Expression of interest - FARM INCENTIVES 2014-15

All applicationS must be received by 5pm on 31 October 2014

Mr. / Mrs. / Miss/ Ms.
First name / Surname
Land owner (if different from above)
Postal address (If different from property address)
Town / City / Postcode
Phone (A/H) / Mobile
Fax
Email
ABN (If applicable)

Property details(where on ground works will be undertaken)

Property name / Property size (Ha)
Property address (Where on ground works will be undertaken)

Lot and DP details (Where works will be undertaken.Available on your rates notice)

Lot / DP

Which incentives are you interested in?

Incentive type (please select) / Incentive type / Minimum requirements / Project timeframe
☐ / Riparian enhancement / Fence erected a 20m average distance from the top bank / Expressions of Interest closes at 5pm on 31st October 2014
A Local Land Services Officer will contact you within 4 weeks of receiving your application to discuss your project.
Landowners will be notified of funding decision by December 2014
2 ha minimum size
☐ / Vegetation conservation management / 2 ha minimum size
☐ / Property management planning / Na
Na

Project description

Please describe your project(s), activities and what you are trying to achieve (refer to funding Fact Sheets; include approximate areas, distances, etc.)
Click here to enter text.
Have you had any Natural Resource Management funding by a government organisation?

☐Yes ☐No

Details: Click here to enter text.

If YES are these projects complete?

☐Yes ☐No

Conflict of Interest

Do you know of any Conflicts of Interest for funding eligibility? (E.g. employment in LLS, relationship to LLS staff member).

☐Yes ☐No

Details: Click here to enter text.

Keep up to date

Would you like to be added to the Central Tablelands Local Land Services mailing list to ensure you don’t miss any future updates?

Privacy Statement: CT LLS COMPLIES WITH THE PRIVACY AND PERSONAL INFORMATION ACT 1998 The information you are providing may be personal information under the Privacy Act. It is collected for the business purposes only of CT LLS and will not be disclosed to any third party except in accordance with the privacy policy of this organisation. You can request access to and correction of your personal information by calling the CT LLS on 1300 795 299. Information collected is a register of attendance required to fulfil our Duty of care and maybe used to contact participants for future meetings on the above topic

☐Yes ☐No

DECLARATION

I declare the information entered on this form is true and accurate to the best of my knowledge.

Name of applicant:

Signature of applicant / Date

______

Please return your completed application to:

POST:Central Tablelands LLS

PO BOX 510 Cowra NSW 2794

Attn: Martha Dorman

EMAIL:

IN PERSON:Drop it into any Central Tablelands LLS office: Bathurst, Cowra, Lithgow, Molong, Mudgee or Orange.

All application must be received by 5pm on 31 October 2014

Any incomplete EOIs will be returned and will result in a new submission date.

Funding applications received after 31/10/2014 will be ineligible for funding in this round.

Central Tablelands Local Land Services

Tel: 1300 795 299 | centraltablelands.lls.nsw.gov.au