www.gea.gov.

gh

GHANA ENTERPRISES AGENCY

GHANA ECONOMIC TRANSFORMATION PROJECT (GETP)

COVID-19 RESPONSE GRANT (CRG) PROGRAMME – PHASE TWO

Application Form for Small and Medium Enterprises

The Ghana Enterprises Agency is implementing the second phase of the COVID-19 Response
Grant programme to provide liquidity and support for Small and Medium Enterprises (SMEs) to
enable SMEs to adjust, and to grow out of the COVID-19 crisis in selected sectors of the
economy. The nationwide grant programme will focus on only the SMEs most impacted by the
COVID-19 pandemic, as well as those who showed resilience during the pandemic. The grant
programme is expected to spur the economic recovery of SMEs.

Kindly read through the grant application manual provided, to provide guidance in the
completion of this form, the documentary requirements, target sectors, and to determine your
eligibility following which you may apply for the grants.

Details of Business Owner

*First *Last Other

Name: Name: Names:

*Owner’s
Residential
Address:

*GPS Address:

*Owner’s Postal
Address:

*Nearest
Landmark:

*Persona
l Phone 1 Personal Email
Phone 2: address:

*Town
: *District: *Region:

1
 www.gea.gov.gh

*Table 1: Mode of identification

ID Type: (please tick Ghana Card [ Passport Driver’s License Voter’s ID Card
one ) ] [ ] [ ] [ ]
ID Card Number  

*Table 2: Gender of Business Owner

Gender: Female [ ] Male [ ]

*Date of Birth of Owner/Principal Shareholder: _____/_______/_________ (dd/mm/yyyy)

Table 3: Age Category of Owner/Principal Shareholder

Less than 18 years [ ]
18 – 35 years [ ]
36 – 45 years [ ]
46 years and above [ ]

*Is the business/enterprise owner a person with disability? Yes [ ] No [ ]

Please specify type of disability …………………………………………………….

*Is the person completing this application form same as the business owner? Yes [ ] No [ ]

If answer to above question is no, please provide name and position of person other than the
owner completing this application form in table 4 below.

Table 4: Details of Authorized Representative Completing Application Form –

complete if different from owner.
Name
Title
Phone Number
Email Address
GPS
Address/Physical
Address

Table 4.1: Authorized Representative’s Mode of Identification

ID Type: (please tick Ghana Card [ Passport Driver’s License Voter’s ID Card
one ) ] [ ] [ ] [ ]
ID Card Number

2
 www.gea.gov.gh

Business Details

*Registered Business Name: _________________

*Business TIN: _________________

*State month and year business commence operation: MM/YYYY___________

* How long has your business been in operation? Tick as applicable:

Table 5: Number of years in operation
Year in operation Select
0 - 1 year [ ] 
2 - 5 years [ ] 
6 - 9 years [ ] 
10+ years [ ]

*Are you currently operating or shut down?

Operating at date of application [ √ ] Shut down at date of application [ ]

*Table 6: Current Employee size (That is, at date of completing this Application
Form)
Indicator Year - 2022
A. Employee size disaggregated by Gender at Date of Full-time male: 4
Application Full-time female: 2
Part-time male: 2
Part-time female: 4
Total current employees: 12
B. Age Disaggregation of Employees as at Date of Less than 18 years: 0
Application: (Please State the number of employees 18 – 35: 10
from the above total that fall within the following age 36 – 45: 2
categories?) 46 years and above: 0
Total current employees: 12

*Table 7: Type of Business Registration

Sole Proprietorship [ ]
Limited Liability Company [√ ]
Partnership [ ]

*Business

3
 www.gea.gov.gh

Location
Address:

*Town: *District: *Region:

*GPS Address:

*Postal Address:

*Nearest
Landmark

State number of
Business
Branches (if
any)

Physical
Location of
branch(es)

Business
*Phone Other *Email
1: Phone 2: address:

*Table 8: Select your business sector:

Agriculture/Agro-processing [ ]
Manufacturing [ ]
Textile and Garment [√]
Food and Beverage [ ]
Pharmaceuticals/companies in the production [ ]
of Personal Protective Equipment (PPE)
ICT [ ]
Education [ ]
Trade/Commerce [ ]
Construction [ ]
Transport & Logistics [ ]
Other: [ ]
Specify: ……………………………..

Are you part of a trade or business association or Union? Yes [ ] No [ ]

4
 www.gea.gov.gh

If yes, please state name of association or Union:

____________________________________________________________________________

*Is your business female-majority owned? Yes [ ] No [ ]

*Table 9: Shareholding structure: (insert as many rows as needed)

Nationality
Ghana (Ghanaian
Card Gender Ownership/Shareholding or non-
No.: Full Name Number (please select) percentage (%) Ghanaian)
      Male Female  
      [ ] [ ]  
      [ ] [ ]  
      [ ] [ ]  
[ ] [ ]
[ ] [ ]
[ ] [ ]
 Total (must sum up
  to 100%)      

Table 10: Business Bank Details

Bank Name
Bank Account Number
Bank Account Name
Year bank account was opened

Business Information: Failure to provide detailed Business Information as

requested in the guidelines below (B1 to B6), may lead to non-consideration of
your application.

B1: Background:
Tell us about your enterprise. What you produce, production capacity, and current volume of
production, product lines, target market and size, profit projections, exports (if any) and
export destinations. (500 words or more)

B2: Challenges:
5
 www.gea.gov.gh

What challenges does your enterprise currently face? Is the challenge historical or just
surfaced because of the pandemic? Is it an existing challenge but worsened by the pandemic?
How would you resolve the challenges identified? (500 words or more)

B3: Impact of COVID-19 on the business:

How did the pandemic negatively affect your business? What are your plans to fully recover
from the effects of the pandemic and enhance the growth of the company?
If your business was not affected negatively, kindly indicate areas where the business showed
resilience? How can GEA SME Grant Programme support your growth process and resilience?
(500 words or more)

B4: Grant Support and Expected Impact:

How will the COVID-19 Grant support help alleviate your challenges identified above? What
immediate results should the GEA expect when the business is supported with grant? How
would grant support impact or lead to job creation, increase in production, revenue, and
exports (if applicable)? (500 words or more)

B5: Risks and Mitigation

What are the key risks involved in operating your business? How has the pandemic worsened
the existing risks involved in operating your business?
What measures have you already put in place to mitigate operational risks identified? (500
words or more)

B6: Grant Request Justification

Explain why the GEA should support your business with grants linking your grant request
justification to the impact, (negative or positive/resilience) of COVID-19 on your business.
(500 words or more)

6
 www.gea.gov.gh

Performance Indicators

Both the negatively impacted as well as resilient, well-performing SMEs will be supported so
long as the applicant is shortlisted and passes the minimum selection criteria. We therefore
expect that applicants will present accurate business performance information and data in
response to this application form.

*Table 11: Did your business export in any of the following years?
Year Yes No
2019 [√ ]  [ ] 
2020 [√ ]  [ ] 
2021 [√ ]  [ ] 

*Table 12: Historical Performance Indicators

Indicator 2019 2020 2021
C. Sales/Turnover (GHS)
D. Employee size disaggregated by Full-time male: 2 Full-time male: 2 Full-time male: 4
Gender at December 31st Full-time female: Full-time female: Full-time
2 2 female:2
Part-time male: 2 Part-time male: 2 Part-time male: 4
Part-time female: Part-time female: Part-time female:
2 2 2
Total employees: Total employees: Total employees:
8 8 12
E. Age Disaggregation of Less than 18 Less than 18 Less than 18
Employees: (Please State the years: 0 years: 0 years: 0
number of employees from the 18 – 35: 7 18 – 35: 7 18 – 35: 10
above total that fall within the 36 – 45: 1 36 – 45: 1 36 – 45: 2
following age categories?) 46 years and 46 years and 46 years and
above: 0 above: 0 above: 0
Total employees: Total employees: Total employees:
8 8 12
F. Exports1 (GHS) 25,000.00 57,000.00 85,000.00

1
Enter zero if you did not export.
7
 www.gea.gov.gh

Table 12.1: Domestic and Exports data: complete this table if applicable
Domestic Market Indirect Exports (%) Direct Total (%)
(%) (sold domestically to a Exports (%)
third party that
exports)
2019
2020
2021

*Has your business been negatively impacted by COVID-19? Yes [√ ] No [ ]

If you answered yes to above question, what challenges due to the coronavirus/COVID-19
outbreak and related restrictions did you face? [select all that apply] 

[ ] Temporary production shut-down due to government-mandated closures.

[ ] Loss in demand
[ ] Difficulties in accessing suppliers due to mobility restrictions imposed by government
[√] Reduction in the availability and/or price increases for the main inputs
[ ] Worker absenteeism arising from mobility restrictions imposed by the government
[ ] Worker absenteeism arising from other reasons
[ ] Managers or executive personnel absenteeism arising from mobility restrictions imposed by the
government
[ ] Managers or executive personnel absenteeism arising from other reasons
[√] Securing access to finance (e.g. banks are closed or operate at restricted capacity)
[ ] Depreciation of productive capital due to inactivity
[ ] Difficulties in accessing customers due to mobility restrictions imposed by government
[ ] Other, please specify in box below:
[ ] No particular challenge, things have proceeded as normal

Skip this portion if you answered yes to the question about negative COVID
impacts.

Has your business performance improved because of the COVID-19 pandemic? Yes [√]
No [ ]
If you answered yes to the above question, which of the following might have caused
your company’s improved performance?
Introduction of new products/services [ √ ] Transition to digital/virtual work [√ ]
Improvement in skillset of staff [√ ] Improvements in productivity [√ ]
Other reasons (please specify in box below)

8
 www.gea.gov.gh

PRODUCTION OF COVID-19 PPEs

How did any of the above listed innovations translate to improved sales and profitability?
Please explain in box below:

Financing

In 2020, did your company try/apply to raise capital on the formal credit market (eg. Bank
loan) or informally (eg. loans from friends and family, drawing down from savings)?

Formal only [ ] Informal only [ ] Both [√] I did not apply to raise any capital [ ]

Was the company successful in raising the capital it applied for?

[ ] Yes, it raised all that it applied for
[√] No, it was not successful at all
[ ] It raised half (50%) or more
[ ] It raised less than half (50%)

Is the business currently servicing any credit facility (eg loan, overdraft, letter of credit etc)?
Yes [ ] No [√ ]

If yes to above question, kindly indicate if you have defaulted in servicing the credit facilities.
Yes [ ] No [√ ]

Grant Request

*Requested Grant Amount (GHS)

(Grant Amount requested should be same as total expected expenditure in table 9

below).

What is the proposed or expected use of the grants? Enter in Table 9 below.

*Table 13: Expected Grants Expenditure:

No. Item Quantity Unit Cost Amount
(GHS) (GHS)
INDUSTRIAL SEWING MACHINE 50 3,000.00 150,000.00
INDUSTRIAL KNITTING MACHINE 10 3,400.00 34,000.00
INDUSTRIAL CUTTER 5 3,000.00 15,000.00
9
 www.gea.gov.gh

Total Expected Expenditure 199,000.00

NB: For all proposed capital expenditure items exceeding GHS5,000 such as machinery and
equipment, applicants MUST submit/upload THREE (3) proforma invoices from separate
vendors.
Where applicant is procuring raw materials, at least ONE proforma invoice must be
submitted to support the Expected Grant Expenditure captured in Table 13.

Has your business benefited from any grant program?

Yes [ ] No [ ]

If ‘Yes’, state name of the Grant Awarding Organization, amount received and year when the
grant was received

Expected Results of Grants Support

How will grant support affect your performance indicators:

*Table 14: Expected Grants Results/Impacts

Performance Pre-grant Post-grant In this column, please
Indicators support (that support explain how grant support
is, current (expected will translate into the
state) incremental expected incremental
changes) changes
Sales/Turnover 212,405.00 400,000.00
Employee size (full- 12 20
time plus any part-
time/casual only)
Exports (if applicable) 85,000.00 300,000.00
Others (include here
and insert as many
rows as needed any
additional measurable
indicators that grant
support would directly
impact incrementally.

Technical Assistance Needs

*Do you need Business Development Services? Yes [ ] No [√]

10
 www.gea.gov.gh

In which of the underlisted areas do you need business development training or advice?
(Please select maximum of 3)

Records and Bookkeeping [ ] Business Management [ ] E-Commerce [ √ ] Costing and Pricing

[ ] Raising Money for Business [ ] Budgeting [ ] Website Development [ ] Product
Development [ ]
Social Media Marketing [ ] Business Strategy Development [√ ] Other [ ]

*How Did You Hear About The COVID-19 Response Grants? (Select all that applies)

TV [ ] Radio [ ] Family [ ] BACs/BRCs [ ] Internet [ ] Trade Association [ ]

Friends [ ] Employees [ ] Customers [ ] Competitors [ ] Suppliers [ ] Other [ ]

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge.
I understand that any false or misleading information, documents or submissions in my
application may result in criminal prosecution for fraud.
I understand that by submitting this application I expressly give the Ghana Enterprises Agency
(GEA) permission to:
- Request my financial records from the commercial banks and the Credit Reference
Bureau.
- Validate and verify my identity documents with the specified issuing agency.
- Validate and verify my company registration details with the Registrar General’s
Department of Ghana.
- Validate and verify my business and personal Tax Identification Number (TIN) with the
Ghana Revenue Authority (GRA)
- Validate and verify my Environmental Permit with Environmental Protection Agency
(EPA) Validate and verify my mobile money records with the operator of my mobile
money account.
- Validate and verify my business and personal address.
- Contact me at any time during and after the processing of this application using the
information I have submitted in this application.

Should this grant application/request be approved, I agree:

A) To apply any grant funding received expressly for the approved purpose
B) To refund in full, and on demand, any grant funding received, if, my company/firm is
found to have provided misleading information, whether deliberate or accidental,
on this application.
11
 www.gea.gov.gh

C) To provide, throughout the grant period, progress updates on the use of the grant
funds and the delivery of the purpose of the grant to GEA in the manner and frequency
as GEA may direct.

*I hereby declare that I understand the contents of this document before submitting.
[ ] CONFIRM Date
:
N/B (Where Grant Applicant cannot read or
write):

I of
(address) hereby declare that I have read over the contents of this document to the Applicant
in (language) and s(he) appear to understand same before submitting.

[ ] CONFIRM

CONSENT TO DATA USAGE AND SHARING

I hereby give my consent that data associated with my application be collected for monitoring
and evaluation purposes and that my data may be shared with evaluation partners (example,
the GETP, World Bank research team).

*Table 15: Details of Authorized Representative or Business Owner

FULL NAME OF AUTHORIZED
REPRESENTATIVE
TEL. NO.
EMAIL ADDRESS
POSITION
DATE

12