sustainability loan v11 full application · 2018. 2. 24. · section 10 - statement of assets and...

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Queensland Rural and Industry Development Authority (QRIDA) GPO Box 211 Brisbane Qld 4001 Freecall: 1800 623 946 F: 07 3032 0300 E: [email protected] Website: www.qrida.qld.gov.au ABN: 30 644 268 943 Queensland Rural and Industry Development Authority Sustainability Loan Section 1 - Enterprise details Accountant Telephone Contact Person Firm Email Fax Bank or Financier Telephone Contact Person Firm Email Fax Individual Trustees Title Given Names Surname Date of Birth Sole Trader Partners 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. Nominated contact person (from above) Business Phone No. Mobile No. Fax No. Email Address Telephone No. Postal Address Please tick if same as Road Address Postal Name Postal Address Town Post code State Town Postcode State Road Address of Enterprise City/Shire/Regional Council ABN Trading Name GST Registered? Yes No Industry Type (e.g. beef, sheep, grain) Section 2 - Business contact details Please tick: Application QRIDA Client ID (if known) Please provide the number of employees (excluding owners, partners, directors, etc): Full Time employees Full Time equivalent* Total employees *Calculating Full Time Equivalent Staff Full time work is 35 hours per week or more. If your business has casual or part time workers, calculate the number of hours worked by these employees and divide that total by 35 to determine full time equivalents. (For example, seven casual employees working 10 hours per week totalling 70 hours per week, equates to two full time employees). V11 1/7/17 OFFICE USE ONLY Client ID No: Application No: Primary Producer

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  • Queensland Rural and Industry Development Authority (QRIDA)GPO Box 211 Brisbane Qld 4001Freecall: 1800 623 946 F: 07 3032 0300E: [email protected]: www.qrida.qld.gov.auABN: 30 644 268 943

    Queensland Rural and Industry Development Authority

    Sustainability Loan

    Section 1 - Enterprise details

    Accountant

    TelephoneContact Person

    Firm Email

    Fax

    Bank or Financier

    TelephoneContact Person

    Firm Email

    Fax

    Individual Trustees

    Title Given NamesSurname Date of Birth

    Sole Trader Partners

    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.

    Nominated contact person (from above)Business Phone No. Mobile No.Fax No. Email Address

    Telephone No.

    Postal Address Please tick if same as Road Address

    Postal Name

    Postal Address

    Town Post codeState

    AddressTown PostcodeState

    Road Address of Enterprise

    City/Shire/Regional Council

    ABN

    Trading Name

    GST Registered? Yes No

    Industry Type (e.g. beef, sheep, grain)

    Section 2 - Business contact details

    Please tick:

    Application

    QRIDA Client ID (if known)

    Please provide the number of employees (excluding owners, partners, directors, etc): Full Time employees

    Full Time equivalent*

    Total employees

    *Calculating Full Time Equivalent Sta�Full time work is 35 hours per week or more. If your business has casual or part time workers, calculate the number of hours worked by these employees and divide that total by 35 to determine full time equivalents. (For example, seven casual employees working 10 hours per week totalling 70 hours per week, equates to two full time employees).

    V11 1/7/17

    OFFICE USE ONLYClient ID No:

    Application No:

    Primary Producer

  • Section 3 - Proposal summary

    Sustainability Loan Application Form - Primary Producer - pg 2 of 10

    Requirements (Please detail below. Include these costs in your cashflow projections)

    Section 5 - Detailed activity requirements and funding details

    Cost

    Amount

    Total*

    Cash contribution

    Other loans (please detail)

    QRIDA loan

    Please outline your preferred repayment terms including length of the loan, interest only periods, repayment frequency and �xed interest rate period.

    Funding - How do you plan to fund the above requirements? (Detail below)

    Other (please detail)

    Section 4 - Do I need a licence, permit, approval or other authorisation?

    Total*

    Security O�eredApplicants are required to provide adequate security in the form of a mortgage over land or other assets acceptable to QRIDA. Please outline the security available to QRIDA (e.g. �rst or second mortgage over property, stock mortgage) should your loan be successful.

    Section 6 - Preferred terms and conditions

    Please note that it is the applicant’s responsibility to ascertain if a licence, permit, approval or other authorisation is required for the proposed activity, the subject of this application. Appendix 1 to the guidelines of the Sustainability Program provides details of activities that may require a licence, permit, approval or other authorisation, but is provided as a guide only and does not represent professional or technical advice.As the applicant, you should obtain independent, technical advice to determine if a licence, permit, approval or other authorisation is required for the proposed activity, the subject of this application. Please con�rm that you have obtained this advice as follows (tick one box):

    The proposed activities, the subject of this application, do not require a licence, permit, approval or other authorisation.

    The proposed activities, the subject of this application, do require a licence, permit, approval or other authorisation, and a copy of the relative document is attached.

    Source of technical advice (e.g. DNRM, DSDIP)

    Name of person providing advice Contact Number

    *Totals should be the same.

    Please provide a brief summary of your initiatives, the activities involved and what you would like to achieve in terms of sustainable management. Please ensure your Management Plan is completed and attached.

    Loan Term:

    Repayment Frequency Monthly

    Years

    Interest Rate Period One Year Fixed Three Years Fixed Five Years Fixed

    Half Yearly Quarterly

    Interest Only period:Note: An initial interest only period can be considered by QRIDA where a �nancial need is clearly demonstrated.

    Years

  • Section 7 - Primary production property details

    Sustainability Loan Application Form - Primary Producer - pg 3 of 10

    Please show all properties owned in which you have an interest, and all properties to be purchased.Please copy and attach separate pages for each property.

    Soil types:

    Dryland cultivation

    Irrigated cultivation

    Improved grazing

    Open downs

    Total Area

    Irrigation potential

    Type of standing timber:

    Unimproved grazing

    Unimproved/timbered

    Other (detail)Dairy Licence

    Number Dairy Processor

    Sugar Farm No. Sugar Mill Supplied

    Unregulated source or storage details & megalitres

    No Yes - Detail to whomHas allocation been assigned?

    No. of allocated Megalitres

    Expiry Date

    Water licence no.

    Water Allocation no.(Water Act 2000)

    Section 8 - Farm improvements and infrastructure

    ha

    ha

    ha

    ha

    ha

    ha

    ha

    ha

    ha

    For agistment/sharefarming properties, please provide details and costs of any agreements in place:

    Other relevant property details:

    Property Name

    Title Ref No or Lease No County Parish

    Lot/Plan No

    Area (ha)

    Property Address

    Registered Owners

    This property is in a direction from the town of

    in the Local Government area of City/Shire/Regional Council.

    kms

    Leased OptionsExpiryLease Payment (pa.) $

    To be purchased Contract Purchase Date $Purchase

    Price

    Year Purchased Current Market Value* (land and improvements) $Owned

    Settlement Date

    Finance Date

    *Please state how you arrived at the current market value of your property (land and impovements):

    Please provide a listing of the farm improvements and infrastructure on the property detailed in Section 7:

    Building

    $$

    $

    $

    Description (type, size) and Construction (e.g. Brick and tile) Condition(e.g. good, fair, poor)

    Insured value(where applicable)

    $

    $

    $

    $

    Main homestead

    Homestead 2

    Shearing shed

    Equipment shed/s

    Hay shed/s

    Feedlot

    Irrigation infrastructure

    Other( )

    Other( ) $

    http://www.qraa.qld.gov.au/__data/assets/pdf_file/0020/7076/Sustainability-Loan-V5-Writable-Add-Property-Page-Reader-Enabled.pdf

  • Sustainability Loan Application Form - Primary Producer - pg 4 of 10 *Given normal seasons and commodity prices

    Section 9 - Production information

    Cows

    Heifers

    Steers

    Calves

    Bulls

    Beef/Dairy

    Total Beef (AE)

    Carrying Capacity

    Breeders

    Growers

    Boars

    Gilts

    Pigs

    No. litters/sow/year

    Av no. live piglets/litter

    EwesWethers

    Hoggets

    Lambs

    RamsCurrent Total

    Sheep

    Total sheep (DSE)

    Carrying Capacity

    Ewes

    Lambing (%)

    Please ensure the following sales and purchase amounts correspond to your �nancial statements or cash book �gures.

    Calving (%)

    Herd Breed: Herd Breed: Current TargetSows

    Licensed for: SPU’s

    Av age @ sale

    Av weight @ sale

    weeks

    kgs

    Other livestock

    Herd Breed:

    Carrying Capacity

    Milkers

    Current Total

    Live

    stoc

    k - C

    urre

    nt N

    umbe

    rs &

    Car

    ryin

    g Ca

    paci

    ty

    Current Total

    Farrowing (%)

    Stock schedules are available on the QRIDA website for your use if preferred.

    Production details Last Financial Year (20_ _ Actuals)This Financial Year Actuals/Estimates

    Next Financial Year Estimates

    Year In - Year Out Estimates*

    Sale

    s

    Livestock Sold (e.g. Wethers,

    Steers, Porkers)Number Total ($) Number Total ($) Number Total ($) Number Total ($)

    Purc

    hase

    s

    Livestock Purchased (e.g. Wethers,

    Steers, Porkers)Number Total ($) Number Total ($) Number Total ($) Number Total ($)

    Dair

    y

    Average no. of milkers in daily production Head Head Head Head

    Total Litres produced Ltrs/annum Ltrs/annum Ltrs/annum Ltrs/annum

    Gross Milk Proceeds $ $ $ $

    Crop

    Info

    rmat

    ion

    Crop Types Area (ha)Total Yield

    Total ($)

    Area (ha)

    Total Yield

    Total ($)

    Area (ha)

    Total Yield

    Total ($)

    Area (ha)

    Total Yield

    Total ($)

    Sugar Tonnes Tonnes Tonnes TonnesCCS CCS CCS CCS

    Area (ha) Area (ha) Area (ha) Area (ha)

    Total ($) Total ($) Total ($) Total ($)

    Woo

    l

    Months Wool Sold ( )

    Number Shorn

    Total Kgs

    Yield %

    Micron

    Total $

    Oth

    er

    Product Quantity Total ($) Quantity Total ($) Quantity Total ($) Quantity Total ($)

  • Section 10 - Statement of Assets and Liabilities

    Sustainability Loan Application Form - Primary Producer - pg 5 of 10

    Complete one Statement of your business and personal Assets and Liabilities including those held individually or jointly with partners, other persons or associated entities. The Statement must include all assets you own and all debts you owe.

    Hire Purchase and Lease Repayment Schedule (if preferable you can attach a list seperately to this form)

    Item Lender

    INSTALMENTS LEASE RESIDUALTotal Owing

    (a x b + c + d)(d)Amount

    Due Date(a)Instalment

    Amount

    Frequency eg.

    Monthly/Yearly

    (b)No. of

    payments remaining

    Date of �nal

    payment

    Total Owing (transfer total to ‘Statement of Assets and Liabilities’ above)

    ASSETS (Show present fair market value)

    LIABILITIES (Current amount owing)

    Cash at Bank

    Farm Properties

    Accounts Receivable

    Debentures/Shares/Investments

    Superannuation (current estimated value)

    Total ASSETS Total LIABILITIES

    Real Estate Loans (show details)

    Margin Loans

    Accounts Payable

    Entitlements Owing to Employees

    Hire Purchase, Leasing & Chattel Mortgage(transfer total from table below)

    Stock Loans/Pastoral House

    1. Land ha @ $

    2. Land ha @ $Other Loans (eg. Private Loans)

    $ $

    Term Deposits

    /ha = $

    /ha = $

    /ha = $

    Livestock/stock (show type)

    Plant & machinery

    Vehicles

    Crops (harvested, stored and unsold)

    Other Real Estate (show details)

    Other Assets (detail)

    Overdra� (Limit:$ )

    Term loans

    Taxation Debt

    Personal Loans

    Credit CardsOther Liabilities (detail)

    (c)Overdue

    payments (Arrears)

    3. Land ha @ $

    Buildings ( ) $

    Buildings ( ) $

    Buildings ( ) $

  • Sustainability Loan Application Form - Primary Producer - pg 6 of 10

    Section 11- Supporting documents checklist

    All business owners, directors or trustees must sign below.

    The following information must also be provided to QRIDA with this application.

    I/We hereby authorise QRIDA and any of its authorised representatives to:(a) collect information that QRIDA or its authorised representatives consider to be necessary or appropriate in connection with this application, from: (i) any accountant, solicitor, business consultant, bank, other �nancier, processor, supplier or other person named or identi�ed in this application or any supporting documentation provided with, or in support of, this application; and (ii) any State or local government agency or authority that QRIDA or its authorised representatives may consider relevant to this application, (each a Relevant Person); and(b) disclose to any Relevant Person and to any contractor or agent of QRIDA involved in the assessment or processing of this application: (i) that I/we have made this application; (ii) information contained in this application or any supporting documentation provided with, or in support of, this application; (iii) information collected by QRIDA or its authorised representatives under paragraph (a) above; and (iv) information about any previous application I/we have made to, or �nancial assistance received from, QRIDA.

    Privacy information Personal information provided on this form or obtained from any Relevant Person may be used by QRIDA or State government agencies and their authorised representatives to assess your eligibility for the above scheme and in relation to the administration and management of the scheme or any assistance provided to you under the scheme. QRIDA may also use this information to research and develop its service, to collate statistical data or in some cases provide you with information on other QRIDA support programs. QRIDA may disclose your personal information in accordance with your Authorisation above. More information about our privacy policy is available on our website at http://www.qrida.qld.gov.au/

    Past 3 (three) Years' Financial Statements - Applicant and all associated entities

    Australian Taxation O�ce (ATO) Integrated Client Account Statement ATO Integrated Client Account Statement (previous 12 months) for the applicant and all associated entities.

    Past 3 (three) Years' Personal Taxation Returns - Applicant and all associated entities.

    - including Pro�t and Loss Statement, Balance Sheet and depreciation schedules- Cashbook �gures are acceptable if �nancial statements have not been prepared

    Yes

    N/A

    Yes

    YesYes

    Yes

    Trust Deed Yes

    Authorisation

    I/We hereby con�rm that the above �nancial and other required documentation is included with this application. I/We hereby authorise QRIDA to also notify the following person/�rm/company of its decision about this application (optional):

    Please provide any additional information or documentation that you feel may support your application.

    AddressContact Person

    Firm

    I/We declare that I /we have resided in Queensland for at least 6 months and do not own, or have disposed of, a viable primary production enterprise.

    Accountant

    Bank

    Financial CounsellorQRIDA - Regional Area Manager

    QRIDA - Head O�ce

    Government Department

    Industry Organisation

    How did you learn about this assistance (please select)?

    Media (radio/newspapers

    Monthly Cash Flows for the Current Financial Year

    Monthly Cash Flows 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/�nance 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 QRIDA.

    Print Name:

    Date:

    Signature

    Applicant (3)

    Position:

    Print Name:

    Date:

    Signature

    Applicant (4)

    Position:

    Print Name:

    Date:

    Signature

    Applicant (1)

    Position:

    Print Name:

    Date:

    Signature

    Applicant (2)

    Position:

    Management Plan

    Copy of Fishing Licence/s and Unit Certi�cates

    Copy of Purchase Agreement / Contract (purchase only)

    Yes

    Yes

    Yes

    Yes

    N/A

    N/A

    Please tick

    I/We authorise any Relevant Person to disclose to QRIDA and its authorised representatives such information as may be requested about me/us in connection with this application.I/We certify that all of the information provided in the whole of this application is true and accurate and discloses our correct �nancial position. I/We also agree to participate in a follow-up survey if requested.

    http://www.qraa.qld.gov.au/__data/assets/excel_doc/0012/1137/Cashflow-primary-production-16_01_13.xlshttp://www.qraa.qld.gov.au/__data/assets/pdf_file/0019/7714/Schedule-of-Account-Details-Writable-Reader-Enabled.pdfhttp://www.qraa.qld.gov.au/__data/assets/word_doc/0017/1196/Sustainability-Loans-Primary-Producers-Management-Plan-new-branding-140716.doc

  • Application & Cashflow guidance

    Sustainability Loan Application Form - Primary Producer - pg 7 of 10

    General guidanceQRIDA has Regional Area Managers based in Bundaberg, Cloncurry, Emerald, Innisfail, Kingaroy, Mackay, Rockhampton, Roma and Toowoomba who can assist you with any questions. To speak to your local Regional Area Manager, please contact QRIDA on Freecall 1800 623 946.Please complete each section in the application form and forward it to QRIDA 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 guidanceThe cashflow forms should be completed by the owners and operators of the business, 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 �nancials) and your knowledge of what might be di�erent this year and the following year. The ability to check your actual results with what you expected will assist you to make critical decisions about your business.

    QRIDA requires a monthly cashflow for the current year, plus the next full �nancial year. Microso� Excel versions of the Cashflow Form are available to download from the QRIDA website (www.qrida.qld.gov.au) and the totals will automatically calculate making it easier to complete. If you have your own computer prepared cashflows, please submit these.

    Completing a CashflowThe steps below outline how to complete a QRIDA application cashflow:

    1. Fill in your name and QRIDA Client Identi�cation Number (if known) at the top of the form and complete the relevant year.

    2. Income Refer to your past �nancials for suitable headings or use those shown as a guide. Please note that livestock/stock sales are shown (not the pro�t), with purchases shown in the purchases section of the form. These monthly �gures should agree with the total sales shown in Section 9 (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 changes to sales patterns or income receipts.

    3. ExpensesAgain you should refer to your past �nancials 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. PurchasesHere you should include all your livestock/stock purchases in the months when you expect to pay for them. These �gures should agree with the total purchases shown in Section 9 (page 4) of your application form. Capital purchases 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 purchase. Include in this section the costs of your activity requirements shown in Section 5 (page 2).

    5. Other ExpensesHere you would list all your: - lease, hire purchase or chattel mortgage payments - interest on overdra� 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 (De�cit)This total will be automatically calculated if you are using the Microso� Excel version of this form from the QRIDA website. If you are completing the form manually, please calculate the di�erence between Income and Expenses. If income is greater, you have made a surplus or pro�t. If Expenses are greater, you have made a (de�cit) 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 overdra� 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 have 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 (de�cit), which then becomes the opening balance for the next month.

  • SUB TOTAL

    Monthly Cashflow for CURRENT Financial Year (Period 1 July to 30 June )

    Sustainability Loan Application Form - Primary Producer - pg 8 of 10

    Name QRIDA Client ID (if known)

    INCOME Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun TOTALLivestock sales

    Crop sales

    Fuel rebate

    Agistment

    Wages/SalaryContracting

    GST & Tax RefundsAsset sales (detail)

    TOTAL INCOME

    Account/Admin fees

    Bank charges

    Electricity & Gas

    Insurance

    Licences

    Phone & Internet

    Rates & Rent

    Subscriptions

    Crop - harvesting

    Fertiliser & Chemicals

    Planting & Seed

    Livestock - dips/sprays

    Fodder & Supplements

    Freight & Selling costs

    Shearing

    Vet costs

    Advertising

    Freight & Cartage

    Fuel & OilMotor Vehicle Expenses

    Plant & Equip Hire

    Repairs & Maintenance

    Salaries & Wages

    Sundry

    Superannuation

    Travel & Accomm

    Workers Compensation

    GST Remitted/Paid

    SUB TOTAL

    Capital

    Livestock/Stock

    OTHER EXPENSESLease/HP/Chattel Mort

    Interest

    Loan Repayments

    Personal Living

    Medical/Educ/Life Ins.

    SUB TOTALTOTAL EXPENSES

    SURPLUS (DEFICIT)Opening Bank Balance

    PURCHASES

    Closing Bank Balance

    EXPENSES - FIXED & VARIABLE (amend, add or delete headings as necessary to suit your business - refer to your past �nancials)

    ....... .......

    Postage & Stationery

  • SUB TOTAL

    Monthly Cashflow for NEXT Financial Year (Period 1 July to 30 June )

    Sustainability Loan Application Form - Primary Producer - pg 9 of 10

    Name QRIDA Client ID (if known)

    INCOME Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun TOTALLivestock sales

    Crop sales

    Fuel rebate

    Agistment

    Wages/SalaryContracting

    GST & Tax RefundsAsset sales (detail)

    TOTAL INCOME

    Account/Admin fees

    Bank charges

    Electricity & Gas

    Insurance

    Licences

    Phone & Internet

    Rates & Rent

    Subscriptions

    Crop - harvesting

    Fertiliser & Chemicals

    Planting & Seed

    Livestock - dips/sprays

    Fodder & Supplements

    Freight & Selling costs

    Shearing

    Vet costs

    Advertising

    Freight & Cartage

    Fuel & OilMotor Vehicle Expenses

    Plant & Equip Hire

    Repairs & Maintenance

    Salaries & Wages

    Sundry

    Superannuation

    Travel & Accomm

    Workers Compensation

    GST Remitted/Paid

    SUB TOTAL

    Capital

    Livestock/Stock

    OTHER EXPENSESLease/HP/Chattel Mort

    Interest

    Loan Repayments

    Personal Living

    Medical/Educ/Life Ins.

    SUB TOTALTOTAL EXPENSES

    SURPLUS (DEFICIT)Opening Bank Balance

    PURCHASES

    Closing Bank Balance

    EXPENSES - FIXED & VARIABLE (amend, add or delete headings as necessary to suit your business - refer to your past �nancials)

    ....... .......

    Postage & Stationery

  • Queensland Rural and Industry Development Authority (QRIDA)GPO Box 211 Brisbane Qld 4001Freecall: 1800 623 946 F: 07 3032 0300E: [email protected]: www.qrida.qld.gov.auABN: 30 644 268 943

    Queensland Rural and Industry Development Authority

    Account Name Facility Type Balance Limit Interest RateExpiry Date

    Repayment Amount

    Balloon or Residual

    Account Name Accounts BSB & Number Account Type

    Branch Address/Stamp

    Phone Number

    DateManager Signature

    Account BSB & Number

    A separate copy of this form is to be completed by each of your lenders.

    Loan Accounts, Equipment Finance & other Borrowings (Debit Accounts)

    Savings Accounts, Term Deposits, Investment Accounts & other Asset Accounts (Credit Accounts)

    Certi�cationI/we con�rm the above information is correct and the account holder currently has the lender’s support. Requests for additional funding and / or continued support will be considered in line with conditions prevailing at the time of any such request and the lender’s usual credit requirements

    Fax Number

    Repayment Frequency Arrears

    Balance

    Manager Name

    Email Address

    (Includes banks, �nance companies, building societies, credit unions and private lenders. For Applicants and all related entities)

    To: _______________________________________________________________________________________ (Bank/Financier Name)

    Applicant’s SignatureName/Company/Firm

    Name/Director/Partner Applicant’s Signature

    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 and directed to discuss my/our accounts with QRIDA and provide any information QRIDA may request regarding my/our accounts.

    Return InstructionsPlease return this form to me/us by:

    Fax ( )

    Email

    Post

    Please arrange for your lenders to return this form to you before submitting your completed review to QRIDA. V7 1/7/17

    OFFICE USE ONLYClient ID No:Schedule of Account Details

    Contingent Liabilities:

    An additional Schedule of Account Details form is available on QRIDA’s website.

    http://www.qraa.qld.gov.au/__data/assets/pdf_file/0019/7714/Schedule-of-Account-Details-Writable-Reader-Enabled.pdf

    Version textbox: V9 1/2/17Title: Surname: Given Names: 1DOB: Entity Type: OffTitle2: Surname2: Given Names2: 2DOB: Title3: Surname3: Given Name3: 3DOB: Title4: Surname4: Given Names4: 4DOB: Company or Trust: OffCompany Name: Trust Name: Trading Name: ABN: Industry Type: [ ]GST Registered: OffClient ID: Nominated contact person: Telephone No: Business Phone No: Fax No: Mobile No: Email Address: Address: Town: State: [ ]Pcode1: CityShireRegional Council: Post Check: OffPostal Name: Postal Address: Town_2: State 2: [ ]Pcode2: Full Time Employees: Full Time equivalent: Total employees: 0Accountant: Telephone: Fax1: Firm: Email1: Bank or Financier: Telephone_2: Fax2: Firm_2: Email2: Please provide a brief summary of your proposal and what you would like to achieve in terms of sustainable management: Proposed Activity: OffDERM DEEDI: DERM DEEDI Person: DERM Telephone No: Requirements Please detail below Include these costs in your cashflow projectionsRow1: CostRow1: Requirements Please detail below Include these costs in your cashflow projectionsRow2: CostRow2: Requirements Please detail below Include these costs in your cashflow projectionsRow3: CostRow3: Requirements Please detail below Include these costs in your cashflow projectionsRow4: CostRow4: CostTotal: 0AmountCash contribution: Other loans please detail: AmountOther loans please detail: Other please detail: AmountOther please detail: AmountQRAA loan: AmountTotal: 0Loan term Yrs: Interest Only Yrs: Repayment Frequency: OffInterest Rate Period: Offmortgage should your loan be successful: Save application: Add page: Property Name: Own Purchase Lease: OffYear Purchased: CM Value: Contract: Settlement: Finance: Purchase Price: Lease Pa: Expiry: Options: Registered: or Lease No: County: Parish: Area ha: LotPlan No: Property: kms: Direction: [ ]direction from the town of: LGA: Soil types: Type of standing timber: DC: IC: IG: downs: UG: UT: Otherlanddetail: Other land type details: Total Area: 0Irrigation Potential: Water Licence No: Water Licence Expiry: Water Allocation No: Amount of Water Allocated: Has allocation been assigned: OffWater Allocation Assigned to: Unregulated Source or Storage details and Megalitres: Dairy Licence: Dairy Processor: Sugar Farm No: Sugar Mill: CMVappraisel: Additional Details 1: Other relevant property details: BulildingDesc: 0: 1: 2: 3: 4: 5: 6: 7: 8:

    Buildcond0: 0: [ ]1: [ ]2: [ ]3: [ ]4: [ ]5: [ ]6: [ ]7: [ ]8: [ ]

    InsuredValue: 0: 1: 2: 3: 4: 5: 6: 7: 8:

    OtherDescription1: OtherDescription2: Herd breed Type 1: Cows: Heifers: Steers: Calves: Bulls: Beef Total: 0Breeders: Milkers: Total Beef AE: Calving: Herd breed Type 2: Ewes: Wethers: Hoggets: Lambs: Rams: Sheep Total: 0Ewes CC: Total sheep: Lambing: CurrentSows: TargetSows: CurrentGilts: TargetGilts: CurrentBoars: TargetBoars: CurrentGrowers: TargetGrowers: SPU's: No litters sowyear: Av no live pigletslitter: Age at sale: Weight at Sale: Farrowing: Herd breed Type: Herd BreedRow1: HerdBreedNo1: Herd BreedRow2_2: HerdBreedNo2: Herd BreedRow3_2: HerdBreedNo3: Herd BreedRow4: HerdBreedNo4: Herd BreedRow5: HerdBreedNo5: Current Total_3: 0Carrying CapacityRow1: Carrying CapacityRow1_2: Carrying CapacityRow2: Carrying CapacityRow2_2: Carrying CapacityRow3: Carrying CapacityRow3_2: Carrying CapacityRow4: Carrying CapacityRow4_2: LFYY: Livestock Sold eg Wethers Steers PorkersRow1: LS Sold1: LYLS Total1: CYLSNo1: CYLS Total1: NFYLS No1: NFYLS Total1: YIYO No1: YIYO Total1: Livestock Sold eg Wethers Steers PorkersRow2: LS Sold2: LYLS Total2: CYLSNo2: CYLS Total2: NFYLS No2: NFYLS Total2: YIYO No2: YIYO Total2: Livestock Sold eg Wethers Steers PorkersRow3: LS Sold3: LYLS Total3: CYLSNo3: CYLS Total3: NFYLS No3: NFYLS Total3: YIYO No3: YIYO Total3: Livestock Sold eg Wethers Steers PorkersRow4: LS Sold4: LYLS Total4: CYLSNo4: CYLS Total4: NFYLS No4: NFYLS Total4: YIYO No4: YIYO Total4: Livestock Purchased eg Wethers Steers PorkersRow1: LYLP1: LYLP Total1: CYLPNo1: CYLP Total1: NFYLPNo1: NFYLP Total1: YIYOP No1: YIYOP Total1: Livestock Purchased eg Wethers Steers PorkersRow2: LYLP2: LYLP Total2: CYLPNo2: CYLP Total2: NFYLPNo2: NFYLP Total2: YIYOP No2: YIYOP Total2: LYMilkers: LYMilk: LYMilk$: CYMilkers: CYMilk: CYMilk$: NFYMilkers: NFYMilk: NFYMilk$: YIYOMilkers: YIYOMilk: YIYOMilk$: Crop Area LY: Area (ha)Yield LY: [Yield]Crop Area CY: Area (ha)Yield CY: [Yield]Crop Area NY: Area (ha)Yield NY: [Yield]Crop Area YIYO: Area (ha)Yield YIYO: [Yield]Crop TypesRow1: LYCA1: LYTY1: LYT$1: CYCA1: CYTY1: CYT$1: NFYCA1: NFYTY1: NFYT$1: YIYOCA1: YIYOTY1: YIYOT$1: Crop TypesRow2: LYCA2: LYTY2: LYT$2: CYCA2: CYTY2: CYT$2: NFYCA2: NFYTY2: NFYT$2: YIYOCA2: YIYOTY2: YIYOT$2: Crop TypesRow3: LYCA3: LYTY3: LYT$3: CYCA3: CYTY3: CYT$3: NFYCA3: NFYTY3: NFYT$3: YIYOCA3: YIYOTY3: YIYOT$3: LYTonnes: LYCCS: LYArea: LYSCT$: CYTonnes: CYCCS: CYArea: CYSCT$: NFYTonnes: NFYCCS: NFYArea: NFYSCT$: YIYOTonnes: YIYOCCS: YIYOArea: YIYOSCT$: Months Wool Sold: LY Sheep Shorn: LYWoolkgs: LYWoolYld: LYWoolMicron: LYWool$: CY Sheep Shorn: CYWoolkgs: CYWoolYld: CYWoolMicron: CYWool$: NFY Sheep Shorn: NFYWoolkgs: NFYWoolYld: NFYWoolMicron: NFYWool$: YIYO Sheep Shorn: YIYOWoolkgs: YIYOWoolYld: YIYOWoolMicron: YIYOWool$: ProductRow1: LYFOQuantity1: LYFOTotal$1: CYFOQuantity1: CYFOTotal$1: NFYFOQuantity1: NFYFOTotal$1: YIYOFOQuantity1: YIYOFOTotal$1: ProductRow2: LYFOQuantity2: LYFOTotal$2: CYFOQuantity2: CYFOTotal$2: NFYFOQuantity2: NFYFOTotal$2: YIYOFOQuantity2: YIYOFOTotal$2: ProductRow3: LYFOQuantity3: LYFOTotal$3: CYFOQuantity3: CYFOTotal$3: NFYFOQuantity3: NFYFOTotal$3: YIYOFOQuantity3: YIYOFOTotal$3: ProductRow4: LYFOQuantity4: LYFOTotal$4: CYFOQuantity4: CYFOTotal$4: NFYFOQuantity4: NFYFOTotal$4: YIYOFOQuantity4: YIYOFOTotal$4: Asset1: Term DepositsRow1: Asset2: Term DepositsRow2: Asset3: Landsize1: $/ha1: Land Total$: 0Buildings desc1: Building Value1: 0Asset4: 0Landsize2: $/ha2: Land Total$2: 0Buildings desc2: Building Value2: 0Asset5: 0Landsize3: $/ha3: Land Total$3: 0Buildings desc3: Building Value3: 0Asset6: 0Other Assets1: Livestock/stock (show type)Livestock type A&L1: [ ]Asset7: Livestock type A&L: [ ]Asset8: Other Assets9: Asset9: Other Assets10: Asset10: Asset11: Asset12: Asset13: Other Assets2: Asset14: Other Assets3: Asset15: Asset16: Other Assets4: Asset17: Asset18: Other Assets5: Asset19: Other Assets6: Asset20: Asset21: Asset22: Other Assets7: Asset23: Other Assets8: Asset24: Total ASSETS: 0OD Bank: [ ]Overdraft Limit: Liab1: Overdraft 2: Liab2: Other Liabs1: Liab4: Other Liabs2: Liab5: Other Liabs3: Liab6: Other Liabs4: Liab8: Other Liabs5: Liab9: Other Liabs6: Liab10: Other Liabs7: Liab11: Other Liabs8: Liab12: Liab13: Other Liabs9: Liab14: Other Liabs10: Liab15: Liab16: 0Other Liabs11: Liab17: Liab18: Liab19: Other Liabs12: Liab20: Liab21: Other Liabs13: Liab22: Liab23: Other Liabs14: Liab25: Other Liabs15: Liab26: Liab27: Liab28: Other Liabs16: Liab30: Other Liabs17: Liab31: Total LIABILITIES: 0ItemRow1: LenderRow1: InstalmentRow1: Repay Frequency1: [ ]RemainingRow1: paymentRow1: ArrearsRow1: AmountRow1: DueDateRow1: TotalOwingRow1: 0ItemRow2: LenderRow2: InstalmentRow2: Repay Frequency2: [ ]RemainingRow2: paymentRow2: ArrearsRow2: AmountRow2: DueDateRow2: TotalOwingRow2: 0ItemRow3: LenderRow3: InstalmentRow3: Repay Frequency3: [ ]RemainingRow3: paymentRow3: ArrearsRow3: AmountRow3: DueDateRow3: TotalOwingRow3: 0ItemRow4: LenderRow4: InstalmentRow4: Repay Frequency4: [ ]RemainingRow4: paymentRow4: ArrearsRow4: AmountRow4: DueDateRow4: TotalOwingRow4: 0ItemRow5: LenderRow5: InstalmentRow5: Repay Frequency5: [ ]RemainingRow5: paymentRow5: ArrearsRow5: AmountRow5: DueDateRow5: TotalOwingRow5: 0TotalOwing: 0Yes_13: OffYes_13a: OffDownload Cashflow: Yes_14: OffYes_14a: OffYes_15: OffManagement Plan: Yes_15a: OffProperty Map: OffCopy of Purchase Agreement: OffCompany Constitution Provided: OffContact: Firm_3: Trust Deed: OffAuth Address: Print Name: Position: Auth Date: Print Name2: Position2: Auth Date2: Print Name3: Position3: Auth Date3: Print Name4: Position4: Auth Date4: CLO: OffFinancial Counsellor: OffAcct: OffGovt Dept: OffHead Office: OffBank: OffIndustry Org: OffMedia: OffCashflow wording: Sample onlyA writable cashflow form is available for download on QRAA's website or by clicking the button below.Schedule wording: A writable Schedule of Account Details form is available for download on QRAA's website or by clicking the button below.Download Schedule: Print and Sign: Save: