TEIP-KIS Proposal: Co-financing statement
| FORM E: Co-financing statement form | | To be filled for each co-financing third party (company/association/organisation) |
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| | Proposal acronym |
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| | Legal Information (legal entity) | | Organisation Legal Name |
| | Short Name |
| | Legal Status |
| Legal Registration n° |
| | VAT number |
| | Business Area |
| | Registered Address of the legal entity | | PO Box |
| | Street Name and Number |
| | Post Code |
| Cedex |
| | Town/City |
| | Country Name |
| | Information concerning participation and involvement | | Amount of funding which the company/association/organisation undertakes to provide for the operation (in Euro) |
| | How and when the co-financing will take place? |
| | Is the co-financing decision irrevocable? |
| | (if the answer is “Noâ€, please comment) | | Role and involvement in preparing the proposed project |
| | Role and involvement in implementing the proposed project |
| | Administrative officer authorised to commit the company/association/organisation | | Title (Dr, Prof., ...) |
| | Family Name |
| | First Name |
| | Position in company |
| | association/organisation | | Telephone n° |
| Fax n° |
| | E-mail |
| | Stamp of company/association/organisation |
| | Date of signature |
| Signature of authorised person |
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