Farm Finance Concessional Loans Scheme Northern Territory

Transcription

1 Farm Finance Concessional Loans Scheme Northern Territory OFFICE USE ONLY Client ID No: Application No: V2 26/06/14 Section 1 - Applicant details Please tick: Title Surname Given Names Date of Birth Sole Trader Partners Individual Trustees Company Directors Company Trust Company name Trust name Please list the company directors details above. If the Trustee is a Company, please provide the Company name in the company box above and the Company directors names in the boxes above the company name. Trading Name ABN GST Registered? No Industry Type (e.g. beef, mango, grain) Is at least one member of the farm business an Australian resident? No Nominated contact person (from above) Business Phone No. Fax No. Mobile No. Telephone No. Address Road Address of Enterprise (if relevant) Postal Address Postal Name Please tick if same as Road Address Town State Postcode Postal Address City/Shire/Regional Council Town State Post code Section 2 - Farm business contact details Accountant Contact Person Telephone Fax Firm Bank or financier Contact Person Telephone Fax Firm The Farm Finance ConcessIonal Loans Scheme (NT) is administered by QRAA on belf of the Northern Territory Government.

2 Section 3 - Loan restructure amount details Please provide details of all eligible debt held and the concessional loan amount requested The concessional loan amount applied for must be less tn 50% of the total eligible debt, up to a maximum of $1,000,000 (the minimum loan amount is $100,000). Please note: Only details of eligible debt should be entered below. Eligible debt does not include: private or family debt not provided at arm s length and at commercial interest rates and terms and conditions equipment finance facilities non-balance sheet loans funding of normal or additional working capital The loan balances entered below should be the same as the Schedule of Account completed by your bank or financial institution. Account name Name Bank/Financier Loan Loan Type type Loan Loan Balance balance Requested Concessional restructure Loan amount s $ $ Section 4 - Preferred concessional loan terms Please outline your preferred loan term and interest frequency. Loan Term Years (Maximum 5 years) Interest only period Years (Maximum 5 years) Interest Frequency Monthly Half Yearly Quarterly Security Offered All successful applicants must provide satisfactory security. Please provide details of the security available (e.g. first or second mortgage over property, stock mortgage) should your concessional loan application be successful. Farm Finance Concessional Loan Application Form - Northern Territory pg 2 of 10

3 Section 5 - Primary production property details Please provide details of all properties owned or leased. (Copy and attach separate pages for each property if necesssary). Property Name Owned Year Purcsed Current Market Value $ Leased Lease Payment (pa.) $ Expiry Options Registered Owners Title Ref No or Lease No NT Portion Section No. & Hundred of Area Lot/Plan No Property Address This property is kms in a direction from the town of in the Local Government area of District (e.g Barkly, Darwin, VRD): Aquaculture: Aquaculture licence type Pastoral/Livestock: Native pasture Licence no. Expiry Date Improved pasture Grazing area Farmed area Agriculture/Horticulture: Crop type Apiculture: Pic no. All: Water licence no. No. of allocated megalitres No. of hives Expiry Date Dryland cultivation Has allocation been assigned? No Irrigated cultivation If yes, to whom? Other For agistment/srefarming properties, please provide details and costs of any agreements in place: Other relevant property details: Farm Finance Concessional Loan Application Form - Northern Territory pg 3 of 10

4 Livestock - Current Numbers & Carrying Capacity Section 6 - Production information Beef Herd Breed: Cows Heifers Steers Calves Bulls Current Carrying Capacity Breeders Current Other livestock Herd Breed: Carrying Capacity Beef (AE) Calving (%) Please ensure the following sales and purcse amounts correspond to your financial statements or cash book figures. Stock schedules are available at for your use if preferred. Sales Production details Livestock Sold (e.g. Cows, Steers, Heifers) Last Financial Year (20 Actuals) This Financial Year Actuals/Estimates Next Financial Year Estimates Year In - Year Out Estimates* Number ($) Number ($) Number ($) Number ($) Aquaculture Crop Information Cattle on agistment Purcses Livestock Purcsed (e.g. Cows, Steers, Heifers) Livestock on Agistment Crop Types Product Type Number ($) Number ($) Number ($) Number ($) Area () Last Financial Year (20 Actuals) Number ($) Number Yield ($) Area () Last Financial Year (20 Actuals) Yield ($) Area () Yield This Financial Year ($) Area () This Financial Year ($) Yield Number Kg ($) Number Kg ($) ($) Product Quantity ($) Quantity ($) Quantity ($) Quantity ($) Other *Given normal seasons and commodity prices Farm Finance Concessional Loan Application Form - Northern Territory pg 4 of 10

5 Section 7 - Statement of Assets and Liabilities Complete this Statement of your Assets and Liabilities for the applicant and all members of the farm business. The statement must include all assets owned and all debts. ASSETS (Show present fair market value) Cash at Bank Term Deposits $ $ LIABILITIES (Current amount owing) Overdraft (Limit:$ ) Term loans Farm Properties *Land Buildings *Land Buildings Other Loans (eg. Private Loans) *Land Buildings Livestock or equivalent Plant & machinery Vehicles Crops (rvested, stored and unsold) Accounts Receivable Debentures/Sres/Investments Other Real Estate (show details) Stock Loans/Pastoral House Hire Purcse, Leasing & Cttel Mortgage (transfer total from table below) Entitlements Owing to Employees Taxation Debt Accounts Payable Margin Loans Real Estate Loans (show details) Superannuation (current estimated value) Life Insurance (estimated surrender value) Other Assets (detail) ASSETS * Value based on carrying capacity Personal Loans Credit Cards Other Liabilities (detail) LIABILITIES Hire Purcse and Lease Repayment Schedule (please attach a separate list if required). Item Lender (a) Instalment Amount INSTALMENTS Frequency eg. Monthly/ Yearly (b) No. of payments remaining Date of final payment (c) Overdue payments (Arrears) LEASE RESIDUAL (d) Amount Due Date Owing (a x b + c + d) Owing (transfer total to Statement of Assets and Liabilities above) Farm Finance Concessional Loan Application Form - Northern Territory pg 5 of 10

6 Section 8 - Supporting documents checklist The following information must also be provided to QRAA with this application. Past 5 (five) Years' Financial Statements - Applicant and all members of the farm business - including Profit and Loss Statement, Balance Sheet and depreciation schedules, Livestock schedules - Cashbook figures are acceptable if financial statements ve not been prepared Past 5 (five) Years' Personal Taxation Returns - Applicant and all members of the farm business All members of the farm business, including directors and trustees must sign below. Please tick Monthly Cash Flows for the Current Financial Year Monthly Cash Flow projections for the Next Financial Year Schedule of Account Details - A copy of the form is to be completed by each of your lenders (including banks, credit unions, lease/finance companies etc) and attached to this application. Please arrange for your lenders to return this form to you prior to submission of the completed application to QRAA. Completed business plan, outlining the five year plan for the farm business. A template is available at or you may submit your own. Company Constitution - Also know as a Memorandum and Articles of Association N/A Trust Deed N/A Please provide any additional information or documentation tt you feel may support your application. Please post your application to: Farm Finance Concessional Loans Scheme - Northern Territory C/- QRAA, GPO Box 211, Brisbane, Queensland 4001 Authorisation I/We ve read and understood the Farm Finance Concessional Loans Scheme Guidelines for the Northern Territory and obtained clarification where needed. I/We ve read the Privacy Statement below and understand how information provided in my/our application may be used. I/We understand tt completed applications under the scheme will be assessed in the order of receipt and loan offers will be based on the availability of funds. I/We hereby authorise QRAA to also notify the following person/firm/company of the decision of the application (optional): Contact Person Address Firm I/We hereby authorise QRAA to obtain and disclose such information as considered necessary in relation to this application from my/our accountants, solicitors, business consultants, commercial lenders (e.g. banks and other financiers), other government departments, regional and shire councils, suppliers, processors or other agents. I/We certify tt all of the information provided in the whole of this application is true and accurate and discloses our correct financial position. I/We also agree to participate in a follow-up survey if requested. Applicant (1) Applicant (2) Signature Print Name: Position: Applicant (3) Date: Signature Print Name: Position: Applicant (4) Date: Signature Print Name: Signature Print Name: Position: Date: Position: Privacy statement Information provided by Applicants may be used by DPIF, QRAA and/or the Australian Government for administration of the Farm Finance Concessional Loans Scheme and assessment of the Application. Provision of information (personal or otherwise) constitutes the Applicant s consent to DPIF, QRAA and/or the Australian Government using the information for the above mentioned purposes and any other incidental or related purpose. DPIF, QRAA and/or the Australian Government may disclose your personal information to any party engaged in the assessment or evaluation of the Concessional Loans Scheme in any jurisdiction. QRAA and/or the Australian Government will store personal information collected through the Application, supporting documentation, the Concessional Loan Agreement and any monitoring and evaluation activities in compliance with their respective obligations under the Information Privacy Act 2009 (Qld) and the Privacy Act 1998 (Cth). You may access or correct your personal information at any time by contacting QRAA via or in writing. Date: Farm Finance Concessional Loan Application Form - Northern Territory pg 6 of 10

7 Application & Cashflow guidance General guidance For assistance with any questions prior to lodgement of this form, please contact DPIF on or Please complete each section in the application form and forward it to QRAA with the required attachments (listed on page 6). Incomplete applications or missing attachments are likely to cause delays in assessing your application and may result in the application being declined. Cashflow guidance The cashflow forms should be completed by the applicant, however your Accountant or Financial Advisor may be able to assist, if needed. A projected cashflow allows you to estimate as accurately as you can the income and expenses for a current/future period. You should base your projections on your historical results (past financials) and your knowledge of wt might be different this year and the following year. The ability to check your actual results with wt you expected will assist you to make critical decisions about your business. QRAA requires a monthly cashflow for the current year, plus the next full financial year. Microsoft Excel versions of the Cashflow Form are available to download from the DPIF website ( and the totals will automatically calculate making it easier to complete. If you ve your own computer prepared cashflows, please submit these. Completing a Cashflow The steps below outline how to complete a QRAA application cashflow: 1. Fill in the application name at the top of the form and complete the relevant year. 2. Income Refer to your past financials for suitable headings or use those shown as a guide. Please note tt livestock/stock sales are shown (not the profit), with purcses shown in the purcses section of the form. These monthly figures should agree with the total sales shown in Section 6 (page 4) of your application form. All income should be shown, including personal wages, interest and dividends from investments, rents from properties, any other personal income, government assistance and all business income. Use your historical records to estimate when income will be received, but adjust for your knowledge of any cnges to sales patterns or income receipts. 3. Expenses Again you should refer to your past financials for suitable headings for your business. Please use the headings shown as a basic guide. These will also assist you with the timing of payments. Do not include non-cash items such as Depreciation or Bad Debts in your cashflow. 4. Purcses Here you should include all your livestock/stock purcses in the months when you expect to pay for them. These figures should agree with the total purcses shown in Section 6 (page 4) of your application form. Capital purcses would include major items such as vehicles or equipment (the cash amount paid excluding lease/hp etc), major renovations or improvements, new fences, irrigation equipment etc. Please make a note of the type of capital purcse. 5. Other Expenses Here you would list all your: - lease, hire purcse or cttel mortgage payments - interest on overdraft or similar type of non reducing facility, and - total repayments on term loans, personal loans, private loans, housing loans and credit cards. You also need to record your personal drawings, medical contributions and payments, education expenses for yourselves or dependants and life insurance payments. 6. Surplus or (Deficit) This total will be automatically calculated if you are using the Microsoft Excel version of this form from the DPIF website. If you are completing the form manually, please calculate the difference between Income and Expenses. If income is greater, you ve made a surplus or profit. If Expenses are greater, you ve made a (deficit) or loss. 7. Note your Opening and Closing Bank Balances If completing the cash flow for the current year, the opening bank balance of your overdraft or operating account for July should be taken from your bank statement and adjusted if necessary for outstanding cheques. If completing the cash flow for the following or subsequent years, the opening bank balance will be the closing bank balance from the previous year s cash flow which you ve completed. The purpose of this calculation is to provide an estimate of your bank balance (the closing balance) at the end of each month, and indicate your peak debt or credit. The closing balance is calculated by adding the opening balance to the monthly surplus or (deficit), which then becomes the opening balance for the next month. Farm Finance Concessional Loan Application Form - Northern Territory pg 7 of 10

8 Monthly Cashflow for CURRENT Financial Year (Period 1 July... to 30 June... ) Name INCOME Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun TOTAL Livestock/sales Crop sales Fuel rebate Agistment Wages/Salary Contracting Capital introduced GST & Tax Refunds Asset sales (detail) TOTAL INCOME EXPENSES - FIXED & VARIABLE (amend, add or delete headings as necessary to suit your business - refer to your past financials) Account/Admin fees Bank crges Electricity & Gas Insurance Licence fees/levies Phone & Internet Postage & Stationery Rates & Rent Subscriptions Crop - rvesting Fertiliser & Chemicals Planting & Seed Livestock - dips/sprays Fodder & Supplements Freight & Selling costs Mustering Vet costs Advertising Freight & Cartage Fuel & Oil Motor Vehicle Expenses Plant & Equip Hire Repairs & Maintenance Salaries & Wages Sundry Superannuation Travel & Accomm Workers Compensation GST & Tax Paid PURCHASES Capital Livestock/Stock OTHER EXPENSES Lease/HP/Cttel Mort Interest Loan Repayments Personal Living Medical/Educ/Life Ins. TOTAL EXPENSES SURPLUS (DEFICIT) Opening Bank Balance Closing Bank Balance Farm Finance Concessional Loan Application Form - Northern Territory pg 8 of 10

9 Monthly Cashflow for NEXT Financial Year (Period 1 July... to 30 June... ) Name INCOME Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun TOTAL Livestock/sales Crop sales Fuel rebate Agistment Wages/Salary Contracting Capital introduced GST & Tax Refunds Asset sales (detail) TOTAL INCOME EXPENSES - FIXED & VARIABLE (amend, add or delete headings as necessary to suit your business - refer to your past financials) Account/Admin fees Bank crges Electricity & Gas Insurance Licence fees/levies Phone & Internet Postage & Stationery Rates & Rent Subscriptions Crop - rvesting Fertiliser & Chemicals Planting & Seed Livestock - dips/sprays Fodder & Supplements Freight & Selling costs Mustering Vet costs Advertising Freight & Cartage Fuel & Oil Motor Vehicle Expenses Plant & Equip Hire Repairs & Maintenance Salaries & Wages Sundry Superannuation Travel & Accomm Workers Compensation GST & Tax Paid PURCHASES Capital Livestock/Stock OTHER EXPENSES Lease/HP/Cttel Mort Interest Loan Repayments Personal Living Medical/Educ/Life Ins. TOTAL EXPENSES SURPLUS (DEFICIT) Opening Bank Balance Closing Bank Balance Farm Finance Concessional Loan Application Form - Northern Territory pg 9 of 10

10 Schedule of Account Details A separate copy of this form is to be completed by each of your lenders. Please arrange for your lenders to return this form to you before submitting your completed application form to QRAA. (Includes banks, finance companies, building societies, credit unions and private lenders. For applicants and members of the farm business) OFFICE USE ONLY Client ID No: Application No: V2 26/06/13 To: (Bank/Financier Name) Name/Company/Firm Consent and Authorisation Please list below details of all my/our accounts held with your company and return this form to me/us according to the Return Instructions (shown to the right of this form). You are also authorised to discuss my/our accounts with QRAA and provide any information QRAA may request regarding my/our accounts. Applicants Signature Return Instructions Please return this form to me/us by: Fax ( ) Post Name/Director/Partner Applicants Signature Loan Accounts, Equipment Finance & other Borrowings (Debit Accounts) Account Name Account BSB & Facility Type Balance Limit Interest Number Rate Expiry Date Repayment Amount Repayment Frequency Balloon or Residual Arrears Contingent Liabilities: Savings Accounts, Term Deposits, Investment Accounts & other Asset Accounts (Credit Accounts) Account Name Accounts BSB & Number Account Type Balance Branch Address/Stamp Manager Signature Phone Number Certification I/we confirm the above information is correct and confirm ongoing support for the account holder if a concessional loan is approved, subject to normal review processes. Manager Name Address Farm Finance Concessional Loan Application Form - pg 10 of 10 The Farm Finance Concessional Loans Scheme is administered by QRAA on belf of the Northern Territory Government. An additional Schedule of Account Details form is available on the DPIF webste at For any queries please contact QRAA on Freecall Date Fax Number