Drought Infrastructure Fund (DIF)

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Section 1 of 6

You will be required to upload a number of documents during this application. Please ensure you have a digital copy of the following documents:

Council rates noticeFarm Business and Risk Assessment Plan (a template is available on the Drought Infrastructure Fund webpage.)Monthly cash flow budget for the next 12 months (a template is available on the Drought Infrastructure Fund webpage.)Signed Mortgagee Consent Form (a template is available on the Drought Infrastructure Fund webpage.)Trust deed (if trust applying)Last three years’ tax returns and financial statements for your farm enterpriseLast three years' individual taxation returns for members of a partnership/family trust and individual directors/shareholders of all companies

I/We have read and understand the program guidelines found on the Drought Infrastructure Fund webpage.

YesNo

You must read the program guidelines before applying for this program.

Do you receive the majority (>50%) of your gross income from primary production under normal seasonal circumstances OR meet industry concessions in section 8.1.d in the program guidelines found on the Drought Infrastructure Fund webpage.

YesNo

Unfortunately you are not eligible for this program.

I have not commenced the proposed works associated with this application and will not commence these works until after the application has been submitted.

YesNo

Unfortunately you are not eligible for this program.

I do not have gross off-farm assets exceeding $5 million, excluding funds in a registered super fund.

YesNo

Unfortunately you are not eligible for this program.

Do you foresee any change to your financial position in the next 12 months? (e.g., retirement, sale of business). If yes, please describe.

YesNo

Please provide details

You are about to make an application for assistance from the NSW Government. Your application will be reviewed by our trained assessors. Applications are not auto-approved. Making false or misleading statements may be a criminal offence leading to penalties as well as causing delays in making payments to applicants who are in genuine need.

I understand and wish to continue with this application

Section 1 of 6

Application detail

Who is completing this application?

ApplicantRural financial counsellorAccountantFamily/FriendOther

Please specify other

Details of person completing this form

Organisation name

First name

Last name

Phone

Landline: +61298721111 / Mobile: +61417000000

Mobile

Mobile: +61417000000

Please note the RAA may seek permission from the applicant to discuss this application with you.

Section 1 of 6

AutoResponder Email

Borrowing entity

Have you previously applied for assistance from the NSW Rural Assistance Authority?

YesNo

BP number (if known)

Numbers only, beginning with 2 (e.g. 2345678)

Entity name

ABN

Include spaces, e.g: 12 312 312 312

Select the borrowing entity type

PartnershipCompanyTrustSole trader

Postal address

Address

Start typing to search for your postal address

I can't find my postal address

complexUnitIdentifier	complexUnitType
formattedAddress	Street Number
Street Name	streetType
lgaPid	lgaName
geoLatitude	geoLongitude
postalDeliveryNumber	postalFullStreet
postalCity	postalState
postalPostCode

Is the postal address a PO Box?

YesNo

Street

PO Box number

Number only

City

Postcode

State

Primary contact

First name

Middle name(s)

Last name

Date of birth

DD/MM/YYYY

Primary phone

Landline: +61298721111 / Mobile: +61417000000

Mobile

Mobile: +61417000000

Email address

Confirm email address

EMAIL CONFIRM MSG

Section 1 of 6

Partnership details

Please provide details of all partners. Up to six can be added by clicking on Add another partner

Full name

Date of birth

DD/MM/YYYY

Email address

Primary phone

Landline: +61298721111 / Mobile: +61417000000

No. of dependents

Section 1 of 6

Company details

Please provide details of all directors. Up to six can be added by clicking on Add another Director/Secretary/Shareholder

Relationship to Business

DirectorSecretaryShareholder

Full name

Date of birth

DD/MM/YYYY

Email address

Primary phone

Landline: +61298721111 / Mobile: +61417000000

No. of dependents

Is this person an authorised signatory?

YesNo

Section 1 of 6

Trust details

Please provide details of all trustees. Up to six can be added by clicking on Add another trustee

Please Select

IndividualCompany/Trust

Organisation name

ABN

Include spaces, e.g: 12 312 312 312

Full name

Date of birth

DD/MM/YYYY

Email address

Primary phone

Landline: +61298721111 / Mobile: +61417000000

No. of dependents

Upload trust deed

Section 2 of 6

A maximum of three properties can be added into this application. To add more properties to your application, please contact the Rural Assistance Authority by emailing rural.assist@raa.nsw.gov.au or phoning 1800 678 593. You can continue and submit your application before contacting the RAA.

Primary property details

The property where work is to be carried out

Property name

Address (NSW only)

Start typing to search

I can't find my property address

complexUnitIdentifier	complexUnitType
formattedAddress	postalCode
streetNumber	streetName
streetType	addressId
lgaPid	geoLatitude
geoLongitude	postalDeliveryNumber
postalDeliveryType	pointfullStreet
pointcity	pointstateProvince

Street	City
State	Postcode / Local Government Area as per rates notice

What best describes the nature of your business on this property?

Start typing (e.g. Beef, Dairy) to see options

PRIMARY INDUSTRY

RAA CODE ID

Area of property (ha)

hectares (no decimal numbers)

Title reference(s)

Can be found on the Rates Notice

Primary property occupier type

Property ownerLessee

Upload council rates notice(s)

Upload copy of current council rates notice(s)

Please ensure file sizes are 2.5MB or less

Total asset value

exclude value of W.A.L

Property owner details

First name

Last name

Primary phone

Landline: +61298721111 / Mobile: +61417000000

Lease agreement

Please upload a lease agreement for the property where you are lessee.

Upload lease agreement

Please ensure file sizes are 2.5MB or less

Is the primary property to be used as security?

YesNo

Please note, RAA cannot take security over property held in a Self-Managed Super Fund (SMSF)

Primary Property must be set as Security or click Yes below to add alternate Security details

warning1 hidden empty field set as required and with condition- prevent submit until corrected

Security questions

Is there a mortgage on this property?

YesNo

Deed held by?

Borrowers / applicantsSolicitorBank

Please add the details of these stakeholders on the following Stakeholders page.

Bank or 3rd party financier details

Organisation name

Contact first name

Contact last name

Contact number

Contact email

Upload mortgagee consent form

Please download the mortgagee consent form found on the Drought Infrastructure Fund webpage and have your bank complete and return via email.

Add another financier for primary property

YesNo

Bank or 3rd party financier details 2

Organisation name

Contact first name

Contact last name

Contact number

Contact email

Upload mortgagee consent form

Please download the mortgagee consent form found on the Drought Infrastructure Fund webpage and have your bank complete and return via email.

Add an additional property holding or security?

YesNo

Add an additional property holding or security?

YesNo

Property 2 details

Is this property to be used as security?

YesNo

Please note, RAA cannot take security over property held in a Self-Managed Super Fund (SMSF)

Property 1 or Property 2 must be set as the Security to submit this application

warning2 hidden empty field set as required and with condition- prevent submit until corrected

Property name

Address (NSW only)

Start typing to search

I can't find my property address

complexUnitIdentifier	complexUnitType
formattedAddress	postalCode
streetNumber	streetName
streetType	addressId
lgaPid	geoLatitude
geoLongitude	postalDeliveryNumber
postalDeliveryType	pointfullStreet
pointcity	pointstateProvince

Street	City
State	Postcode / Local Government Area as per rates notice

What best describes the nature of your business on this property?

Start typing (e.g. Beef, Dairy) to see options

RAA CODE 2

PRIMARY2

Area of property (ha)

hectares (no decimal numbers)

Title reference(s)

Property occupier type

Property ownerLessee

Upload council rates notice(s)

Upload copy of current council rates notice(s)

Please ensure file sizes are 2.5MB or less

Total asset value

exclude value of W.A.L

Property owner details

First name

Last name

Primary phone

Landline: +61298721111 / Mobile: +61417000000

Lease agreement

Please upload a lease agreement for the property where you are lessee.

Upload lease agreement

Please ensure file sizes are 2.5MB or less

Security questions

Is there a mortgage on this property?

YesNo

Deed held by?

Borrowers / applicantsSolicitorBank

Please add the details of these stakeholders on the following Stakeholders page.

Bank or 3rd Party Financier details

Organisation name

Contact first name

Contact last name

Contact number

Contact email

Upload mortgagee consent form

Please download the mortgagee consent form found on the Drought Infrastructure Fund webpage and have your bank complete and return via email.

Add another financier for property 2

YesNo

Bank or 3rd party financier details 2

Organisation name

Contact first name

Contact last name

Contact number

Contact email

Upload mortgagee consent form

Please download the mortgagee consent form found on the Drought Infrastructure Fund webpage and have your bank complete and return via email.

Add an additional property holding?

YesNo

Property 3 details

Property name

Address (NSW only)

Start typing to search

I can't find my property address

complexUnitIdentifier	complexUnitType
formattedAddress	postalCode
streetNumber	streetName
streetType	addressId
lgaPid	geoLatitude
geoLongitude	postalDeliveryNumber
postalDeliveryType	pointfullStreet
pointcity	pointstateProvince

Street	City
State	Postcode / Local Government Area as per rates notice

What best describes the nature of your business on this property? *

Start typing (e.g. Beef, Dairy) to see options

RAA CODE3

PRIMARY3

Area of property (ha)

hectares (no decimal numbers)

Title reference(s)

Occupier type

Property ownerLessee

Upload council rates notice(s)

Upload copy of current council rates notice(s)

Please ensure file sizes are 2.5MB or less

Total asset value

exclude value of W.A.L

Property owner details

First name

Last name

Primary phone

Landline: +61298721111 / Mobile: +61417000000

Lease agreement

Please upload a lease agreement for the property where you are lessee.

Upload lease agreement

Please ensure file sizes are 2.5MB or less

Section 2 of 6

Stakeholders

Please provide details of key stakeholders for this application if not entered previously or click checkbox if there are no additional stakeholders

No stakeholders to add

Up to four stakeholders can be added by clicking on Add another stakeholder

AccountantAdvisorOther bank / FinancierSolicitorRural financial counsellor

Organisation name

First name

Last name

Phone

Landline: +61298721111 / Mobile: +61417000000

Mobile

Mobile: +61417000000

Does the applicant give permission for RAA to contact this stakeholder to obtain information regarding this application?

YesNo

Section 3 of 6

Loan purpose

Please select the eligible purpose type/s and the amount you expect to spend on each.

Type

Expected amount

How much do you require for the selected resource type?

Loan terms

Preferred loan term (years)

Maximum 20 years

Please outline your preferred repayment terms

MonthlyQuarterlyHalf YearlyAnnual

Monthly

Please specify the months you wish to make repayments

Jan, Apr, Jul, OctFeb, May, Aug, NovMar, Jun, Sep, Dec

Please specify the months you wish to make repayments

Jan, JulFeb, AugMar, SepApr, OctMay, NovJun, Dec

Please specify the month you wish to make repayments

JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

Total estimated cost of works (ex GST)

Full details of the proposed works

How will the work complement your Farm Business and Risk Assessment Plan and ensure the long term productivity and profitability of the farming business?

Amount of loan required

Use of Resources Total must be more than $50,000 and not exceed $1,000,000

Section 4 of 6

Liabilities

Liabilities for all associated individuals should be added to this section. To add additional liabilities please select 'Add additional liabilities'.

Facility type

Limit

Lender

Interest rate

Is this rate fixed or variable?

FixedVariable

Balance owing

Repayment frequency

Repayment amount

Is your commitment interest only?

YesNo

Section 4 of 6

Assets and financial position

What is your average financial turnover (gross) per financial year

$0 - $100,000$100,001 - $250,000$250,001 - $500,000$500,001 - $1,000,000$1,000,001 - $3,000,000$3,000,001 +

Total water access licence(s) held

Total off-farm assets

Total other real estate

Total livestock and commodities value

Total plant, machinery, and motor vehicles

Total cash at bank/farm management deposits

Total share portfolio held/co-operative shares

Total superannuation

Did you want to add an additional (other) asset

YesNo

Other (describe)

Other amount

Did you want to add an additional (other) asset

YesNo

Other (describe)

Other amount

Have you ever been bankrupt, assigned a liquidator, or are there any unsatisfactory judgements against you in any court?

YesNo

Details

Section 4 of 6

Payment details

Please provide the bank account details that you wish to receive payments to if your application is approved.

Account holder name

Bank/credit union name

BSB number

Account number

Upload front page of bank statement

I/we agree to have payment for future goods and services supplied to the Department of Industry and Investment credited into the account above in accordance with creditor terms.

Yes

Section 5 of 6

Upload tax return and financial statements

Please upload:

Last three years' balance sheets and financial statements of your farm business (these include profit and loss statements, stock trading account and depreciation schedules).

Note: Tax Assessment Notices are not acceptable

Last three years' individual taxation returns and a current listing of all assets and liabilities held by each:

Individual member of a partnership/family trust
Individual director/shareholder of all companies

Note: In each of the above, each director/shareholder, etc. is to provide details including the source of income, if they are not primarily dependent on the business for their livelihood.

Please black out, hide or remove any Tax File Numbers from these documents.

Upload tax return and financial statements

Please ensure file sizes are 2.5MB or less

Upload cash flow statement and monthly general expenses

If you do not have one, download the template found on the Drought Infrastructure Fund webpage.

Upload farm business and risk assessment plan

Upload Farm Business and Risk Assessment Plan

If you do not have one, download the template found on the Drought Infrastructure Fund webpage.

Supporting documentation

Please upload any other relevant documentation/information

Do you want to provide any supporting documentation?

YesNo

Please do not upload any tax invoices here – an assessment officer will advise you of how and when to submit your tax invoices after your application has been assessed.

Supporting documentation

Additional comments

Any comments about your application you would like the Assessment Officer to know

Section 6 of 6

General Statement *

Not providing the information requested in this application or providing false or misleading or incomplete information may impact on the ability of the Authority to accurately assess your application. Failure to provide such information may result in the Authority refusing your application.

Any person who knowingly and with intent to defraud the Authority or another person, files an application for assistance containing any materially false information or conceals for the purpose of misleading information concerning any fact material thereto, commits a fraudulent act, which is a crime under the Crimes Act 1900 and subjects the person to criminal penalties.

Privacy Collection Notice *

The information in this application is provided voluntarily and is being collected by the NSW Rural Assistance Authority (‘the Authority) for purposes related to the administration of the scheme of assistance under which you have applied, including the assessment of the effectiveness of the scheme. This may involve disclosing the information in this application to a third party engaged by the Authority or to either State or Commonwealth government agencies. The Authority will supply you with details of those parties that the Authority has disclosed information to if you apply to the Authority in writing. Information regarding this application may also be discussed and exchanged by the Authority with the authorised nominated contact persons listed by you as part of your application.

The Authority agrees to take all reasonable measures to ensure that the personal information collected by the Authority is stored securely.

You may access or correct your personal information by contacting the Authority by telephone on 1800 678 593 (toll free) or by writing to: Manager Administration, NSW Rural Assistance Authority, Locked Bag 23, ORANGE, NSW, 2800. Calls to "1800" numbers from your home phone are free. Calls from public phones and mobiles may be timed and attract charges.

Your Statement *

I understand and declare that:

1. I have read, understood and will comply with the scheme guidelines.

2. The information I have provided in this application is true and correct.

3. If I am applying on behalf of a partnership, trust or corporation, I have the authority to make this application on its behalf.

4. The applicant of this application meets the eligibility criteria for an eligible business in accordance with the scheme guidelines.

5. I will be required to repay any overpayment or any misappropriate payment (not paid in accordance with the scheme) that I receive from the Authority as a result of my application.

6. I may be required to provide to the Authority my personal tax returns in addition to financial information for all business entities with which I have a formal interest including companies, partnerships, trusts and self-managed super funds.

7. The invoices claimed under this application have not been recovered through insurance or used to secure any other government funding and I have not been reimbursed for these invoices in the past.

8. I authorise the Authority to discuss this application with relevant private/public authorities, financial lending institutions and accountants, including my nominated financial counsellor/advisor and my nominated contact person. If required, I will provide documents from the relevant authority, including any third-party authorities to permit the Authority to do this.

9. The Authority may share information provided in this application with other NSW or Commonwealth Government agencies for the purpose of coordinating the administration and assessment of related Government programs.

10. The Authority may use and provide the information from this application to a third party engaged by the Authority for the purposes of assessing the effectiveness of the scheme.

11. Any assistance received under this scheme will be applied in accordance with the scheme guidelines and the Authority may conduct an audit or inspection, or seek verification through official third parties as needed.

12. The Authority can make relevant enquiries to ensure I receive my correct entitlement.

13. I will seek independent financial advice to understand the taxation implications of assistance granted to me, if needed.

14. Statistics will be collected and analysed in such a way as to protect my anonymity.

15. I agree to provide feedback in relation to this scheme.

16. I have obtained/will obtain all required work approvals and permits prior to commencing work, and I understand the need for any development to be ecologically sustainable, in accordance with the Rural Assistance Act 1989 (NSW). If requested, I will provide evidence of these approvals and permits to the Authority.

Do you agree to the Terms and Conditions?

I agree

I/We consent to you providing my details to the local Rural Financial Counselling Service (RFCS) or recovery services offered by the Commonwealth or NSW Governments who may contact me to arrange an appointment

YesNo

Thank you for completing the Drought Infrastructure Fund Loan Application.

Please check "I agree" in order to submit your application.

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