Farmer Support 10 - Website - Assistance Application 20240213

Assistance Application

Thank you for reaching out to Drought Angels.

You must be a registered Primary Producer to be eligible for assistance.
All questions must be answered for your application to be considered. If you are unsure how to answer use the " ? " that are hints

Please Note: Drought Angels do not provide stock feed or water.

This information is for Drought Angels only and we do not provide any of your personal information to third parties.

If you or someone you know needs immediate assistance please contact Lifeline 131114.

Property Name or Trading Name *

Please enter your Trading Name, Property Name or Family name for the farm affected.

Would you like assistance interpreting?

Please note this form needs to be filled out in English.
We are able to provide assistance to fill out this form and for when we call you, if required.

Yes

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We're committed to providing assistance and recognize that Australia is a multicultural society where not everyone may be fluent in English. If you require assistance, we can arrange an interpreter to ensure you receive support during this challenging period.

If yes, what is your native language?

Please list your native language for us to provide an interpreter for when we call you.
Please note this form needs to be filled out in English.

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This section is for individuals filling out the form on behalf of someone else. We kindly ask for your details in case we need to reach out for further clarification or assistance. Your information will only be used for communication related to this form and its submission.

Are you assisting someone in completing this form? *

If you are the applicatant, please select NO and proceed to the next section.

Yes

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If you are helping a farmer to complete this form, please fill out your details here.

Name of person helping farmer to fill out this form;

If you are helping someone to fill out the form please provide your details in case we need to contact you.

First name

Last name

Mobile phone

Direct line

Your Email address

Relationship to Applicant *

Adult Non - Dependant

AOP

AOR

Drought Angel Employee

Parent

Service Provider

Sibling

Spouse

Staff

+ Add another

- Remove

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Please help us to understand your primary production business and the natural disaster impact you are dealing with.

Are you a primary producer?

Yes

Primary Production has been impacted by: *

Please select the circumstances of what is affecting your Primary Production

Biosecurity

Drought

Fire

Flood

Hail

Other

Storm Damage

Trade limitations

Other Adverse Circumstance

Enter details of unique circumstance creating distress for Primary Production business

ABN Number *

PIC Number

Please note if you have livestock you are required to provide your PIC Number.

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Details of Applicant

Name of Applicant *

First name

Last name

Do you identify as being of Aboriginal or Torres Strait Islander descent? *

Prefer not to say

Aboriginal

Aboriginal and Torres Strait Islander

Torres Strait Islander

Gender *

Female

Male

Other

Date of Birth *

Email address *

This is the email address that communication emails from Drought Angels will come from concerning your assistance. If you do not have one please adress to your trusted advisor.

Home phone

Please type N/A if no landline

Mobile Phone Number *

Please type N/A if no mobile

Marital Status *

Divorced

Married/De Facto

Separated

Single

Widow

Guardian *

If you have dependent children, please select " YES " and proceed with filling out their details.

If NOT please select " NO " .

Yes

+ Add another

Are there any additional household members (including partner, children, parents and staff that live in your house)? *

This helps us to understand you and your families circumstances.

Yes

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Additional people within your home. Please include all people that are staying in your home included the likes spouse, kids, grandparents and staff.

Persons name

First name

Last name

Gender *

Female

Male

Other

Date of Birth *

Relationship to Applicant? *

Child Dependent

Child Non Dependent

Cousin

Grandchild

Other

Parent

Parent Grand

Sibling

Sibling Child

Sibling Spouse

Spouse

Staff

Staff Child

Staff Spouse

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- Remove

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Property Information

Are you the Primary Property Owner? *

Yes

If No Please describe.

Please let us know if you are leasing or share farming the property.

Property Name

Please help us by entering the state in this format; QLD , NSW, ACT, VIC, TAS, SA, WA, NT

Applicant's Property Address *

This is the farms property address that is affected. Please help us by entering the state in the following format QLD, NSW, ACT, VIC, TAS, SA, WA, NT

Address Type

Address line 1

Address line 2

City/Suburb

State/Territory

Postcode

Please help us by entering the state in this format; QLD , NSW, ACT, VIC, TAS, SA, WA, NT

Residential Address *

This is the Address that you live at.

Same as previous

Address Type

Address line 1

Address line 2

City/Suburb

State/Territory

Postcode

Please help us by entering the state in this format; QLD , NSW, ACT, VIC, TAS, SA, WA, NT

Applicants Mailing Address *

This is the address that you perfer to recieve your mail and packages to.

Same as previous

Address Type

Address line 1

Address line 2

City/Suburb

State/Territory

Postcode

How many Acres? *

Local Government/Council Authority. Start typing and select from list *

This is the Local Council/Government for your property.

Closest Major Town? *

Kilometers to closest town?

Parcel/Lot Number *

As shown on your rates notice

Plan/Section Number *

As shown on your rates notice

Please describe the impact on your property due to this event/disaster *

Do you operate on other properties? *

Yes

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Describing the other properties that are affected by natural disaster.

Property Name

Please list all other properties details that you own or operate on so that we have a clear understanding of your circumstances. This included investment properties that recieve an income from.

Please help us by entering the state in this format; QLD , NSW, ACT, VIC, TAS, SA, WA, NT

Additional Farm Address

This is for additional property addresses that you have.

Address line 1

Address line 2

City/Suburb

State/Territory

Postcode

Local Government/council Authority *

Please select the local Government /council authority. If you start typing the letters it will take you to your area quicker.

+ Add another

- Remove

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Understanding your financial situation

Is this property your primary source of income? *

Yes

Do you work off farm to support yourself and family? *

Yes

How is the Event/Disaster affecting your income?

Do you receive Farmers Household Allowance? *

Yes

If No please provide details as to why you don't receive the farmers household allowance..

If you are unsure how to apply, we will be happy to point you in the right direction.

Do you receive any Child Related Support? *

Yes

Do you receive any other Government Pensions? *

Yes

Please list any other Government Pensions you receive.

Have you previously received support from Drought Angels? *

If you have received Drought Angel assistance before please provide the amount and date

Have you received support from any other organisation?

If yes please provide amount and date

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Details of your Primary Production Business

Please select your enterprise classification

Stock

Yes

Cropping (inc. Fruit & Vegetables)

Yes

Mixed

Yes

Please provide a high level overview of your enterprise.

For example this could be the number of stock you have on your farm currently and what you normally would be holding. How many hives do you have. How many acres you would normally have planted and how long since you last had a successful crop. If you are a high density farm like Fruit & Vegetables. What size is your green house? How long before you can be up and running again.

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Understanding what support we can provide for you.

Please note: Drought Angels do not provide stock feed or water.

Support Required

Please note: Drought Angels do not provide stock feed or water. We are about providing assistance to the household and house paddock.

Groceries

Pet food

Utility Bills

Other

If other assistance is required please describe

Additional information

Is there anything else you would like to disclose in reference to your application at this time?

Date

Signature

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Terms and Conditions

When we contact you, you will need to support a claim as a primary producer in Australia, by providing one of the following acceptable Primary Producer Declaration (PPD) documents. Make sure that the document is signed and dated, as this is essential for processing your application. Here are the documents you can submit:

Current Government Vehicle Registration Notice: This document should be in your name and show that the vehicle is used for Primary Production or Produce Carrying. Please ensure that the registration notice is current and includes your name.

Australian Tax Notice of Assessment: The Notice of Assessment should be in your name and on the 1st or 2nd page, it must show the term "Primary Production Averaging Income." This document is usually issued by the Australian Taxation Office (ATO).

Letter from Your Accountant: Provide a letter from your accountant on their letterhead, which includes their contact details. The letter should be signed and dated within the last 12 months. It must include your name or business name, ABN (Australian Business Number), and the address where you conduct your Primary Production business.

Declaration of Eligibility for a Registration Concession Form: If your accountant is using a specific form for this purpose, ensure that it is signed by both you and your accountant, and the signatures are dated within the last 12 months. This form may vary but should demonstrate your eligibility for a registration concession.

Please confirm below with a Yes or No for our T&C.

I confirm all the details provided by me to be true and correct. *

Yes

I confirm I am the applicant listed on this form. *

Yes

I understand to receive assistance from Drought Angels that we are a registered primary producer? *

Yes

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You may not be eligible as you have indicated you are not a primary producer. Please confirm by answering the following question to determine if you can receive assistance.

Are you a primary producer?

Thankyou for your time but you have said that you are not a primary producer and we cannot provide assistance to you.
If this is incorrect please select say YES you are a primary producer and proceed with filling out the form. If you are not a primary producer please select NO and submit the form for us to assess.

Yes

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You may not be eligible as you have indicated a "No" to one of our T&C's. Please confirm by answering the following question if you would like to change your answer or submit the form. Please note if you select 'No" you may not be eligible.

Would you like to review you T&C's answers to submit your form, as you said NO?

If you do not wish to agree to the T&C's the form will be submitted but you may not be eligible.

Yes