ISPA Financial Instrument

APPLICATION FOR ASSISTANCE

The application must be accompanied by a full report describing the measure and its contribution to the National Programme for the Adoption of the Community Acquis, and any other information relevant to its assessment, including:

In order to facilitate the assessment, summaries of technical documentation may be provided.

 

Ref. N°...............................

ISPA
- APPLICATION FOR ASSISTANCE -

1. BODY RESPONSIBLE FOR THE APPLICATION

1.1 Name:
1.2 Address:
1.3 Contact:
9.2 Telephone:
9.3 Telex/Fax:
9.4 Internet E-mail:


2. BODY RESPONSIBLE FOR EXECUTION

2.1 Name:
2.2 Address:
2.3 Contact:
2.4 Telephone:
2.5 Telex/Fax:
2.6 Internet E-mail:


3. BODY RESPONSIBLE FOR OPERATION (if different from 2)

2.1 Name:
2.2 Address:
2.3 Contact:
2.4 Telephone:
2.5 Telex/Fax:
2.6 Internet E-mail:


4. BODY TO WHICH PAYMENTS ARE TO BE MADE

3.1 Name:
3.2 Address:
3.3 Contact:
3.4 Telephone:
3.5 Telex/Fax:
3.6 Internet E-mail:


5. Measure type and location

5.1 Title of measure:

5.2 Location:

 Applicant State:
 Region(s):
 District(s):
 (please enclose maps)

5.3 Sector:

  Transport

_____

  Environment

_____

5.4 Type:

  Single project

_____

  Stage of project

_____

  Group of projects

_____

  Other (specify)

_____