RAA Natural Disaster Relief Grant Form

RAA Natural Disaster Relief and Recovery Grant

RAA Natural Disaster Relief and Recovery Grant

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Natural Disaster Event

Please select your type of business and declared event.




There are no registered declared events for Small Business Operators



There are no registered declared events for Primary Producers



There are no registered declared events for Sporting & Recreation Clubs



There are no registered declared events for Not for Profit Organisations

raa_home  About You  >  Assistance Required  >  Accountant Details  >  Supporting Documents  >  Declaration

>  About You
    Assistance Required
    Accountant Details
    Supporting Documents
    Declaration




Confirm Selected Event





If the correct event is not available, please exit this form and review the Declared Natural Disasters page on our website.


Numbers only






Include spaces, e.g: 12 312 312 312


A Trust is not an eligible borrowing type




e.g. Director, Manager, Partner, etc










Previous / Involvement Details







Parties and associated entities to the business
Note: If Trust, list trustee company/individual(s)




DD/MM/YYYY

Include spaces, e.g: 12 312 312 312
Key Contact Information



DD/MM/YYYY

Landline: +61298721111 / Mobile: +61417000000

Mobile: +61417000000



Contact Person Information



DD/MM/YYYY

Landline: +61298721111 / Mobile: +61417000000

Mobile: +61417000000


Property Address
Business Address
Sporting and Recreational Club Address
Not for Profit Organisation Address


Number only





as per rates notice




Postal Address


Number only





raa_home  About You  >  Assistance Required  >  Accountant Details  >  Supporting Documents  >  Declaration

✓  About You
>  Assistance Required
    Accountant Details
    Supporting Documents
    Declaration


Assistance Required













Insurance Details


Landline: +61298721111 / Mobile: +61417000000


raa_home  About You  >  Assistance Required  >  Accountant Details  >  Supporting Documents  >  Declaration

✓  About You
>  Assistance Required
    Accountant Details
    Supporting Documents
    Declaration


Bank Details




raa_home  About You  >  Assistance Required  >  Accountant Details  >  Supporting Documents  >  Declaration

✓  About You
✓  Assistance Required
>  Accountant Details
    Supporting Documents
    Declaration


Accountant's Details




Landline: +61298721111 / Mobile: +61417000000

Mobile: +61417000000

Rural Financial Counsellor's Details




Landline: +61298721111 / Mobile: +61417000000

Mobile: +61417000000

raa_home  About You  >  Assistance Required  >  Accountant Details  >  Supporting Documents  >  Declaration

✓  About You
✓  Assistance Required
✓  Accountant Details
>  Supporting Documents
    Declaration



Please ensure file sizes are 2.5MB or less

Please ensure file sizes are 2.5MB or less


from Australian Taxation Office or registration from Department of Fair Trading

Copy of rates notice, gas bill, electricity bill, phone bill, or lease agreement


Must include Profit and Loss Statements and Balance Sheet for your organisation

Can be supplied post assessment. No payments will be made on quotations
Upload Tax Return
Most recent Tax Returns & Financial Statements for your Farm Business
Include individual Taxation Returns and a current listing of all Assets and Liabilities held by each:

 Individual members of a Partnership/ Family Trust
 Individual Director(s)/Shareholder(s) of all Companies


Please ensure file sizes are 2.5MB or less

Please ensure file sizes are 2.5MB or less
Supporting Documentation
Please upload any other relevant documentation/information

raa_home  About You  >  Assistance Required  >  Accountant Details  >  Supporting Documents  >  Declaration

✓  About You
✓  Assistance Required
✓  Accountant Details
✓  Supporting Documents
>  Declaration


General Statement
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
The information in this application is provided voluntarily and is being collected by 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 contractors engaged by the Authority or to either State or Commonwealth government agencies. We will supply you with details of those that we have disclosed information to, if you apply to us in writing. Information regarding your application may also be discussed and exchanged with the nominated contact persons listed by you in your application.

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.

The NSW Rural Authority agrees to take all reasonable measures to ensure that the personal information collected by it 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 I 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 business meets the criteria for an eligible business for the scheme.
  5. When asked for financial information, I must provide my personal tax returns in addition to financial information for all business entities with which I have a formal interest including companies, partnerships and self-managed super funds.
  6. The invoices for this application have not been used to secure any other NSW government funding. (i.e. I have not been reimbursed for these invoices in the past).
  7. I will be required to repay any overpayment I receive.
  8. I authorise RAA to discuss this application with relevant private/public authorities, financial lending institutions and accountants, including my nominated financial counsellor/advisor. If required, I will provide documents from the relevant authority to permit the RAA to do this.
  9. Any assistance received under this scheme will be applied in accordance with the scheme guidelines and the RAA may conduct an audit or inspection to ensure I have complied.
  10. 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 No 97.
  11. I will provide feedback in relation to this scheme if requested.
  12. Any statistics collected and analysed will be done in such a way to protect my anonymity

   
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