NLCE Application Form

Please note membership to North Lincolnshire Community Energy (NLCE) is currently only open to local people. Please do not complete this form unless you have contacted NLCE beforehand.

North Lincolnshire Community Energy (NLCE) Application

IMPORTANT
Before completing this Application Form you must:

Read the accompanying Share Offer of North Lincolnshire Community Energy Limited (the “Offer Document”)
Pay special attention to the community, environmental, educational and social objectives described in the offer document;
Pay special attention to the Risk Factors set out on pages 8 and 9 of the Offer Document
Consider whether you need to take financial advice or other advice in relation to the Terms and of Conditions the offer contained in the offer document; and
Read the Rules

Download the Offer Document here

"*" indicates required fields

North Lincolnshire Community Energy Limited - Registration number RS8805

Amount To Invest*

I apply to become a member of and wish to invest the total amount shown below in North Lincolnshire Community Energy Limited on the Terms and Conditions of the Offer Document dated 3 December 2024 at the price of £1.00 per Share. You must invest at least £50 but not more than £100,000.

Please enter the figure without a pound sign.

Please enter a number from 50 to 100000.

Applicant Details

Name*

Prefix First Last

Address*

Street Address Address Line 2 City County Postcode Country

Date Of Birth*

Day

Month

Year

Email Address*

Enter Email Confirm Email

Main phone number*

Alternative phone number

Mobile or evening number (optional)

Application Type*

Are you applying just for yourself, or as a nominee for a child

Self Only

Nominee for a child

If Applicant is nominee for a child

Child's Forenames*

Child's Surname*

Child's Date Of Birth*

Day

Month

Year

Child's Address

Enter the child's address if different from that given above

Child's address line 2

Child's Town

Child's County

Child's Post Code

Payment Details

Payment Type*

If paying by electronic transfer through the banking system please pay into North Lincolnshire Community Energy Limited's bank account quoting your surname and date of birth as a reference.

Account details: account number 67244906, Sort Code 08-92-99.

I have paid by bank electronic transfer or BACS to 'North Lincolnshire Community Energy Ltd'

I will send a cheque or bankers draft crossed A/c Payee to the value indicated above, payable to 'North Lincolnshire Community Energy Ltd'.

I understand that the cheque supporting this application will be presented for payment following receipt and I warrant that it will be paid on first presentation. I have written my name and address on the back of the cheque

Payment Date

(for electronic BACS payments only)

DD slash MM slash YYYY

Annual Share Interest Payments

North Lincolnshire Community Energy Society Limited will pay share interest by electronic transfer via BACS. In order to receive your share interest please provide the following details:

Bank Account Number*

Bank Sort Code*

Name on account*

We would be grateful if you would inform us how you first heard of this Share Offer:

Energy4All Ltd

Social Media

Word of Mouth

Local Press

Leaflet/Poster

North Lincolnshire Council

Other (please specify)

To help reduce paper costs (and CO2 emissions), North Lincolnshire Community Energy Society and Energy4All would like to send you notices and information by email and refer you (by email) to documents posted on the North Lincolnshire Community and Energy4All websites. By submitting this form you are consenting to receiving such notices by email and accessing documents through the websites.

Opt-in to Energy4All Limited

If you would like North Lincolnshire Community Energy to share your contact details with Energy4All in order to receive information from them about its work, investment opportunities, projects and Energy4All’s Newsletter, please tick the box below. You can stop receiving marketing information from Energy4All at any time by emailing info@energy4all.co.uk. Full details of Energy4All's privacy policy can be read here.

Opt-in to Energy4All Limited

Declaration*

I confirm that:

1. I have read the Offer Document, including the Social, Community and Environmental Benefits, Risk Factors and the Guidance Notes to this Application Form;

2. I support the aims and objectives of North Lincolnshire Community Energy as set out in the Offer Document;

3. I am over 18 and the Applicant meets the Offer eligibility criteria;

4. North Lincolnshire Community Energy is hereby authorised to make such enquiries as are deemed necessary to confirm the eligibility of this Application;

5. the Applicant is not making an application or multiple applications for a total of more than 100,000 Shares in total;

6. the Applicant is not relying on any information or representation in relation to the Shares, North Lincolnshire Community Energy or the Site which is not included in the Offer Document;

7. the Applicant shall provide all additional information and documentation requested by North Lincolnshire Community Energy in connection with this Application, including in connection with anti-money-laundering, taxation or other regulations applicable to North Lincolnshire Community Energy; and North Lincolnshire Community Energy with the assistance of Energy4All will perform identity checks on applicants using a secure third-party provider as part of their anti-money laundering, prevention of fraud and customer due diligence checks.

8. if submitting this Application on behalf of any person/organisation I am doing so with express authority.

Tick to agree to the above statements