Application for the
Native Vegetation Assistance Package
Send applications to:
NSW Rural Assistance Authority
Locked Bag 23, Orange NSW 2800
1. Applicant(s) details
Applications must be in the name of the registered proprietor of the land on which the PVP
applied or is to apply.
Full name(s) of owners:
Position (Director,
Trustee, Partner, etc.):
Company/Trust/Trading name:
ABN: __ __
__ __ __
__ __ __
__ __ __
Please nominate a contact person for your application.
Contact name:
Phone:
Fax:
Mobile:
Email:
Postal address:
Town:
Postcode:
2. What component of the Native Vegetation Assistance Package for landholders are
you applying for (please tick)?
Sustainable Farming Grant
□
or
Farmer Exit Assistance
□
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3. Statement of Impact
i.
Please provide details on the total hectares held and outline all commercial activities
conducted on the area affected by the Private Native Forestry (PNF) Code of Practice or
Native Vegetation Act 2003.
ii. Please advise how you had planned to use the area and/or what activities you had
proposed to undertake in the area covered by the PVP.
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iii. How has the introduction of the PNF Code or Native Vegetation Act 2003 significantly
impacted your farm business? (i.e. what production increases or benefits were you
expecting to gain from clearing or undertaking forestry on this area of land?)
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4. It is ESSENTIAL that you provide ALL the following attachments to support your
application:
Copy of the NVAP case referral details and PVP property map provided by your PVP case
officer
Copies of the financial statements for the farm enterprise for the last three years. These should
include profit and loss statements, stock trading account and balance sheets.
□ Yes
□ Yes
Copies of the individual taxation returns for each applicant for the last three years
□ Yes
A current listing of all assets and liabilities held by each applicant
□ Yes
If applying for a Sustainable Farming Grant, a copy of the completed project proposal form
which has been sent to:
Coordinator, Native Vegetation Assistance Package
Department of Environment and Climate Change
PO Box A290, Sydney South NSW 1232
□ Yes
5. Declaration (all applicants to sign)
I/We solemnly declare that the information provided in this application is true and correct.
Name:
Name:
Signature:
Signature:
Date:
/
/
Date:
Name:
Name:
Signature:
Signature:
Date:
/
/
Date:
/
/
/
/
Privacy statement
The information in this application is provided voluntarily and is being collected by the NSW Rural Assistance Authority
for purposes related to the administration of the scheme of assistance under which you have applied. This may involve
disclosing the information in this application to contractors engaged by the Rural Assistance Authority, or to government
agencies including the Department of Environment and Climate Change, the Department of Primary Industries and the
NSW Nature Conservation Trust.
Not providing the information requested in this application or providing false, misleading or incomplete information may
impact on the ability of the Authority to accurately assess your application.
The NSW Rural Assistance Authority agrees to take all reasonable measures to ensure that the personal information
collected by it is stored securely.
Send applications to:
NSW Rural Assistance Authority, Locked Bag 23, Orange NSW 2800
DECC 2009/529
July 2009
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