Emergency Water Infrastructure Online Form

RAA Emergency Water Infrastructure Rebate Form

RAA Emergency Water Infrastructure Rebate Form

Please download and complete the Water Availability Statement template and attach in the below fieldWater Availability Template Link




Please provide your 6 digit BP number, if available



Applicant Details




DD/MM/YYYY




A Trust is not an eligible borrowing entity

Applicant Details








A Trust is not an eligible borrowing entity
Property Address






per rates notice

Postal Address





Property requiring Water Infrastructure







per rates notice
Details of Water Infrastructure to be established on the property



Bank Details




  

Please ensure file sizes are 2.5MB or less

Please ensure file sizes are 2.5MB or less
Upload Tax Invoices

Please ensure file sizes are 2.5MB or less
Upload Tax Return
Most recent Tax Returns 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
  
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/We understand that:
  1. Deliberately giving false or misleading information is a serious offence.
  2. The NSW Rural Assistance Authority can make relevant enquiries to ensure I receive my correct entitlement.
  3. Any overpayment will be recovered.
  4. Personal information is protected and can be given to someone else where state/territory or Commonwealth legislation requires or where I give permission.
  5. Statistics may be collected and analysed in such a way as to protect my anonymity.
  6. Any assistance I/we receive under this Rebate is to be applied in accordance with the Emergency Water Infrastructure Rebate Scheme Guidelines.
  7. The NSW Rural Assistance Authority may conduct an audit/inspection to ensure that any assistance I/we receive under this Rebate has been used in compliance with the Emergency Water Infrastructure Scheme Guidelines and not for any other purpose.
  8. Prior to applying for this assistance I sought independent financial advice and the taxation implications of any assistance granted has been explained to me.
I/We:
  1. Agree to provide feedback in relation to this Scheme.

   
Thank you for completing the Emergency Water Infrastructure Rebate Application
Please check "I agree" in order to submit your application