CYBER SECURITY COOPERATION PROGRAM APPLICATION FOR FUNDING

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1 Section 1 - Project Information Project Title Proposed/Planned Project Start and End dates Section 2 - Applicant Identification Legal Name Operating Name (if different than above) Business or Registration Number (if applicable) Address City/Town Province/Territory Postal Code Telephone Number address Mailing address (if different than above) Section 3 - Organization Contact (if applicable) Given Name/Surname Position Title Telephone number address Section 4 - Project Description a) Project Stream (check one): Cyber Security Assessments Best Practices and Research Alternative Measures b) Funding Mechanism Grant Contribution c) Project Objectives 1

2 d) Project Activities e) Expected Results f) Knowledge Translation 2

3 g) Implementation Plan h) Safeguarding Information i) Risk Management 3

4 Section 5 Capacity Expertise Section 6 - Funding Source Name Funding In-kind ($ value) Section 7 Proposed Project Budget Include a detailed budget of the amount sought using the form below: Annex A, Project Budget must be attached, detailing expenditures and revenues by fiscal year (April 1 March 31). Please ensure you consult the Terms and Conditions for the Cyber Security Cooperation Program Grants and Contribution Program for eligible expenses. It is recommended you use the eligible expenses categories as much as possible when detailing your proposed budget in Annex A. Section 8 - Disclosure a) This proposal involves a prospective recipient who is subject to the Values and Ethics Code for the Public Service, the Conflict of Interest Act (S.C. 2006, c.9) or the Parliament of Canada Act (R.S. 1985, c.p-1.01): No Yes, details are attached. b) The proposal makes use of the services of a lobbyist, as defined by the Lobbying Act: No Yes, details are attached. 4

5 c) The proposal involves a departmental official or reviewer who may sit on an advisory committee or board for the proposal: No Yes, details are attached. Section 9 - Declaration Signature of Authorized Representative Dated: Submit to: By By mail: CSCP-PCCS@ps-sp.gc.ca CSCP c/o National Cyber Security Directorate Public Safety Canada 340 Laurier Avenue West, 13 th Floor Ottawa, ON K1A 0P8 5

6 Cyber Security Cooperation Program Annex A - Project Budget For multi-year projects, please complete the information below for each year of the project, by fiscal year (April 1 - March 31). Revenues for Fiscal Year: - Government Funding (municipal, provincial, territorial and federal) Subtotal Cash 1 In-Kind Government Funding Subtotal In-Kind 2 A. Government Funding Percentage of eligible expenses for fiscal year Non-Government Funding and other Subtotal Cash In-Kind Non-Government Funding and other Subtotal In-kind B. Non-Government Funding Percentage of eligible expenses for fiscal year C. Government, Non-Government and In-Kind Revenues 1. Cash: actual dollar value of revenues received 2. In-Kind: non-cash input which is given a cash value 1

7 Cyber Security Cooperation Program Annex A - Project Budget Eligible Expenses for Fiscal Year: - DETAILED CASH ELIGIBLE EXPENSES Detailed Eligible Expenditures*, according to Program T&C Categories Public Safety Canada Funding Government Funding Non Government Funding and (e.g. conference fees, salaries, supplies, travel, etc.) Subtotal Cash 1 DETAILED IN-KIND ELIGIBLE EXPENSES Detailed Eligible In-Kind 2 Expenditures, according to Program T&C categories Public Safety Canada Funding Government Funding Non Government Funding and Subtotal In Kind DETAILED TOTAL CASH AND IN-KIND ELIGIBLE EXPENSES Detailed Eligible Expenditures, according to Program T&C Categories Public Safety Canada Funding Government Funding Non Government Funding and Cash and In-Kind 1. Cash: actual dollar value of revenues received 2. In-Kind: non-cash input which is given a cash value * Any eligible travel expenditures must be in accordance with the National Joint Council Travel Directive 2