or arbitration nor are there any circumstances known to be likely to lead to any such claim, legal action, proceeding or arbitration.

Yes

17. I acknowledge that IF these declarations are no longer accurate on the date on which my company/firm submits its claim for the financial assistance from Enhanced ISPRINT, IDA reserves the right to withhold the grant of the financial assistance.

Yes

18. I understand that unless otherwise agreed by IDA, all payments are to be made by company cheque or through our corporate bank account.

Yes

19. I understand that, in the event that the grant is not approved by IDA, I am required to pay the outstanding amount(s) owed to the ICT Solution Provider, where applicable.

Yes

20. General

a) Contact Person from Participating SME
i) Name

ii) Designation

iii) Email

iv) Contact No. (Office)

iv) Contact No. (Mobile)

v) Corporate Website(URL)

b).Does your company/firm at the Site currently own or use any software/ IT system?

Yes

If “YES”, please indicate the software/ IT system owned/ used
Type of Software/ IT System
Accounting & Finance

Name of Software/ IT System
Human Resource Management (e.g. Payroll, Leave, Time Attendance, etc)

Name of Software/ IT System
Inventory/ Stock Control/ Warehouse Managemen

Name of Software/ IT System
Point-of-Sales

Name of Software/ IT System
Other

Name of Software/ IT System

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c) Please indicate if anyone in your company/firm (shareholder/ director/ employee) is related to any personnel in the ICT Solution Provider

Yes

If “YES”, please provide the names and their relationshipPersonnel in Participating
Personnel in Participating
SME 1

Personnel in ICT Solution
Provider 1

Relationship 1

Personnel in Participating
SME 2

Personnel in ICT Solution
Provider 2

Relationship 2

Personnel in Participating
SME 3

Personnel in ICT Solution
Provider 3

Relationship 3

21. Projected Benefits as a result of Implementation
(Note; Projects without projected benefits will not be supported)

Areas of Improvement

Sales Revenue (S$) (3)

Last FY

1 st Year After Project
Implementation

Areas of Improvement

Operational Costs (S$) (3)
Last FY
1 st Year After Project
Implementation

Areas of Improvement
Total No. of Employees (4)
Last FY

1 st Year After Project
Implementation

(3) Figures indicated under Last FY should not be more than 18 months from the Start Date of Participating SME’s Qualifying Period

(4) Refers to employees that are reflected in the Participating SME’s payroll

22. List of Supporting Documents Required at Self Declaration
(Please ensure that the LATEST VERSION of ALL the following documents are submitted)
For ICT Packaged Solution
a)Latest (not more than 6 months old) ACRA business profile of
Participating SME

Yes

Corporate parent, that holds more than 50% of the total shareholding, and any subsequent parent companies

Yes

Subsidiaries, in which the Participating SME holds more than 50% of the total shareholding, and any subsequent subsidiaries

Yes

b)For Private Education Institutions (PEIs),
Copy of the registration certificate with Council for Private Education

Yes

Copy of the EduTrust Certificate (for PEIs that enrol international students)

Yes

c) Copy of quotations for the packaged solution(s), issued by the ICT Solution Provider and accepted and signed by the Participating SME, including the one-time costs for customisation/ setup and training services

Yes

d) Copy of contract/ agreement for the subscription of the Software-as-a-Service (SaaS) ICT Packaged Solution, issued by the ICT Solution Provider and, accepted and signed by the Participating SME

Yes

e) Copy of tenancy agreement or equivalent

Yes

f) Copy of authorized document i.e. NEA and BCA license, to identify applicable sector

Yes

WE DECLARE THAT
I) We hereby confirm and certify that the above declarations are true, accurate and correct, and the accompanying supporting documents which we have submitted in respect of this declaration have been verified against the relevant original documents.

ii) We understand that we may not enjoy financial assistance under the Scheme if the conditions for the Packaged Solution are not met.

iii) We understand that any disbursement of a claim under the Scheme shall be at the sole and unfettered discretion of IDA notwithstanding that a complete application is submitted to IDA within the stipulated time periods and has been approved by IDA. For the avoidance of doubt, IDA may revoke its approval of any application at any time without prior notice to us, the Participating SME or the ICT Solution Provider, and all such decisions and acts or omissions of IDA shall be conclusive, final and binding on us, the Participating SME and ICT Solution Provider, and IDA shall not be obliged to give any reasons or explanations whatsoever.

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iv) We also understand that we are liable to refund the full amount of financial assistance received under the Scheme and will be subject to legal proceedings if any of the above declarations are found to be false, irrespective of whether the false declarations were made intentionally or unintentionally.

v) We shall permit IDA, or its appointed agents or sub-contractors, without any prior notice, full and free access to its place of operation, payroll registers, financial statements, books, documents, papers and all such information in any form related to the Packaged Solution(s) and render all such co-operation as may be required for the purpose of monitoring the purchase and implementation of the Packaged Solution(s), or verifying the claims submitted by us and/or through the ICT Solution Provider on behalf of us (as applicable). We shall allow IDA, or its appointed agents or sub-contractors, to inspect, copy or make extracts from such registers, statements, books, documents, papers and information for the aforesaid purposes.

vi) We understand that information pertaining to our application will be shared between IDA and relevant government agencies for administration and evaluation of our application and claims. We thereby consent to the release of any information from IDA to other government agencies, and vice versa, in relation to our application under the Scheme.

vii) We understand that the grant of financial assistance under the Scheme and/or the listing of the Packaged Solution(s) and the ICT Solution Provider by IDA is not to be taken as any form of endorsement or recommendation by IDA and IDA assumes no responsibility or liability for the adequacy, suitability, performance of the Packaged Solution and the level, kind and quality of service rendered by the ICT Solution Provider. In this regard, we understand that our purchase of the Packaged Solution(s) is strictly on a private basis between us and the ICT Solution Provider.

viii) We understand and agree that IDA’s approval and disbursement of the subsidy/ grant to us is conditional amongst other things, that our business at the Site remains in operation.
ix) We agree that in no event will IDA be liable to us for any direct or indirect losses or damages, including loss of income, profit or savings or indirect, incidental, special, consequential, or punitive damages arising from or in connection with any aspect of the Scheme or the Packaged Solution(s).

x) We have read, fully understood and will comply with the terms and conditions set out in the “Enhanced ISPRINT Terms for Self-Declaration Form (ICT Solution)”, which is attached herewith as Appendix A.

We understand

Yes

ACRA REF. NO. / UEN
(Note; Only the sole proprietor, partner or company director of the Participating SME, as registered with ACRA, may sign this declaration.)

NAME(IN BLOCK LETTERS)

DESIGNATION

DATE

Declaration by ICT Solution Provider

I DECLARE THAT

I) I/We are a company that is not related 1 to the Participating SME. None of our partners/directors or shareholders or vendors/consultants has any interest in or are in the employ of the Participating SME or any company affiliated to the Participating SME or any joint venture partner or principal or agent (in a trading/ agency relationship) of the Participating SME. The services which we provide under the Packaged Solution(s) are for a limited duration and, unless agreed to by the Infocomm Development Authority of Singapore in writing, shall not lead to full time employment of our partners/ directors or shareholders or vendors/consultants with the Participating SME or its affiliated companies for at least one (1) year from the completion of the Packaged Solution(s).

ii) I/We are presently not engaged whether as plaintiff or defendant or otherwise in any claim, legal action, proceeding or arbitration nor are there any circumstances known to be likely to lead to any such claim, legal action, proceeding or arbitration.

iii) I/We have informed the Participating SME of the qualifying costs and grant cap pertaining to its purchase of the Enhanced ISPRINT Packaged Solution and clearly explained the same to the Participating SME.

iv) I/We and/or our partners/directors or shareholders or vendors/consultants, have not given any monies, rebates, discounts, refunds, liquidated damages or any other payment, whether in cash or in kind, to the Participating SME’s management, directors or shareholders or any other person related to the aforesaid persons, in connection with the Packaged Solution(s), and there is no intention to give such monies, rebates, discounts, refunds, liquidated damages or payments hereafter. I/ We undertake to inform the Infocomm Development Authority of Singapore before giving any such monies, rebates, discounts, refunds, liquidated damages or payments.

v) The Participating SME at the Site has not already or previously purchased or use any software or IT system/service, from my company/firm, that perform a similar set of functions as the Packaged Solution(s) that the Participating SME is now purchasing.

NAME(IN BLOCK LETTERS)

DESIGNATION

DATE

Examples of related parties include (but are not limited to) subsidiaries, associated companies, joint ventures, key management staff and their close family members (e.g. spouse, children, domestic partner, and dependents). The examples cited are by no means exhaustive. For the purpose of determining related party relationships, the ICT Solution Provider should refer to the Financial Reporting Standard (FRS) 24 at http//www.asc.gov.sg.

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Explanatory Notes
Eligibility Criteria for Financial Assistance under Enhanced ISPRINT Scheme
Participating SME must be incorporated/registered in Singapore and must satisfy all of the following conditions

(a) Participating SME has at least 30% of its shares owned by Singapore citizens or permanent residents or business entities registered in Singapore; and

(b)Participating SME has a group annual sales turnover of not more than S$100 million; OR the Participating SME has a group employment size of 200 or fewer.
In addition to the above conditions, the Participating SME must fulfil the following to enjoy the subsidy for the respective areas

(c) For ICT Packaged Solution (Basic/ Intermediate/ Specialised/ Sector Scale Up/ Sector Seed/ Sector Emerge), Participating SME at the Site must not currently use any software or IT system that perform a similar set of functions as the Packaged Solution(s) that it is now purchasing under the Scheme.
Support Level under Enhanced ISPRINT Scheme

Category

ICT Packaged Solution – Basic (on-premise/ SaaS)

Up to 70% of qualifying costs, and up to 1 year support for SaaS

Capped at S$2,000 per solution

Category

ICT Packaged Solution – Intermediate (on-premise/ SaaS)

Up to 70% of qualifying costs, and up to 1 year support for SaaS

Capped at S$20,000 per solution

Category

ICT Packaged Solution – Specialised (on-premise/ SaaS)

Up to 70% of qualifying costs, and up to 1 year support for SaaS

Capped at S$25,000 per solution

Category

ICT Packaged Solution – Sector Scale Up (on-premise/ SaaS)

Up to 70% of qualifying costs, and up to 2 years support for SaaS

Grant cap on case-by-case basis per Site

Category

ICT Packaged Solution – Sector Seed (on-premise/ SaaS)

Up to 70% of qualifying costs, and up to 2 years support for SaaS

Grant cap on case-by-case basis per Site

Category

ICT Packaged Solution – Sector Emerge (on-premise/ SaaS)

Up to 80% of qualifying costs, and up to 2 years support for SaaS

Grant cap on case-by-case basis per Site

Definition of Group

Annual sales turnover and employment size of the Participating SME will be computed on a “Group” basis, meaning that the annual sales turnover and employment size of all members of the “Group” should be added up for the purposes of the declarations in this form.

The term “Group” means, if applicable

(a) ALL corporate shareholders holding more than 50% of the total shareholding of the Participating SME (the “said corporate shareholders”);

(b) any parent companies of the said corporate shareholders which hold more than 50% of the total shareholding of the said corporate shareholders (the “subsequent parent companies”);

(c) any parent companies of the subsequent parent companies which hold more than 50% of the total shareholding of the subsequent parent companies;

(d) ALL subsidiaries in which the Participating SME holds more than 50% of the total shareholding (the “said Participating SME’s subsidiaries”);

(e) any subsidiaries of the said Participating SME’s subsidiaries, in which the said Participating SME’s subsidiaries holds more than 50% of the total shareholding (the “subsequent subsidiaries”); and

(f) any subsidiaries of the subsequent subsidiaries, in which the subsequent subsidiaries holds more than 50% of the total shareholding.
For calculation of annual sales turnover, in the event that

(a) the Participating SME has a parent company which holds more than 50% of the total shareholding of the Participating SME, the annual sales turnover of the ultimate parent company (which holds more than 50% of the total shareholding of any parent company or subsequent parent company of the Participating SME) is deemed to be the annual sales turnover of the “Group” for the purposes of this form; OR

(b) the Participating SME does not have a parent company holding more than 50% of the total shareholding of the Participating SME, the annual sales turnover of the Participating SME is deemed to be the annual sales turnover of the “Group” for the purposes of this form.

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ENHANCED ISPRINT TERMS FOR SELF-DECLARATION FORM (ICT SOLUTION)

APPENDIX A

1 INTERPRETATION

1.1 In the application for an Enhanced ISPRINT grant/ subsidy, the following words and phrases shall have the meanings hereby assigned to them unless the context otherwise requires

“Application” means the application made by the Participating SME directly and/or by the ICT Solution Provider on behalf of the Participating SME (if applicable) for support for the Packaged Solution(s) under the Scheme and includes any relevant documents, forms and information provided by the Participating SME and/or the ICT Solution Provider on behalf of the Participating SME (if applicable) as may be required by IDA from time to time.

‘Confidential Information’ means information in whatever form (oral, written, electronic, etc.) pertaining to IDA, the Government of the Republic of Singapore or the Scheme that is disclosed to or obtained by the Participating SME, as well as all correspondence or discussions between the Participating SME and any director, employee, officer or representative of IDA, BUT EXCLUDES information that (a) the Participating SME develops independently without use of any information disclosed to or obtained by the Participating SME by or from IDA; (b) is or becomes publicly available without breach of this obligation of confidence or other legal obligations; and (c) is previously known to the Participating SME without any obligations of confidence or is disclosed to the Participating SME by a third party who is not subject to any obligations of confidentiality.

2SD V11 Self Declaration Form

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