Native Title Officer Funding Scheme
Application form—2016 funding round
This scheme is administered under the Native Title Officer Funding Scheme Guidelines (November 2015) (the
guidelines). This application form should be completed in accordance with the guidelines.
Applications must be submitted in full by 5pm EDST 11 December 2015. The department will not assess
incomplete applications. Applications will be deemed incomplete if:
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any relevant questions are not answered, or are only partially answered, and/or
the required supporting documentation is not provided.
For further information, or if you have any questions, please contact the Financial Assistance Section between
8:30am and 5:00pm EST, Monday to Friday on (02) 6141 4770 or 1800 117 995, or by email at
finass@ag.gov.au.
Section 1 - Applicant details
Name of organisation:
Primary contact person:
Position:
Telephone:
Fax:
Email:
Postal address:
Australian Business Number (ABN):
Name of native title officer (if known):
Summary of native title officer’s experience (if applicable):
Section 2 – Funding Proposal
Please refer to paragraph 4 of the guidelines when completing this section.
1. Please provide the amount of funding requested for the grant period ending 31 December 2016 (please
include details of salary, and number of days per week and weeks per year it is proposed the native title
officer will work).
2. What sector does your organisation represent, and are you a peak industry body?
3. Please outline the scope of the proposed work.
4. Please outline the nature of the interests and the rights of the respondents that the native title officer will
be assisting.
5. Please outline how the native title officer position will achieve value for money (including the number of
respondents likely to benefit and the number and scope of current native title claims the respondents are
actively involved in).
6. Please provide evidence of your organisation’s ability to match the department’s investment, noting the
requirement that native title officer grants must be matched on at least a dollar-for-dollar basis.
7. Has your organisation previously received funding for a native title officer?
8. Please provide evidence of your organisation’s ability to undertake the proposed activity and manage the
funding
9. What are the key performance indicators of the native title officer position?
Section 3 - Evaluation
10. How will you evaluate the success of the native title officer position?
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Section 4 - Supporting documents
Please ensure you attach the below documents to support your application:
General documents
Duty statement for the proposed native title officer position (there is an example duty statement on
the department’s website).
Documents to evidence your organisation’s ability to match Commonwealth funding.
For example, evidence of the proposed native title officer’s annual salary or work arrangements.
Financial documents
Most recent annual financial statement (if exceptional circumstances apply) setting out annual income
from all sources, total value of all assets and total balance of all savings/shares
Section 5 - Declaration and additional information
Declaration
I,
declare that I am duly authorised to make this application on behalf of the applicant organisation and that the
information provided in this application is true and correct to the best of my knowledge. I understand that any
omission or false statement may result in the rejection of this application.
Sign to accept the declaration: _________________________________________________________
Privacy
The Attorney-General’s Department is subject to the Privacy Act 1988 (Cth) which requires that we comply
with the Australian Privacy Principles (APPs) set out in the Act. Any information you provide to this
department will be treated in accordance with the APPs, which set out how Australian government agencies
should collect, use, store and disclose personal information and how individuals can access records
containing their personal information. Identifying information about recipients of NTO grants will be
published on the Department’s online grants register.
Sign to acknowledge: ________________________________________________________________
Freedom of information
Your completed application, as documents in the possession of this department, is subject to the operation of
the Freedom of Information Act 1982 (Cth) and could, subject to the provisions of that Act, be released
pursuant to a request made under it. However, there are various exemptions available under the Act,
including those that ensure that certain personal information or information relating to business affairs is not
unreasonably disclosed to the public.
Sign to acknowledge: ____________________________________________________________________
Dated:
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