Farm Business Skills. Application for Reimbursement

Transcription

1 Form Farm Business Skills Professional Development Program Print Farm Business Skills Professional Development Program Application for Reimbursement Checklist Please make sure you have all you need before you begin as the form can not be saved partially complete. Have you applied previously for assistance from the NSW Rural Assistance Authority? Does this claim relate to an activity where you have previously sought pre-approval from the RAA? This form is to be completed ONLY if you have finished the course and are ready to make your claim. Please ensure you have the following ready before you commence as you will be unable to partially complete. Do you have ready 1. Confirmation you have completed the course (certificate or attendance record) 2. Evidence of costs incurred to attend training (receipts) 1. About you * ABN Title

2 * First Name * Last Name Phone * Mobile Fax * * Date of Birth How would you like to receive future correspondence from the RAA? (please tick) Property Address Mail Facsimile Other * Address Line 1 Address Line 2 * Suburb * State NSW * Postcode Local Government area of property Is this address different to your postal address? About your primary production enterprise * Legal Registered Name(s) Trading name if different from the legal / registered name * ABN / ACN Do you earn more than 50% of your gross income from the farm? NOTE: If you are ineligible to apply for this grant To assist us in better understanding the users of the Farm Business Skills program

3 we would like you to answer the following questions * Does your farm operate as * What is the major commodity that you produce? Is your average gross farm income 0 - $250K $251 - $500K $501K - $1M $1M+ * What is the highest level of education of the enterprises main decision maker? Are you undertaking training other than that supported by the Farm Business Skills Program? 2. About the professional development course * Name of Course * Name of Course Provider * Date course commenced * Full Cost of Course $ * Other costs incurred: (eg. travel, accommodation, childcare) te: please upload copies of receipts * Amount of program funding sought (50% of receipts to maximum $5,000) Did the course relate to $ $ Management of Risk Financial or Business Management Farm Business Planning / Drought Preparedness Planning MPI Audit * What was your major learning? (maximum 250 words)

4 * Did the activity meet your expectations? Bank Account Details * Account Name * Bank/Credit Union Name * Branch * BSB * Account Number Supporting Documentation For your request to be processed without delay please: Scan documents as PDF format at 300 dpi, black and white, if available (PDF Help Link) Review scanned documents and ensure that the scanned copy is clear and easy to read Set camera or scanner to low resolution to prevent unnecessarily large files Name files appropriately Total file size cannot be larger than 25MB - Total file size means the combined total of all of your attachments not the size of each individual attachment. Any attachment larger than the limit should be ed to the Authority at rural.assist@raa.nsw.gov.au clearly showing your name and the course completed. Please note: supporting documents will only upload after you submit your application. It may take a moment for the files to upload (sometimes several minutes if your files are large). Please do not close or refresh the browser window. Please upload any receipt copies, course completion information here. New

5 Document 1 Choose file N n (Upload documents) Delete 3. Statements General Statement Privacy Statement Your Statement * By checking this box I acknowledge that I have read and agree with all the statements above and I am authorised to sign this Application on behalf of the business listed in this application Submit * Required Field