Australian Government Farm Finance:
Concessional Loan Scheme 2013–14
APPLICATION
Complete Applicationsclose 5.00pm 30April2014
RuralBusinessDevelopmentCorporation
C/- DepartmentofAgricultureandFood WA
LockedBag4
BENTLEYDELIVERYCENTRE WA 6983
Freecall: 1800198231
Fax: 9367 4265
ABN: 84 524 088 562
Email:
Website:
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1.Guidelinesand assessment checklist
V 2 –190214RBDC FFCLS – Page1of7
IMPORTANT –Please ensure you have read and understood the Scheme GuidelinesDocument. That document outlines the Eligibility Criteria you must satisfy(Clause 8) and the Loan Assessment Criteria that your request for a Farm Finance: Concessional Loan will be assessed by (Clauses 9 & 10).
Before you commence filling out this Application, please go through the
Assessment Checklist(Appendix A) at the end of this form.
If you have any doubts, pleasecontact ourofficetodiscussyoureligibilitybeforeprogressingapplication.
If you believe you may qualify, please complete every section of the application form and forward it with all necessary attachments as listed in bold on p.7, tothe Rural Business Development Corporation.
IncompleteApplications(includingmissingattachments)willcausedelaysandmayresultinyourapplicationbeingdeclined.Approved applicants will be funded in the order their COMPLETED applications enter the assessment queue, until Scheme funds are committed. An application may have been received, but it will not be considered to be in the assessment queue until ALL required information has been received.ALL required information to make the application complete must be received by 5.00pm 30 April 2014.
2(a)Farmbusinessdetails
ACNABN
GST Registered? / Yes / No / Client or File Ref No. (if known):
Sole Trader Partnership Trust Company
Please tick entity type
Full business
trading entity name
Postal address
Town / Postcode
Please tick if the road address of your farm is the same as your postal address
Road addressTown / Postcode
How long has the Applicant been continuously farming? years (since )
Have you applied for and/or received a FFCLS loan in any other State?...... YesNo
Is there any unsatisfied judgement entered, or a judgement likely to be entered, in a court against the Applicant or Applicant company of which you are/were, a shareholder/officer, and, if a company, is the Company in liquidation (voluntarily/otherwise), or has a Receiver and Manager been appointed? Yes No
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2(b)Membersofthefarmbusiness
Pleaselistalladultpersonsactivelyinvolvedinthefarmbusinessandtheirposition (e.g.business partner,director,trustee,beneficiary, etc.).
Ifthereisinsufficient room,pleasecopythispageandattachittoyourapplication.
permanent
resident / % time worked on farm
// / %
// / %
// / %
// / %
// / %
// / %
// / %
// / %
*Please nominate above which of the Applicant members are at least an Australian permanent resident?
2(c)Primarycontactpersonforthefarmbusinesswithrespecttothisapplication from 2 (b) above
Title / Surname / Given namesTelephone / Mobile / Fax
2(d)Keybusinesscontacts
Bank or Financier:Contact person / Telephone / Mobile
Firm/company / Email
Farm consultant:
Contact person / Telephone / Mobile
Firm/company / Email
Accountant:
Contact person / Telephone / Mobile
Firm/company / Email
2(e) Electronic funds transfer details (for to and from fund transfers) – must be an Australian bank account number
Name of farm business’ bankAddress of bank
Name of farm business bank account
BSB / Account number
The minimum repayment is the interest component, on a six monthly basis, each 15 March and 15 September.
2(f) Farming property description
Property nameTotal area of farm (ha) / Total arable area (ha)
Pick your main industry:
Apple and pear growing / Aquaculture / Beef cattle farming
Dairy cattle farming / Deer farming / Grain growing
Grain-sheep/beef cattle farming / Grape growing / Pig farming
Sheep-beef cattle farming / Sheep farming / Stone fruit growing
Vegetable growing / Other
The property is located* / km in a / direction from the town of
In the Shire of / in the State of
* If you have a number of properties spread over a wide area (or even in another state), please attach details to this application form.
------
Owned / Hectares / Year purchased / Current market value ($)------
Commencement date / ExpiryLeased / Hectares / // / //
Lease payment (PA) ($) / Options
------
Commencement dateSharefarmed / Hectares / // / Expiry / //
------
To be purchased(include copy of signed sales contract)
Hectares / Purchase date / Finance date / Settlement date / Purchase price ($)
// / // / // / $
3. Summary of proposed project
(Note: Also include these costs in your cashflow projections)
Purpose of loanfrom yourFive year Business Case and Management Plan / Cost ($)$
$
$
$
$
Important note:
Please attach copy/copies of relevant information as applicable:
– Pro-forma invoices/quotes
– Offer and Acceptance agreement/s
– Any other documents pertaining to purchase/s (e.g. make, model, engine numbers, etc.)
– Management Plan and Business Case for 5 years / (A)Total / $
Funding: How do you plan to fund the above requirements? (Detail below) / Amount ($)
Cash contribution: ...... / $
Other loans
(please detail):
$
$
$
Farm Finance Concessional Loan (min. $50,000 to max. $200,000) / $
TOTALS (A) MUST EQUAL (B) / (B)Total / $
4(a) Property title details (also include off-farm property(s))
Title description / Name of registered owner(s) / Estimatedmarket value $Title Locationname or Lease number / Title Location/
Plan number / Area ha of
each title
(i) / $
(ii) / $
(iii) / $
(iv) / $
(v) / $
(vi) / $
(vii) / $
(viii) / $
(ix) / $
(x) / $
(xi) / $
(xii) / $
Add additional page if necessary / $
Total ha / Total / $
Non-farm properties
(i) / $
(ii) / $
(iii) / $
(iv) / $
Total / $
Note: Please describe ALL non-farm properties, e.g. town building block, brick and tile home, commercial property, etc. Including address(es):
For lease and sharefarming properties, please provide a signed copy of your agreements:
Other knownproperty encumbrances (e.g. caveats, trading, mining lease, biosecurity, covenants):
4(b) Security offered for consideration – Optional (do not need to complete if not known)
All loan recipients are required to provide ‘best and most appropriate’security for this loan. This security could be in the form of a first or subsequent mortgage over land, or a specific security agreement (a security charge on a specific item of equipment).
If known, what security is available to secure the requested Farm Finance: Concessional loan?
Is the security in names other than the applicants (i.e. parents)?Yes / NoPlease provide details
5.Statement of Assets and Liabilities (For cropping businesses this should as at your last annual review with your bank; all others should be as at date of application)
Complete one combined Statement for all BUSINESS and PERSONALAssets and Liabilities, including those held individually or jointly with partners, other persons or associated entities. The Statement must include all assets and all debts of all members of the business.
ASSETS (Show present fair market value) / LIABILITIES (Current amount owing)FARM ASSETS / FARM LIABILITIES
Farm land (including improvements)
Land / ha @ $ / /ha = / $ / Base limit / $ / Overdraft balance / $
Land / ha @ $ / /ha = / $ / Term loans (incl. commercial bills and fixed interest loans)
Land / ha @ $ / /ha = / $ / $
SUB TOTAL OF FARM LAND ASSETS / $ / $
Town/residential property for farm use...... / $ / $
Livestock...... / $ / $
Plant, machinery, and vehicles...... / $ / Other loans
Shares/debentures/deposits...... / $ / $
Grain (harvested, stored and unsold)...... / $ / $
Seed on hand, fertiliser...... / $ / Stock firm...... / $
Other produce/materials on hand (e.g.wool)...... / $ / HP,leasing andchattel mortgage...... / $
Farm Management Deposits...... / $ / Creditors (A/C’s payable)...... / $
Cash at bank...... / $ / Taxation liability...... / $
Accounts receivable...... / $ / TOTAL FARM LIABILITIES / $
TOTAL FARM ASSETS / NONFARM LIABILITIES
Personal loans......
Margin loans (e.g. shares) ......
$ / $
NON FARM ASSETS (business and personal)
$
Other real estate (show address and market value below) / Real estate loans (show details) / $
$ / $
$ / $
Complying Superannuation (current estimated value)... / $ / Credit card/s...... / $
Other assets / Other liabilities
Non-farm vehicles/boats/caravans/vintage, etc...... / $ / $
$ / $
TOTAL NON FARM ASSETS / $ / TOTAL NON FARM LIABILITIES / $
TOTAL ASSETS / $ / TOTAL LIABILITIES / $
EQUITY / $
Please have your main financial institution’s relationship or account managersign this page with their bank stamp. We also require EACH of your financial institutions to complete and sign the separate ‘Schedule of Accounts’ form.
I, / of / (name and office/branch of the financial institution)I do hereby confirm that this Statement is consistent with information known to us. ______
Signature and date
6. Consent and Statutory Declaration
For the purposes of this application:
I/We authorise the Rural Business Development Corporation / Department of Agriculture and Food, Western Australia (RBDC/DAFWA) to seek any additional relevant information it considers appropriate to process this application (including information from my solicitors, accountants, commercial lenders and insurance companies, and anycredit reporting agencies), and I/we request and authorise any person or entity to supply to the RBDC/DAFWA all such information the RBDC/DAFWA requests from it;
I/We have read and understand the Privacy Statement at Appendix B on how information provided in my/our application or collected in relation to me/us or the application or our security providers may be used and disclosed, and I/we consent to and authorise all such uses and disclosures;
I/We have read and understand the Farm Finance: Concessional Loan Scheme – Scheme Guidelines document and obtained clarification where needed, and I/we agree to those Guidelines applying to my/our application and any loan or finance provided to me/us in response to the application;
I/We solemnly and sincerely declare that the information, shown in this application and attachments, and any subsequently provided, is true and correct in every particular, and discloses full details of the financial position of the applicant/s, the applicant partnership, the applicant company and/or the applicant Trust/beneficiaries and I/we make this declaration under the Oaths, Affidavits and Statutory Declarations Act 2005.
INDIVIDUAL DECLARATION:
All sole traders, partners, and trusteesof trusts are to sign.Each Director must also sign and have witnessed this individual declaration, in their capacity as individuals.
This declaration is true and I/we know that it is an offence to make a declaration knowing that it is false in a material particular.
at (place) / By (Applicants):(date) / (Signature of person making the declaration)
Name:
in the presence of: / (Signature of person making the declaration)
(Signature of authorised witness – See Appendix C) / Name:
Name of authorised
witness / (Signature of person making the declaration)
Name:
Qualification of
authorised witness
(Signature of person making the declaration)
Name:
COMPANY DIRECTORS DECLARATION:
The Company’s authorised Directors are to sign this Company declaration.
(Note: The Directors must also sign and have witnessed the individual declaration above, in their capacity as individuals.)
Director / Director/Secretary7. Supporting documents checklist
Please make sure you fully complete the application form (including signatures) and provide all relevant attachments.
Incomplete applications will not be accepted to be assessed, nor enter the assessment queue until ALL information is provided.
Missing information will need to be provided within 20 business days of the RBDC’s receipt of your application to retain your place in the assessment queue, and before 5.00pm of 30 April 2014. Failure to provide the missing information within the 20 business days will result in your application losing its place in the assessment queue. In this circumstance, you canstill provide the required information, however you will enter the assessment queue as at the date you provided the last of the required information.If missing information is not supplied, the application will be declined.If there is heavy demand for funding, the RBDC will close applications early if commitments reach the $25M available funding set for the 2013–14 financial year.
The following information IN BOLD must also be provided to the RBDC with this application so it is
considered fully completed:Please tick
– Include Profit and Loss Statements, Balance Sheets and depreciation schedules
– *Monthly cashflow actual for the 2013 farm year is acceptable if financial statements have not been prepared for
2012/13......
Yes
2)Monthly cashflow actual for the past farm year ...... / Yes
3)Monthly cashflow budget for the current farm year ...... / Yes
4)Main Financier Supporting Information Form ...... / Yes
5)‘Schedule of Accounts’ form from EACH main financial institution – not required for equipment financiers..... / Yes
6)Copies of Trust Deeds (if applicable) ...... / Yes
7)Copies of Company Constitution (if applicable) – also known as a ‘Memorandum and Articles of Association’... / Yes
8)Management Plan/Business Case outlining productivity improvement/s for the next 5 years...... / Yes
9)Copies of written Lease and or Sharefarming Agreement(s) (if applicable)...... / Yes
10)Copies of all relevant documents such as invoices for plant and machinery (including type, make, model,
registration, engine and VIN numbers, etc.), Offer and Acceptance forms for the purchase of land ......
Yes
11)Details of assets (over $50,000) purchased and sold over the last financial year, this financial year and estimates for the next financial year
Yes
12)Has each member of the applicant business signed the declaration on p. 6 (partners, directors, beneficiaries,
trustees, etc.)? ......
Yes
13)Have your signatures been witnessed by an ‘authorised witness’ (see the Appendix C for who is an authorised
witness) ......
Yes
14)Where applicable, have the Directors of your company signed the declaration on page 6 on behalf of the companyand again in their capacity as individuals?
Yes
15)Where applicable, have all adult beneficiaries of the Trust involved in the farm business of the trading entity been listed?
Yes
16)Have you provided details of other properties on another sheet if there are insufficient room in the form? ...... / Yes
17)Has your financial institution signed the Assets and Liabilities statement on page 5? ...... / Yes
Have you read and understood the Scheme Guidelines document? ...... / Yes
Have you completed the Eligibility Checklist at Appendix A?...... / Yes
Have you fully completed all sections of the application form? ...... / Yes
Have you attached all required information?...... / Yes
If sending by Australia Post:If sending by courier/hand delivery:
Rural Business Development CorporationRural Business Development Corporation
Department of Agriculture and FoodDepartment of Agriculture and Food
Locked Bag 43 Baron-Hay Court
BENTLEY DELIVERY CENTRE WA 6983SOUTH PERTH WA 6151
Further information is available at website:
Email enquiries:
Contact telephone: Freecall: 1800 198 231
Please note that COMPLETEapplications must be received by 5 pm 30 April 2014
(Applications for the second round of funding during the 2014–15 year will open on 1 July 2014)
Farm Finance is an Australian Government initiative that aims to build the ongoing financial resilience of farm businesses through the provision of concessional loans. The Concessional Loans Scheme in Western Australia will assist farm businesses that are considered viable in the longer term, that are experiencing debt servicing difficulties, by providing loans for them to undertake productivity enhancement activities.
RBDC FFCLS – Page1of7
Appendix A
Australian Government Farm Finance Concessional Loan Scheme (FFCLS)
These Assessment Criteria come from Clauses 8, 9 and 10 of the Scheme Guidelinesdocument. Please read the Scheme Information document in full.
The following questions are mostly those that the RBDC considers when assessing your application.
Please read through these and indicate ‘Yes’ or ‘No’ as to how you believe you may be considered.You may not be able to consider/answer all questions, but it will help you decide if you should fill out and put together a full application.
In general, if you can answer ‘Yes’ to all items(except criteria 15 and 16), it may be a good indication that you could be eligible for an Australian Government Farm Finance Concessional Loan Scheme loan.
Part one of the assessment process is theEligibility for Assessment Criteria (Clause 8)
YesNo
1.Have you provided all requested documents and signatures?......2.Is FFCLS funding still available (check DAFWA/RBDCwebsite)?......
3.Will the application be lodged prior to the closing date and time (subject to funding ......
still being available)?
4.Have you (the applicant) owned and operated the farm business for at least ......
the past five consecutive years; and
5.Are you operatingas a sole trader, trust, partnership or private company; and ......
6.Involved within the agricultural, horticultural, pastoral, apicultural or ......
aquacultural industries; and
7.Wholly located in Australia; and......
8.Registered for tax purposes in Australia with an Australian Business Number (ABN), ......
and registered for GST; and
9.Not a public company under the meaning of TheCorporations Act 2001 (Cth)......
10.Has each of the applicants been through a ‘Verification of Identity’ with their main bank / ...
financier?
11.Is at least one Applicant member of the farm business a farmer who, under normal ......
circumstances, contributes at least 75 per cent of his or her labour and derives
at least 50 per cent of his or her income from the farm business?
12.Is the majority of the applicant’s farm business (business operations, income, ......
and land/lease holdings) conducted in the state of Western Australia
13.Is at least one member of the farm business at least an ‘Australian Permanent ......
Resident’?
14.If a lessee/sharefarmer (in part or wholly), does the applicant have a signed ......
lease or sharefarming agreement?
YesNo
15.Is the applicant or its members under external administration or bankruptcy? That is, is....there any unsatisfied judgement entered, or a judgement likely to be entered, ina court against the Applicant or Applicant company of which you are / were, a shareholder / officer, and, if a company, is the Company in liquidation (voluntarily / otherwise), or has a Receiver and Managerbeen appointed?
16.Has the applicant applied for or been a loan recipient under the Farm Finance: ......
Concessional Loan Scheme in any other (state or territory) jurisdiction?
17.Do all members of the farm business (including partners,shareholders, beneficiaries......
etc.) have net non-farm assets totalling less than $421,500 (excluding complying superannuation funds); and
18.Do all members of the farm business (including partners,shareholders, beneficiaries,.....
etc.) have liquid assets totalling less than $400,000 (e.g. farm management deposits,shares, cash at bank, etc.)
Part two of the assessment process is the Loan Assessment Criteria (Clause 10)
YesNo
19.Is the application for eligible productivity enhancement activities only ......(see Clause 9)
20.Has the farm business taken all reasonable steps to service its farm business debt......
21.Has the farm business experienced and is continuing to experience difficulties......
servicing its debt; and
22.Does the farm business have a financial need for a concessional loan; and......
23.Does the farm business have the capacity to repay the concessional loan and ......
have sound prospects for a return to commercial viability within the term of the
concessional loan; and
24.Does the farm business have the ongoing support of its current commercial ......
lender(s) for the availability of additional necessary carry-on finance; and
25.Do you have the ongoing support of commercial lender(s) with the ......
concessional loan assistance?
26.Will the requested concessional loan amount be less than the total eligible (long term) .....
debt ofthe farm business?
27.Will you be able to provide the RBDC with ‘best and most appropriate’security ......
to secure the amount of the proposed loan?
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