Registration of Interest
Registering your interest is one way of ensuring we have your correct contact details so we can email you when updated details about the program are available.
Business Details
Have you applied previously for assistance from the NSW Rural Assistance Authority?
Yes
No
BP Number Update
Your BP number has changed and will now begin with the number 2.
(e.g. 2545678)
BP Number
7 characters left.
Numbers only, beginning with 2 (e.g. 2545678)
Type of Business
Please select...
Primary Producer
Small Business
Non-Profit Organisations
Sports and Recreation Clubs
Individual
Business Name
255 characters left.
FORMULA BUSINESS NAME
Click here
for the ABN Lookup.
ABN
Include spaces, e.g: 12 312 312 312
Industry
Contact Details
First Name
50 characters left.
Last Name
50 characters left.
Primary
Phone
Landline: +61298721111 / Mobile: +61417000000
Mobile
Mobile: +61417000000
Email Address
255 characters left.
Confirm Email Address
Email Confirm Msg
BOX HIDER
Property Address
Primary property location.
Street
50 characters left.
City
50 characters left.
State
Please select...
NSW
ACT
NT
QLD
SA
TAS
VIC
WA
Country
Please select...
Australia
Postcode / Local Government Area
as per rates notice
Your Situation
How were you impacted by the Storms and Floods (please select one)?
Please select...
Fencing
Loss of livestock
Pasture damage or silage
Infrastructure damage ie: sheds and equipment
Infrastructure Aquaculture
House
Loss of income
Damage to roads
All of the above
Other (please describe in Additional Comment box)
Additional comments on how you have been impacted
What kind of assistance are you interested in?
Please select...
Disaster Assistance Loans
Disaster Assistance Grants
Transport Subsidies
Referral to the Rural Financial Counselling Service
Technical advice through Local Land Services or industry group
All of the above
What is the size of your property?
Less than 10 ha
10-40 ha
41-100 ha
100-400 ha
400+ ha
What are you interested in hearing about?
Option 1 - RAA Newsletter
Option 2 - Drought Updates
Would you like a follow-up contact by a recovery officer regarding your situation?
Yes
No
When would you like to be contacted?
Tomorrow
In 3 days
In 5 days
In a week
Would you like to receive updates, alerts and notifications from the NSW Rural Assistance Authority about other potential assistance and support that could be relevant to you?
Yes
No
The information in this form is provided by you voluntarily and is being collected by the Department/Authority for purposes related to the administration of assistance under which you have indicated interest, including the assessment of applicability and the effectiveness of the scheme. This may involve disclosing the information in this form to contractors engaged by the Department/Authority or to either State or Commonwealth government agencies.
I Agree
Agent Comments
Any additional comments you may have about the individual's situation.