SAMPLE - 創新及科技基金Enterprise Support Scheme ("ESS") Application Form Reference Date/ Time of Receipt-(For Official Use) Project Title (Chi) (Eng) Company Name (Chi) (Eng)

Enterprise Support Scheme ("ESS")

Application Form

Reference Date/ Time of Receipt-

(For Official Use)

Project Title(Chi)

(Eng)

Company Name

(Chi)

(Eng)

General

1. Unless the context otherwise requires, terms defined and expressions used in thisApplication Form shall bear the meanings set out in the Interpretation of theApplication Guide. The Rules of Interpretation set out in the Interpretation of theApplication Guide shall also apply to this Application Form. Please read the'Enterprise Support Scheme (“ESS”) - Guide to Filling in the ApplicationForm' (available at www.itf.gov.hk) carefully before completing this ApplicationForm.

2. The Government shall have the right to disclose, without further reference to theApplicants, whenever it considers appropriate, information in relation to theApplicants’ application for ESS, including information on the Application Form,information of the Applicants, information submitted by the Applicants, descriptionof the Projects etc. In submitting the Application Form, each Applicant irrevocablyand unconditionally authorises the Government to make and consents to theGovernment making any of the aforesaid disclosure. For example, when anapplication is approved, the information denoted with “#” in this form will bepublished through the Innovation and Technology Fund (“ITF”) website(www.itf.gov.hk) and/or carried forward in the related progress/final reports.

ITF Form 7.2 P. 1

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3. When registering as an Applicant for the ITF for submission of applications or otherdocuments related to the ITF, you will be required to provide personal information.For matters relating to the collection of personal information, "Personal InformationCollection Statement" as shown on the Innovation and Technology CommissionFunding Administrative System (https://itcfas.itf.gov.hk) shall apply.

4. This form is divided into the following sections: -

Part A The Applicant

Part B The Project

Part C Justifications

Part D Implementation Plan

Part E Benefit-Sharing

Part F Supplementary Information

Part G Attachments for the Application

Part H Disclaimers, Declaration and Undertaking

For applications made under Hong Kong-Israel (HK-IL) R&D Cooperation Programme, Applicants should state so in Section 3(i) of Part C III of the Application Form and include information of their Israeli partners in the same section.

5. This Application Form has been translated into Chinese. If there is anyinconsistency or ambiguity between the English version and the Chinese version,the English version shall prevail.

ITF Form 7.2 P. 2

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Part A The Applicant

Please complete Part A according to the Certificate of Incorporation / Certificate of Registration of Non-Hong Kong Company (“CI”) issued by the Companies Registry (“CR”) of the Government and the Business Registration Certificate (“BR”) issued by the Inland Revenue Department of the Government.

Please submit a copy of the following as attachment(s) to this application:(i) CI;(ii) latest Annual Return (or the Incorporation Form for newly established company);(iii) Notice of Change of Company Secretary and Director (Appointment/Cessation) (if any);(iv) Notice or Certificate of Change of Company Name (if any); and(v) organisation chart of the Applicant's company (and its company group, if any).

I. Applicant Company

1. Particulars of the Applicant Company #

Name in English

Name in Chinese

Registered Address -

Company's Registered Office

Address filed with the CR

Date of Incorporation

[dd/mm/yyyy]

Business Address shown on the

BR

Nature of Business

Telephone Number

Fax Number

Email Address

Webpage

No. of Employees of the

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Company Group

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II. Information on Related Companies

1. Particulars of the Company Group (if applicable)

Information on Holding Company (if applicable)

Company Name (Eng)

Company Name (Chi)

No. of Employees

Date of Incorporation

[dd/mm/yyyy]

Place of Incorporation

Nature of Business

2. Information on Subsidiaries (if applicable)

NoCompany Name

(Eng)

Company Name

(Chi)

No. of

Employees

Place/Date of

Incorporation

[dd/mm/yyyy]

Nature of

Business

1

2

# Corresponding information will be published through the Innovation and Technology Fund (“ITF”) website (www.itf.gov.hk) and/or

carried forward in the related progress/final reports.

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Part B The Project

I. Key Information of the Project

1. Project Title #

English (not more than 20 words) :

Chinese (not more than 30 words) :

2. Actual Total Project Cost (HK$'000):

Company Matching Fund (no less than the net amountrequested from ESS) :

- Source of Company Matching Fund^ Angel Fund:

Angel InvestorInvestment Amount(HK'000)

Venture Capital:

Venture CapitalistInvestment Amount(HK'000)

Self-finance

Net Amount Requested from ESS (HK'000):

3. Overall Schedule #

Commencement Date (dd/mm/yyyy):

Completion Date (dd/mm/yyyy):

Project Duration (months):

4. Location of R&D work

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Name/location of organisation(s) and/ or 3rd party technology

partner(s)

Percentage of R&D Work to be Undertaken

Local %

Mainland %

Overseas %

5. Benefit-Sharing^

Offer to share benefit with the Government under the benefit-sharing arrangement?

Yes (Please complete Part E Benefit-Sharing)

No

# Corresponding information will be published through the Innovation and Technology Fund (“ITF”) website (www.itf.gov.hk) and/

or carried forward in the related progress/final reports.

^ Please select (by putting in ‘√’) where appropriate.

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II. Brief Description of the Project

1. Technology Area^

Advanced Manufacturing/Process Development

Automotive Parts and Accessories

Biotechnology

Chinese Medicine

Electronics

Energy

Environmental Protection

Information and Communication Technologies

Logistics and Supply Chain Management

Nanotechnology and Materials Science

Testing and Certification

Textile/Clothing/Footwear

Others (please specify)


2. Industrial Sector ^P. 8

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2. Industrial Sector ^

Banking/Financial Market/Fund Management/Insurance

Biotechnology

Chinese Medicine

Electrical and Electronics

Environmental

Food and Beverage

General (Cross Sectors)

Import and Export Trade

Information Technology

Manufacturing Engineering

Materials

Precision Engineering

Printing and Publishing

Professional Services

Real Estate/Property Management

Telecommunications

Textiles/Clothing/Footwear

Tourism

Transportation

Wholesale and Retail

Others (please specify)


3. AbstractP. 9

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3. Abstract

Please include in this section a brief description of the Project:(i) a problem statement explaining the key issues or problems existing in the

concerned area(s) selected for the R&D work;(ii) a brief description of the products/services/processes/system to be launched in the

market for solving the problems;(iii) an highlight of the key innovation and technology to be developed or to be

deployed for developing (ii) above;(iv) the competitive advantage of (ii) above; and(v) the ways in how (ii) above will be commercialised.

An abstract written in both English and Chinese is required.

(Eng) (not more than 500 words)

(Chi) (not more than 600 words)

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Part C Justifications

Please refer to Part C of the 'ESS - Guide to Filling in the Application Form' for how to fill in the following sections.

Please submit a 6-slide PowerPoint introduction of the Project as attachment to this application. It is advisable to include the following areas:(i) key problem(s) to be solved;(ii) innovation and technology to be developed/deployed in the Project;(iii) scope of R&D work;(iv) technical challenges;(v) target market and business model; and(vi) competitive analysis.

I. Innovation and Technology Component (25%)

Details

(a) Objectives:(i) problem(s) to be solved (ii) products/services/ processes/system to be developed for solving the problem(s)(iii) innovation and technology to be developed or to be deployed for developing item (ii) (Please identify what is new in terms of ideas, concepts, knowledge, technologies, methods and/or applications and provide details.)

(b) Scope of R&D Work (ie. Core R&D activities to be conducted for achieving the project deliverables detailed in

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(c) below. They should be consistent with 'Project Milestones' in Part D.)

(c) Project Deliverables(Please include measurable parameters indicative of the functions, purposes and performance of the expected deliverables. Please also indicate at which milestones they will be achieved. Information provided should be consistent with 'Project Milestones' in Part D.)

Hardware:

Software:

Platform:

Others:

(d) Technical Challenges / Risks (Please indicate what are the technical challenges/risks in accomplishing the project objectives and milestones and how will they be tackled.)

(e) Technology Roadmap For Applicant which has less than 100 employees and is seeking funding support of no more than $2.8 million, it is not required to provide a plan for technological advancement of the project deliverables for further development.

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II. Commercial Viability of Project Deliverables (30%)

Details

(a) Target Customers /Market / Geographical Regions

(b) Commercial / Market Risks

(c) Competitive Analysis

(d) Business Model For Applicant which has less than 100 employees and is seeking funding support of no more than $2.8 million, it is not required to complete the application with the following components.

1. Value Propositions

2. Customer Relationships

3. Key Resources

4. Key Activities

5. Key Partnerships

6. Cost Structure

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(e) Commercialisation Plan(Please include plans for revenue generation, reaching out to customers, managing the supply chain, cost and pricing strategy etc.)

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III. Technical and Management Capability (20%)

Please submit a copy of the following as attachment(s) to this application for all project team members: (i) Curriculum vitae (CV) prepared in ITC's prescribed format obtainable at Part G; and(ii) Supporting documents including –

(a) proof of academic and professional qualifications, e.g. certificate(s), testimonial(s) or academic transcript(s);

(b) proof of relevant business/work experience, e.g. reference letter(s), employment letter(s) or contract(s) issued by employer(s), commercial contracts; and

(c) latest employment contracts issued by the Applicant's company.

The project coordinator and deputy project coordinator of the Project shall be employed by the Applicant or being a key member of the Applicant (e.g. Director) at the time of application and throughout the project period.

1. Project Coordinator #

Name (Eng)

(Chi)

Position

Fax No.

Department (if any)

Organisation Name

Telephone Number

E-mail Address

Major Duty in the

Project

Full time ^? No Yes

Shareholder of the Applicant ^? No Yes

With salary charged to this project^? No Yes

Currently taking part in other ITF Project(s)^? No Yes

Please describe project details:


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2. Other Team Members #

No.

Name as shown

on HKID

Card/Passport

Scope of duties in the

Project

(provide details only for

member(s) whose salary

NOT charged to the

Project)

Position or Project Post/

Rank, Department and

Organisation

F S SH D I R

1

2

3

4

Remark:

F = Full time

S = Salary charged to this Project

SH = Shareholder

D = Deputy Project Coordinator

I = Currently taking part in other ITF project(s)

R = To be recruited

3. Collaborating Parties in the Project # (if applicable)

No ^ Please select (by putting in ‘√’) whereCollaboration with other organisations ^? Yes appropriate.

Collaboration with Israeli partner(s) ^? Yes No

If yes, please elaborate on the following –

[For application of Hong Kong- - ,Israel (HK IL) R&D Cooperation Programme† please .state so in (i) and include information of the Israeli partner(s) ]

(i) details of such collaborations. Letter(s) of intent for collaboration issued by the collaborating organisations or any form of agreement(s) made with the collaborating organisations will be useful reference for the assessment panel;

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(ii) special arrangements arising from such collaborations, e.g. licensing of intellectual property rights (if any);

(iii) agreement(s) between your company and the collaborating organisations on the sharing of the royalties or intellectual property rights or any other sorts of income to be generated from the project results/deliverables (if any). Please attach copies of the relevant agreement(s) to Part G; and

(iv) information of the contact persons of the collaborating parties.

NoEnglish Name

(Chinese Name)Address/ Webpage

(if any)Contact Person

Tel No./ Fax No./Email Address

1

2

# Corresponding information will be published through the Innovation and Technology Fund (“ITF”) website (www.itf.gov.hk) and/

or carried forward in the related progress/final reports.

† For programme details, - . . . . please refer to the Guideline for the HK IL R&D Cooperation Programme at www itc gov hk

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Total: Professionals: Fresh graduates:

IV. Relevance with Government Policies or in Overall Interest of theCommunity (10%)

1. Technical Jobs Creation

(i) Technical jobs that will be created during the project period.

NoProject Post/

RankQualifications Required Full Time?

1

2

(ii) Estimated technical jobs that will be created after project completion.

Basis for the estimation

2. Please explain how the Project can support important Government initiatives.

3. Please describe any benefit that the Project will bring to the society.

4. Offer to share benefit with the Government under the benefit-sharing arrangementas indicated in Section I of Part B of this application:

Yes (Please complete Part E Benefit-Sharing)

No

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V. Financial Considerations (15%)

Please refer to the allowable and disallowed expenditure items in Part C of the 'ESS – Guide to Filling in the Application Form'.

A. Expenditure

Please ensure that all expenditure items are incurred between the commencement and completion of the Project.

Summary:

Cost(HK$'000)

(i) Manpower

(ii) Equipment

(iii) Other Direct Costs

Total Project Cost (A):(i)+(ii)+(iii)

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(i) Manpower

Please note that manpower should only include those employed by the Applicant's company and are directly involved in the Project's technology R&D activities. The deployment of each post-holder with salary charged to this Project must be justified by providing details with respect to the following:(a) required qualifications and experience;(b) roles and responsibilities;(c) core R&D activities to be conducted in this Project; and(d) ways in which these R&D activities contribute to the achievement of results

detailed in 'Project Deliverables' in Part C and 'Project Milestones' in Part D.

It is advisable to articulate the details set out in (b) to (d) with the estimated project duration.

Project Post/RankDuration

(man-months)(A)

Monthly Rateor Equivalent

(HK$'000)(B)

Total(HK$'000)

(A)x(B)

Justifications(e.g. qualifications,

duties, core R&D work performed for

completing projectmilestones and

producing projectdeliverables with clear articulation to project

duration etc.)

1

2

3

4

Sub-total A(i):

1.

2.

3.

4.

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(ii) Equipment

Please note that only additional equipment costs directly arising from the Project should be included. The deployment of each equipment item must be justified by providing details of the following:(a) its principle function(s);(b) ways in which it will be utilised for the achievement of results detailed in 'Project

Deliverables' in Part C and 'Project Milestones' in Part D; and(c) division of work if purchasing more than one unit.

Item DescriptionQuantity

(A)

Unit Cost(HK$'000)

(B)

Total(HK$'000)

(A)x(B)

Justifications(e.g. functions, how it

helps completeproject milestones,division of work if

more than one unit isrequested, etc.)

Sub-total A(ii):

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(iii) Other Direct Costs(e.g. consumables, production of samples/prototypes, etc. Only costs that are directly arising from the Project should be included.)

Justifications for each cost item should be provided by specifying:(a) its main purposes/scope of service;(b) ways in which it contributes to the achievement of results detailed in 'Project

Deliverables' in Part C and 'Project Milestones' in Part D; and(c) reasons for the quantity requested.

If it is a service item, it is advisable to provide details of the expected service provider, duration and location of service if the location is outside Hong Kong.

Please include Audit Fee: The maximum funding allowed for an interim/final audited account of a project costing less than HK$1 million, between HK$1 million and HK$5 million and more than HK$5 million should not be more than HK$8,000, HK$14,000 and HK$20,000 respectively.

Item Description Quantity(A)

Unit Cost(HK$'000)

(B)

Total(HK$'000)

(A)x(B)

Justifications(e.g. purposes, scope of

service, how it contributes to achievement of results, reasons for the quantity

requested etc.)

Audit Fee

Sub-total A(iii):

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B. Company Matching Fund (no less than the net amount requested from ESS)

Amount(HK$'000)

% of Total Project

Expenditure

Company Matching Fund %

C. Net Amount Requested from ESS

Amount(HK$'000)

Total Expenditure (A):

Company Matching Fund (B):

Net Amount Requested from ESS (C): (C)=(A)-(B)

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Part D Implementation Plan

Project Milestones

The information in this section is for monitoring the technical progress of the Project. Please set out the project milestones to be achieved every six months for the generation of the project deliverables described in Section I of Part C.

From (dd/mm/yyyy) To (dd/mm/yyyy)

1st Project Milestone:

Core R&D Activities (Details should be consistent with

Section I of Part C.)

Key Accomplishments (Please specify what will be

accomplished upon the completion of the core R&D

activities. Also include measurable parameters to

indicate functions, purposes and performance of the results.)

Project Team Member(s) to be Deployed


2nd Project Milestone:








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3rd Project Milestone:









4th Project Milestone:








Note: dd/mm/yyyy

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Part E Benefit-Sharing

I. Estimated Gross Benefit Generated from Project Deliverables

Please list all the estimated income after project deliverables are successfully commercialised.

Estimated Income to be Received

At Year after Project Completion

Basis of Projection/AssumptionsAmount

(HK$'000)

Total :

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II. Proposed Benefit-Sharing Formula

Please set out how the benefit generated from the Project will be shared with the Government.

Details

Proposed Benefit-Sharing Formula

Basis of Projection/Assumptions

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Part F Supplementary Information

1. Any previous or ongoing project(s) undertaken by your company (and yourcompany group, if any) and/or key project team members that are supported bythe ITF and other government funding schemes, for example, the incubationprogrammes of Hong Kong Science and Technology Parks Corporation andCyberport? ^

Yes No

If yes, please briefly describe the related project(s).

2. Is this application a re-submission of a previously rejected application? ^

Yes No

If yes,i) please set out the project reference number of the previous application;

ii) please highlight the main differences between this application and the previousone; and

iii) please explain how the differences have addressed the concerns previouslyraised by the assessment panel.

3. Intellectual Property Rights of the Project Results/Deliverables

Any intention to patent any project results/deliverables to be developed under theProject? ^

Yes No

If yes, please state the name of the patentable item(s) and the country/countries where such registration will be filed.

4. Internship Programme

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ESS funded project with a project period of 12 months or longer is eligible to hire two interns to assist in the Project. The Internship Programme under the General Support Programme of ITF would cover a maximum of HK$14,000 of the monthly basic salary and the minimum mandatory employer's contribution to the Mandatory Provident Fund (if any) for each intern with a first degree, and for an intern with a master's degree or above, a maximum of HK$16,500 of the monthly basic salary and the minimum mandatory employer's contribution to the Mandatory Provident Fund.

Would your company consider hiring interns if your Project is approved by ESS?^

Yes No

5. The R&D Cash Rebate Scheme

ESS funded project is eligible to apply for the R&D Cash Rebate Scheme, whichaims to reinforce the research culture among business enterprises and encouragethem to establish stronger partnership with designated local public researchinstitutions. Under the R&D Cash Rebate Scheme, a company will receive a cashrebate equivalent to 40% of its expenditure in its project under ITF.

Would your company consider applying for the R&D Cash Rebate Scheme if yourProject is approved by ESS?^

Yes No


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Part G Attachments for the Application

Annex No. File Name File Descriptions

1

2

3

4

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Part H Disclaimers, Declaration and Undertaking

Disclaimers

1. Whilst the information provided by the Government in the Application Form and inthe Application Guide has been prepared in good faith, it does not claim to becomprehensive or to have been independently verified. Neither the Government,nor any of its officers, agents or advisors, accepts any liability or responsibility asto, or in relation to, the adequacy, accuracy or completeness of the informationcontained in the Application Form, the Application Guide or any other written ororal information which is, has been or will be provided or made available to anyApplicant; nor do they make any representation, statement or warranty, expressor implied, with respect to such information or to the information on which theApplication Form or the Application Guide is based. Any liability in respect of anysuch information or any inaccuracy in the Application Form or the ApplicationGuide or omission from the Application Form or the Application Guide is expresslydisclaimed. Nothing in the Application Form, the Application Guide nor in anyother written or oral information which is, has been or will be provided or madeavailable to any Applicant should be relied on as a representation, statement orwarranty as to the intentions, policy or action in future of the Government, itsofficers or agents.

2. The submission of the Application Form or any proposal by an Applicant shall betaken to be an acceptance of the terms of the Disclaimers herein.

3. The invitation for submission of applications under the ESS does not constitute anoffer nor does it constitute the basis of any contract which may be concluded inrelation to the ESS or the carrying out of and completion of any Project.

4. Each Applicant should make its own independent assessment of the proposedterms of the ESS after making such investigation and consulting its ownprofessional advisors and taking such other advice as may be prudent in order toassess the risks and benefits of the application for the ESS, as well as in respectof any financial, legal, tax and other matters concerning the Project.

5. The Government reserves the right, without prior consultation or notice, to changethe proposed terms of the ESS, including but not limited to the terms in theApplication Form and the Application Guide. The Government also reserves theright to negotiate with any Applicant about the terms of its application andterminate any or all negotiations at the Government's discretion before executingany binding contract with a successful Applicant. The Government is not bound togive any reasons therefor.

6. Applicant should note that its application for the ESS may not be approved, andeven if approved, the approved amount of funding from the Government may bedifferent from the one proposed in the Application Form. All project expendituresshould be incurred within the approved project period. Should the Applicantchoose to incur/commit any expenditure for the Project before funding approval isconfirmed, the Applicant will have to bear its own risk and pay for the incurred/committed expenditure itself. For the avoidance of doubt, Applicant submits itsapplication for the ESS at its own cost and expense. The Government will not beliable for any costs and expenses whatsoever incurred by the Applicant inconnection with the preparation or submission of its application or in any relatedcommunication with the Government, whether before, on or after the submission

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connection with the preparation or submission of its application or in any relatedcommunication with the Government, whether before, on or after the submission of application.

7. The Government is not bound to accept any application, and reserves the right toaccept or reject all or any part of any application at any time and is not bound togive any reasons therefor.

Declaration

We hereby declare that:

(a) this application for Enterprise Support Scheme is submitted by CITINet Systems Limited ;

(b) all factual information provided in this application as well as the accompanying information accurately reflects the status of affairs as at the date of submission. We shall inform the Secretariat of the Enterprise Support Scheme immediately if there are any subsequent changes to the above information;

(c) the ideas of the proposed Project are original without any constituted or potential act of infringement of the intellectual property rights of other individuals and/or organisations; and

We have carefully read and agree to the terms and conditions stated in the Undertaking.

Undertaking

In consideration of the Government considering and /or approving this application for the ESS, the Applicant hereby undertakes, warrants, declares and agrees and with continuing effect that:-

1. the Applicant has carefully read and fully understood the Application Guide andthis Application Form including but not limited to the Disclaimers herein;

2. the Applicant is eligible to apply for the ESS in accordance with the ApplicationGuide;

3. without prejudice to and notwithstanding any specific request for information anddocuments in this Application Form, the Application Guide or otherwise, to the bestof its knowledge and belief, the information and supporting documents provided tothe Government in connection with its application, whether in its own hand or not,are true, up-to-date, accurate and complete in all respects. The Applicant has notwithheld, and is not aware of, any material facts or circumstances that have notbeen disclosed to the Government and which might influence the assessment of itsapplication or the decision of the Government in considering whether or not toprovide funding to the Applicant;

4. if this application is successful, the Applicant shall within such time limit asprescribed by the Government4.1 enter into the fund agreement and to complete the Project in accordance with

the provisions of the fund agreement;4.2 comply with all the terms and conditions laid down in the fund agreement,

including this Application Form, and all instructions and correspondences

issued by CIT or his or her representative from time to time in respect of theP. 32

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issued by CIT or his or her representative from time to time in respect of the Project;

4.3 submit to the Government all other information as required by the Government from time to time;

5. regarding all materials which have Intellectual Property Rights which are used forthe Project and in respect of which any Intellectual Property Right is vested in athird party, the Applicant must obtain all necessary licences before the use of suchmaterials;

6. this application may not be processed by the Government if the Applicant fails toprovide all the information required by the Government;

7. all persons whose personal or other data have been included in the informationprovided to the Government have consented to the provision of such data to theGovernment and for disclosure if the Government considers necessary;

8. the Applicant will use the funding under ESS (i) for the sole purpose of carrying outand completing the Project and for no other purposes; and (ii) in accordance withthe budget as approved by the Government;

9. whether or not for bona fide commercial reasons, the Applicant must not, whetheron its own or in collusion with others enter into, facilitate or permit any transaction,agreement or arrangement, whether or not legally binding, which in the opinion ofGovernment, directly or indirectly, has as its purpose or effect or one of itspurposes or effects (other than de minimis), the contravention or avoidance of therequirements of the ESS, including this Application Form and the Application Guide;

10. the Applicant is not in breach of or in default under any agreement to which theApplicant is a party or which is binding on the Applicant or any of the Applicant'sproperty to an extent or in a manner which might have a material adverse effect onthe Applicant any business or financial conditions;

11. no corporate action or other steps have been (or are being or are intended to be)taken, and no legal proceedings have been started (or are impending or beingthreatened), for the winding-up, bankruptcy, dissolution, administration orre-organisation of the Applicant or for the appointment of a receiver, administrator,administrative receiver, trustee or similar officer over the Applicant or any or all ofits revenue and assets;

12. the Applicant is not involved in any litigation, arbitration or administrativeproceedings (whether inside or outside Hong Kong) and no claim (whether insideor outside Hong Kong) is presently in progress or pending or threatened againstthe Applicant or any of its assets;

13. no R&D activity of any part of the Project has been commenced prior to the projectcommencement date as approved by CIT (failure to observe this clause will renderthe application ineligible);

14. the Government has the right to review and revise the arrangements andrequirements regarding the ESS at any time and from time to time as it may deemnecessary in order to ensure that the objectives of the ESS will be properlyachieved and the Applicant shall comply with such other requirements or directivesas may be issued by the Government in writing from time to time;

15. the Applicant undertakes to inform the Government immediately if any Informationprovided in connection with this Application is no longer applicable, true, accurateor complete;

16. if any undertaking, warranty or declaration given by the Applicant in connectionwith this application is not up-to-date, true, accurate or complete or if the Applicantfails to comply with any provisions of this Part H Disclaimers, Declaration andUndertaking, without prejudice to any powers, rights, remedies and claims that theGovernment may have under this Application Form or in law, the Government shallbe entitled to reject immediately this application or, as the case may be, terminateimmediately the provision of funding under ESS to the Applicant and require the

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Applicant to repay to the Government forthwith upon demand all moneys advanced to the Applicant together with interest thereon;

17. the Government reserves the right to, at any time, obtain further information ordocument from the Applicant;

18. the Applicant is fully aware of the serious offences created under the TheftOrdinance (Chapter 210 of the Laws of Hong Kong) (including sections 17(Obtaining property by deception) and 18 (Obtaining pecuniary advantage bydeception)) and the Prevention of Bribery Ordinance (Chapter 201 of the Laws ofHong Kong) (including section 8 (Bribery of public servants by persons havingdealings with public bodies));

19. the Applicant shall notify the Government for any changes to the information andany other information and documents provided to the Government in connectionwith this application or otherwise. The Government may at its absolute discretionreject such changes;

20. much of the information relevant to its eligibility and continuing entitlement underthe ESS, whether as an application or as a successful Applicant, is known oravailable to it or could be known or available to it by making reasonable and timelyenquiries of others;

21. the Applicant fully understands that non-disclosure or misrepresentation of anyinformation provided by the Applicant would entitle the Government to reject itsapplication;

22. this Part H Disclaimers, Declaration and Undertaking shall be governed by andconstrued in accordance with the laws of Hong Kong and the Applicant and theGovernment shall irrevocably submit to the exclusive jurisdiction of the Courts ofHong Kong; and

23. the Applicant has read the provisions of Part H Disclaimers, Declaration andUndertaking carefully and fully understood its obligations and liabilities thereunder.

Signed for and on behalf of the Applicant:-

Authorised Signature with Company Chop

- Chop -Name of Signatory

Title of Signatory

Name of the Applicant

Date (dd/mm/yyyy)Company Chop

P. 34

SAMPLE

Documents

SAMPLE - 創新及科技基金Enterprise Support Scheme ("ESS") Application Form Reference Date/ Time of Receipt-(For Official Use) Project Title (Chi) (Eng) Company Name (Chi) (Eng)