NSWF Floods Small Gift 2022 Application Form

NSW Farmers' Floods Small Gift 2022 Application Form
This program has now been closed.
What is the LGA of your impacted farming property?
What is the address of your impacted farming property?*

Address L1

Address L2

TownState

Post Code
How have you been impacted?

As a primary producerOther
DESCRIBE YOUR EXPERIENCE
How has your property been impacted or damaged?

Principal place of residence and/or household assets destroyed or damagedPrincipal farm buildings, infrastructure and/or major assets destroyed or damagedLoss of livestockDestruction of farm produceLoss of cropLoss of incomePersonal injury, health, safety, or medical issuesCommunity issues – roads, transport, etc.Supply issuesEconomic impactsOther
Please describe your experience of the severe weather and flooding that impacted your property in Feb/Mar 2022.
100 words maximum
YOUR CONTACT DETAILS
Full Name

First NameLast Name
Position/relationship
eg. owner, lessee
Business Name
ABN
Property Address

Address L1

Address L2

TownState

Post Code
E-mail *
Phone Number
Mobile/Home Phone
NSWF Member No.
If applicable
*Please note that we will send the e-gift card to this nominated email address should you be successful in your application. Please ensure that you have secure access to this nominated email.
MY DECLARATION

By clicking the below AGREE & SUBMIT button, I declare that all the information I have provided is true and correct and understand that giving false or misleading information is a serious offence. I understand that there is limited fund available as part of this Small Gift Program and my application may not be accepted once the total fund has been exhausted. I accept that NSW Farmers Natural Disaster Relief Fund decision is final and is not subject to further review or appeal.
Should be Empty:

NSW Farmers' Floods Small Gift 2022 Application Form