Event Number
(LLS office use only)
Hunter Local Land Services Flood Recovery Grant Application Form – 2015-16
This form is to be used to apply for funding under any Hunter Local Land Services (LLS) Grants
Programs. Please refer to the Grants Program Guidelines for further information about the terms and conditions of
applying for LLS funding.
Funding for LLS Grants programs is provided from a variety of sources including the Australian
Government’s National Landcare Program, New South Wales Government’s Catchment Action NSW,
and Hunter Catchment Contributions.
1. PROGRAM DETAILS
 Hunter Flood Recovery Program
What LLS Grant Program are you
applying for funds through?
 Flood Readiness Program
Please refer to the Guidelines for each Program for
grant eligibility and identified priority areas.
 Torryburn Green Army Assistance Program
If you are eligible, only one program can be applied for
per application form.
Note: Your application may also be considered for funding under other LLS Programs.
2. APPLICANT AND PROPERTY DETAILS
Applicant (The name at the Applicant should
match the name of ABN holder if provided)
Contact Person
Mr/Mrs/Ms
Landowner(s) (if not applicant)
Mr/Mrs/Ms
Is the applicant an Aboriginal or Torres
Strait Islander individual or organisation?

Yes

No
Property Address (Project Location)
Suburb:
Applicant Postal Address
Suburb:
Postcode
Postcode
Contact Details
Telephone
Home:
Bus:
Mob:
E-mail
Project Location:
Lot/DP:
Property Identification Code (PIC):
LGA:
Area of proposed project (Ha)
Total Area of Property (Ha)
ABN and GST Status
HRXXX – Grant Application - Name
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Registered Business name:
Are you currently registered
for GST?

Yes

ABN:
No
Group membership
Are you affiliated with an Industry,
Landcare or community group

Yes

No
Group name: _____________________________________________
Property Planning
Do you have a current Property
Plan?

Yes

No
If no, would you be interested in undertaking training?
 Yes  No
3. PROJECT DESCRIPTION
Please provide a description of your project and the objectives you are aiming to achieve. Include
your production, environmental, cultural, and social objectives.
Project Description:
HRXXX – Grant Application - Name
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4. TECHNICAL ADVICE AND CONSULTATION
Please provide details of what advice you have sought or consultation you have undertaken in
developing your application.
5. RELEVANT LAND MANAGEMENT EXPERIENCE
Please provide an outline of your experience in land management, including details of any relevant
training or qualifications you have.
HRXXX – Grant Application - Name
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6. PROJECT PLAN
What are you proposing to achieve through
implementing the project (outcomes)?
Examples: re-establish native vegetation; improve
groundcover and pasture species composition, raise
community awareness
HRXXX – Small Grant Application - Name
What works or activities will you undertake?
Examples: Plant & establish 500 trees; 2km fencing to exclude stock from
stream; install 5 stock watering points, control 2ha of lantana & blackberry
Completion date?
(month & year)
(Implementation of projects must be
completed by 31 December 2016
according to project plan timeframes)
7. PROJECT BUDGET
Note: For estimate purposes landholders/community groups should cost their in-kind labour component at $30/hour.
LLS funding is provided exclusive of GST. Please see the LLS’s GST Fact Sheet for more advice on funding and the GST implications.
Proposed activity/work/action
Examples: Plant trees, erect electric fence
Unit of
Measure
Quantity
Unit Cost
(excl GST)
Total Item
Cost (Excl
GST)
LLS Funds
Sought
(Excl GST)
Own Cash
Contribution
(Excl GST)
TOTALS
NOTE: An excel version of the budget sheet is available from your Hunter LLS Contact Officer upon request.
HRXXX – Grant Application - Name
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Own
Labour
In-kind
@$30/hr
Total – funds
sought + in kind+
cash contribution
(Excl. GST)
GST
8. MONITORING, MAINTENANCE AND REPORTING
How will you monitor whether your project is achieving
the Outcomes?
(BOLD rows are mandatory)
Tick adopted
monitoring
techniques.
Frequency or due date
Photo-point monitoring
Before and after photos of works
Step Point transect for assessing groundcover
Event evaluation sheets
Attendance records
Pasture composition quadrats
Tree survival rates
Final Report
Grazing records/Plan
8. ABORIGINAL CULTURAL HERITAGE AND CONSULTATION
Checklist Questions
Yes
No
Yes
No
Do you know of any Aboriginal sites or objects on your property or in the immediate area?
Are you aware of any Aboriginal history, stories or significant events that took place on your property or in
the immediate area? If YES, please provide a brief description below.
Is your project area located near a river, stream, lake, wetlands or watercourse?
Does your project area contain any of the following landforms: rocky or sandy hills, mountains, claypans,
caves, sandstone overhangs?
Will there be any native vegetation removed permanently?
Are you interested in planting any native vegetation on your property?
Will there be any ground disturbance involved in the project? If YES, please provide brief description
below.
Is the property on private (freehold) land?
Do you give permission for relevant project information to be provided to the Local Aboriginal Land
Council for the purpose of cultural heritage assessment?
Other Notes:
10. PUBLIC LIABILITY INSURANCE
I currently have Public Liability Insurance and a copy is attached
If you currently don’t have this insurance coverage, are you willing to acquire $10 million public liability
coverage, if you are successful?
HRXXX – Small Grant Application - Name
11. MAP OF PROPOSED PROJECT WORKS
Contact your Hunter LLS contact officer to discuss your project and to develop a map of your project
area and works proposed for inclusion in your application.
You may also wish to provide photographs or a sketch of the proposed project site in the space
provided below to support your application.
12. CONFLICT OF INTEREST
Outline any conflict of interest you may have with the business or any director or staff of Hunter LLS
HRXXX – Grant Application - Name
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13. OTHER FUNDING
Please list any current or previous grants or financial assistance you have received that is relevant to
the activities in this project.
Funding source
Year
Project title
Amount
Continuing
commitments
Do you have any other related funding applications currently under consideration?
YES / NO (If Yes list)
HRXXX – Grant Application - Name
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14. DECLARATION AND SIGNATURE
Before signing please ensure your application is complete in all sections as incomplete applications
will not be considered.
Successful applicants will need to adhere to the terms and conditions outlined in the Program
guidelines.
If a company or organisation, the applicant must be an authorised representative of the entity.
I,
Name of applicant (please print)
as the applicant confirm that all details outlined in this
application are true and correct.
Signature of applicant
Date
If you are applying to undertake a project on land of which you are not the owner, the landowner must
also sign the application for private holdings or the responsible entity must sign for public land. If the
landowner or responsible entity is a company or organisation, the signatory must be an authorised
representative of the entity.
I,
Name of land owner or responsible entity (please print)
as the landowner (or responsible entity) grant permission for
the applicant to undertake the project on the land and confirm
that I will be bound to all details outlined in this application.
Signature of landowner
Date
Submission details for each Program are presented in the Program guidelines.
HRXXX – Grant Application - Name
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Applicants Checklist for Grant Application
Do you have in your application for submission...
Yes
No
Have you attached your LLS generated map?

Yes

No
Have you attached a copy of your Public Liability
Insurance?

Yes

No
Has the land owner or responsible entity signed the
application?

Yes

No
Does the person/entity responsible for the agreement
name match the name against the ABN number (if
applicable)?

Yes

No
Are you aware of LLS minimum activity standards and/or
activity definitions for projects and that you will be required
to deliver your project in accordance with these?
 Yes

No
Have you answered every question?


No
HRXXX – Grant Application - Name
Yes
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