Fill - Free fillable hospitality-action Covid-19 grant PDF form

Covid-19 Grant

HOSPITALITY ACTION

Hospitality Action, 62 Britton Street, London EC1M 5UY, 0808 802 0282

Confidential Application Form 2020

Covid-19 Grant

Please complete all the sections overleaf and enclose the supporting paperwork. Incomplete

applications will be responded to by e-mail but this will lead to a delay in processing which might mean

the funds are exhausted before your case can be considered.

Grant Scheme

Covid-19 Grants are for £250 per household.

This grant scheme will be paid out from the 27th March 2020 until funds are exhausted.

To be eligible you must be :

Currently working within the UK hospitality industry or have worked in the industry within the last

month and have savings of less than £1,000 per person or £2,000 for a family or couple (including

rolling bank balance). We do not take into account any income you receive from state benefits.

Application Process

To apply for the grant you need to:

• Complete the short application form on the next two pages.

• Provide us with evidence of your current or most recent employment within the hospitality

industry by sending us a copy of a full month’s bank statement for the previous month showing

your salary and name of employer.

• Please attach a recent statement for all accounts (bank, building society, post office).

• Please also send in any written evidence from your employer where you have either been made

redundant or had your hours or pay reduced as a direct result of the coronavirus.

• Applications can be considered from the 23rd March 2020 until this fund is exhausted.

Applications are limited to one per household.

Please send your completed application to help@hospitalityaction.org.uk with the subject

heading: C-19 Grant

PLEASE DO NOT POST TO THE ADDRESS ABOVE AS WE MAY POSSIBLY HAVE TO CLOSE OUR OFFICE AND

WORK REMOTELY AND/OR ROYAL MAIL MAY NOT BE ABLE TO CONTINUE TO DELIVER POST TO US

1. Applicant details

Winter Fuel Grant

Confidential

Title: First name: Surname:

Address: Telephone Number:

2. Household Details

3. Employment in the hospitality industry

Name of Company Your Job Date Started

Who shares your home with you? Apart from you please give details of all adults who live in your home

Please provide us with bank statement evidence of your current employment as without this

information we cannot process your application

Date of Birth: Annual Salary £ National Insurance No.

5. Bank Details - for account grant should be credited to (please use block capitals)

Bank Name:

Account Name:

Account Number:

Sort code:

Covid-19 Grant

HOSPITALITY ACTION

Hospitality Action, 62 Britton Street, London EC1M 5UY, 020 3004 5508

Name Relationship to Please indicate if they are employed/in education or if other Annual Salary/Income

Name Relationship to you Age Name Relationship to you Age

Now give details of all children aged under 16 in full time primary or secondary education

4. How did you hear about the scheme ______________________________________________________

6. Declaration

Please read this section carefully and sign to confirm that you understand the statement.

• All the information provided in the application form is true and correct and full disclosure of all income, capital,

savings and investments has been made.

• I /we will inform Hospitality Action of any change in circumstances that I/we may have during the application

process.

• Any false or misleading information can result in the withdrawal or repayment of any grant that may be

awarded.

• I/we consent to the collection, processing and dissemination of this information by Hospitality Action in line

with the General Data Protection Regulation (GDPR) (EU) 2016/679 and to its storage in both paper and digital

format.

Signed ………………………………………………………………… (applicant) ……………………………………………………..(partner)

Date ………………………………………………………... Address ………………………………………………………………………..

…………………………………………………………………………………………………………………………………………………………………………

………………………………………………………………………………………...Post Code ………………………………………………………...

Additional Information

• Applications are limited to one per household and cannot be processed until evidence of your employment and

change in work circumstances due to Covid-19 has been received.

• Where a grant is awarded it will be for £250 per household and will be paid by direct bank transfer into the

account detailed in Section 4.

• There is a limited amount in the Covid-19 Grants fund and once it has been exhausted no further awards can be

made.

• Please return your completed application via help@hospitalityaction.org.uk with the subject heading:

C-19 Grant

• If you have any further questions please don't hesitate to contact us on 0808 802 0282 .

For Office Use Only

HA Ref: Date Received .

Proof of Work seen:.

Approved By:  Amount:  Payment Date: .

By signing the application form you are confirming that the following apply to you:

• I currently work within the UK hospitality industry or have worked in the industry within the

last month

• I have savings of less than £1,000 for an individual or £2,000 for a couple or family (including

rolling bank balance).

• I have lost or had income reduced as a direct result of Covid-19

5. Eligibility

Additional Information

Please tell us about any extenuating circumstances or particularly difficult situation you think we should be

aware of when processing your request.

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