PROJECT TITLE
  • Please read the Technofund Guidelines carefully before you fill in this form.
  • All information required in the application form must be given.
  • Please submit the project proposal together with the business plan (1 hard copy and 20 CDs) but save the project proposal in a separate file.
  • Incomplete application and/or application received after the closing date of each cycle will be returned.

For Secretariate use only
Project No.
Date received
Project Officer

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PART 1: APPLICATION PARTICULARS

1.1 / Entity name and address
Entity name:
Company registration number (if applicable):
We are currently a (Please mark (X) in
appropriate box):
Government Research Institutes (GRIs)
Malaysian Institute of Higher Learnings (IHLs)
Small / Medium Malaysian Company
Corporatives Registered with MCC (Malaysian Coperatives Commission)
(Remarks if any):
Address:
Contact Person :
Designation :
Telephone no : Fax no :
e-mail:
1.2 / Collaborator name and address
(if applicable)
Main collaborator (mandatory for IHL/GRI):
Company registration number:
Our main collaborator is:
Please mark (X) in appropriate box
Government Research Institutes (GRIs)
Malaysian Institute of Higher Learnings (IHLs)
Small / Medium Malaysian Company
Corporatives Registered with MCC (Malaysian Coperatives Commission)
Address:
Telephone no :
Fax no :
e-mail:
1.3 / Project Team
Describe the technical and business capabilities, qualifications and experience of project team members. Please attach CV of each team member.

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1.4 / Business details (if IHL/GRI applicant, please fill in your collaborator’s details)
Authorised capital :
Paid up capital :
Structure of shareholding:
Nationality / RM / %
Malaysian
  • Bumiputera
  • Non-Bumiputera

Foreign
Total
Number of full time employees (please provide evidence) :
Turnover (in your most recent annual accounts). Please provide profit and loss statement.
RM
Balance Sheet (total assets net of depreciation). Please provide latest balance sheet.
RM
Is your business part of a group?
Yes / No
If yes, please provide group name.
1.5 / Contact Person
Name:
Position:
Telephone No.:
Fax No.:
e-mail:
1.6 / Have you or your business previously applied or been connected with an application, for other Government R&D, commercialisation or related funding? Please mark (X) in the appropriate box.
Yes / No
If yes, please give details:
1.7 / Have you or any other partner, member or director of your business ever been disqualified from becoming a director?
Please mark (X) in the appropriate box
Yes / No
If yes, please give details:
1.8 / Have you or any other partner, member or director of your business ever been an owner, partner or director of a business which went into bankruptcy, liquidation or receivership? Please mark (X) in the appropriate box
Yes / No
If yes, please give details:
1.9 / How you plan to fund your share of the project costs? Provide evidence of funding (e.g.
bank statement, bank facility / OD, etc)
1.10 / You are applying for
Type / Mark (X) in the appropriate box / Project Cost
(RM)
Pre-Commercialisation
IP Acquisition
TOTAL
1.11 / Technology Sub-Cluster
Please mark (X) in the appropriate box
Food & Agro-Based Industry
Crops
Livestock
Marine/Aquatic

PART 2: PRE-COMMERCIALISATION

2.1 / Project Title
2.2 / Project Summary
2.3 / Proposed Project Duration (months)
2.4 / Technical Aspects
2.4.1Previous Work Done (Laboratory Proof of Concept)
2.4.2Project Objectives
2.4.3Methodology
2.4.4Technology Benchmarking
2.4.5Project Deliverables
2.4.6Regulatory and Standards
2.4.7Patentable Output (Please elaborate novelty)
2.4.8Project Risks (Technical and financial risks)
2.4.9Project Benefits (To applicant and country)
2.4.10Project milestones and activities– List the major milestones of the project (typically 5 to 8) in the table below. Outline the major activities of the proposed projects. A project typically consists of 8 to 12 activities. These activities should collectively cover the scope of the project. The activity costs should be equal to the total project cost.
NO. / MILESTONES / ACTIVITIES / DELIVERABLES / COMPLETION DATES
1.
2.
3.
4.
5.
2.4.11Project Gantt Chart (Please attach)
2.4.12Project Costing (Please itemise and provide breakdown for expenses of each component and sub-component involved)
NO / EXPENSES / ITEMS / COST
(RM) / TOTAL
(RM)
1. / Pilot Plant (if applicable)
2. / Up-scaled production unit (if applicable)
3. / Commercial Ready Prototype
4. / Equipment
5. / Market Testing of Commercial Ready Prototype
6. / Regulatory and Standards Compliance
7. / Contract Expenditure
8. / Expenditure of Services
Total Proposed Project Cost

PART 3 : DECLARATION

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3.1 / Declaration

This form must be signed by someone with the legal authority to bind the applicant entity/institution (for example, an executive director of your entity)

I / We certify that:

  1. I / We have read, understood and agreed to abide by the TechnoFund Guidelines For Applicants;
  1. The information provided in this application, including attachments, is true and correct to the best of my knowledge;
  1. I / We understand and accept that the Ministry of Agriculture and Agro-Based Industry may use the Project Title and description in Section B for public promotional purpose of the TechnoFund; and
  1. The Entity/Institution is free from any litigation pertaining to the proposed project in Malaysia and overseas.

Name:

Designation:

Signature:

Date:

For enquiries, please e-mail to

Applicants must use the latest version of the Project Proposal form for submitting applications and fill in the TechnoFund Project Proposal Checklist separately. MOA reserves the right to withdraw approval based on false information submitted by applicants.

TECHNOFUND PROJECT PROPOSAL CHECKLIST

Reference No.
Entity Name
Project Title
No. / Please mark (  ) in the appropriate box
(  ) / (For Official Use)
Book 1 (5 hard copies)
Executive Summary (2 pages) /  / 
Project Proposal /  / 
Curriculum Vitae of project team /  / 
Form 9 (Company Act,1965) /  / 
Form 24 (Company Act,1965) /  / 
Form 49 (Company Act,1965) /  / 
Recent EPF statement of all employees (Company Applicants and IHL/GRI Main Collaborator) /  / 
Letter of Undertaking from Main Collaborator (to finance portion of project cost not funded by TechnoFund and to commercialise project output) (IHL/GRI applicants only) /  / 
Book 2 (5 hard copies)
Business Plan /  / 
Latest audited Financial Report (annual turnover, profit and loss statement, balance sheet, cash flow, etc) (Company applicants and IHL/GRI Main Collaborator) /  / 
CD (5 soft copies)
Project Proposal + Business Plan + Executive Summary (in separate file) /  / 
(For Official Use Only)
Processed by RO / Verified by AD
Date Received: / Status: Complete Incomplete & Returned
On Time Late & Returned
Status: Complete Incomplete & Returned / Remarks:
On Time Late & Returned
Signature: / Signature:

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