Appendix 3.1
Form for the Innovation Subsidy Plan, chapter 3, article 3.13
For an extensive explanation:
- website: /innovatiekrediet
- telephone: +31 (0)88 602 5420 (on working days from 08:30am – 5:30pm) / Send the completed form with appendixes to:
Agentschap NL
NL Innovatie
Innovatiekredieten
Postbus 93144
2509 AC The Hague
  1. Applicant

Company / organization

Name of organization:
Department/study group:
Mailing address:
Zip code: / Town/City:
Country:
Address:
Zip code: / Town/City:
Country:
Bank account number: / Bank:
Chamber of Commerce registration number: / Legal structure:
Year of registration:
If your organization is VAT-exempt, you can regard the tax payable as expenses, as this VAT cannot be deducted. The VAT payable is therefore eligible for subsidy
You can determine this with the SME test, which you can download from

If SME, attach signed SME test / Your organization is1: / VAT-registered / VAT-exempt
Your organization is: / an SME2 / Other, namely
no SME2
Has a petition been filed on behalf of your organization for a moratorium on the payment of debts, bankruptcy/liquidation or the declared application of the Debt Rescheduling Scheme? / Yes
Explanation: / No

Applicant contact person3

3 Enter the contact details of the applicant here. If correspondence is being carried out by an intermediary, enter the contact details of the intermediary on the following page / Name: / Mr. Ms.
Title(s):
Job title:
Telephone: / Fax:
E-mail address: / Mobile telephone:

Intermediary contact details (if applicable)

Name of organization:
Name: / Mr. Ms.
Title(s):
Job title:
Telephone: / Fax:
E-mail address: / Mobile telephone:
  1. Project

Project name:
4 The project type is important for determining the interest rate, see article 3.9 of the plan / Project type4 / Technical development project Clinical development project
Sustainable Technical development project
5 If so, add a cash flow forecast, in which you have not included the expected revenues from the development project.
6 The credit is a maximum of 35% of the project costs. / Do you expect to be able to pay back the credit in the event the development project is not a commercial success? / Yes5 No
Project start date: / -- / Expected project end date: / --
Total project costs: / € / Requested credit6: / €
Has this project, or any part of it, been granted a subsidy by the Minister of Economic Affairs, another administrative body, or the European Commission? / Yes, namely:
Subsidy amount: € / No
  1. Signature

The undersigned declares that all the necessary documents for the application are enclosed and that he/she is familiar with the conditions and procedures of the Innovation Subsidy Plan.

Completed as true and correct:

7 This person must be authorized to sign on behalf of the applicant. The authorized party may also be an intermediary. In this case, include an original authorization, which grants the intermediary the authorization to carry out correspondence. / Name:7
Job title:
Date: / --
Signature:

Mandatory appendices8

8 Your application is only complete and able to be processed if all appendices have been enclosed. See “Appendix explanation” on the following page. / Appendix A: Business plan
Appendix B: Project Plan
Appendix C: Financial Plan
Appendix D: Most recent Annual accounts or Opening balance sheet
Appendix E: Completed and signed SME test form
Appendix F: Appendix to the SME test: the organization chart with all partner companies, including data (staff numbers, turnover and balance sheet totals)
Appendix G: (if available) Feasibility study report, market research report, patent applications and novelty searches, relevant publications

Explanation of appendices

A) Business plan

In the business plan, you indicate how you intend to earn money with the product, process or service to be developed. Current data are to be used when substantiating the business plan. In addition to a description of any possible existing activities, the importance of the development project to the organization must be made clear. The following aspects in particular must be examined:

- Existing knowledge and experience among owner(s), management and/or important members of staff with the organization chart

- Stockholders and legal structure of the (group of) business(es)

- Strategy and business model

- Market analysis of existing alternatives, competitors and trends

- Distinctive qualities of the product to be developed in comparison to existing products

- Numerical explanation of commercial perspective, market scope, concrete added value for end user, intended market share and cost structure

- Marketing method

- Turnover, profit and cash flow forecast

- Profitability calculation for the development project.

If a business plan is not available, a commercial plan for the product, process or service to be developed, including a profitability calculation, may be supplied.

B) Project plan

In the project plan, you indicate how you expect to realize the product, process or service. In it,

you describe, among other things, the following points:

- Innovativeness of the technology and knowledge protection strategies

- Substantiation of the technical feasibility (“proof of principle”), with previously conducted (research)activities

- Status of the technology, with an overview of the most important remaining technical problem areas and risks and the

anticipated solutions and execution thereof.

- Clear planning of activities, with a clear phasing, logical milestones and a quantification of interim goals (toward final “proof of concept”)

- Project organization, project manager experience, important experts (including specialized suppliers)

- A phased project budget, in which you estimate the development costs per phase (you can make use of the

website model to do so)

C) Financial plan

In this appendix, you provide insight into how you can provide the necessary finances for the project and the business plan.

This includes both the development phase and the commercialization phase. Add (concept)