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Australian Small Business Advisory Services Program Application Form
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Australian Small Business Advisory Services Program Application Form
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Australian Small Business Advisory Services Program Application Form
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Instructions

Australian Small Business Advisory Services Program Application Form
Applications may be submitted at any time up until .
Please save your form regularly and take note of the tracking code. Fields marked with  * are required.
About the Australian Small Business Advisory Service (ASBAS) Digital Solutions
The $18.02 million ASBAS Digital Solutions (the program) aims to support the Australian Government’s commitment to enhance the capabilities of business advisory service providers to deliver low cost, high quality, digital advisory services to Australian small businesses in metropolitan and regional areas across four priority digital capabilities: websites and selling online social media and digital marketing using small business software, and online security and data privacy Advisory service providers (you) will provide direct services to small businesses through a combination of channels and formats, including face to face and remote delivery methods such as video calls online, webchats, interactive webinars or phone calls. The services will include assessment of small businesses’ needs, tailored digital engagement plans where required, and advisory support in relation to one or more of the priority digital capabilities listed above. The program’s intended outcomes are: increased access by small businesses to advisory services that support and enhance their digital competency increased number of businesses using digital tools improved small business satisfaction through meeting their increased demand for quality and tailored advice on digital business enquiries
Completing this form
Please read the program guidelines before completing this application form.
Disclosure of information
The Commonwealth’s use and disclosure of both your personal and confidential information (provided in this application or otherwise) is set out in the program guidelines. Ensure that you have read this document and understand the information contained therein. For further information regarding the ’s (the department’s) obligations in accordance with the Privacy Act, refer to the department’s Privacy Policy.
Google Places
The address search fields in this form use Google Places to help fill in the address details. By using this feature you agree to be bound by Google’s terms of service and are subject to Google’s privacy policy.
Getting help
If you require assistance completing this application form please contact us on 13 28 46 or at business.gov.au. Our website and staff can help you with forms, finding business information and services and allow you to provide feedback, comments or suggestions. You should also read and understand the program guidelines and sample grant agreement before completing an application.
Requirements
This form functions best when it is completed using the most recent version of your internet browser. This form is not compatible with Internet Explorer 8 or earlier browsers. If you are using an earlier browser version, you may have difficulty in displaying the form correctly or it may not display at all.
Important information
Save regularly. Click the 'Save for Later' button regularly while completing this form to ensure the information entered is saved. Saved forms will be retained for a maximum of 60 days. If you do not save or submit your form within this timeframe, you will need to start a new form.This form has a tracking code displayed in the top right corner. Please make a note of this tracking code for your records. The tracking code is required to reopen your saved form and you will need to provide this code if you require assistance with your form.Do not use your internet browser's 'back' or 'refresh' buttons as this will cause the form to close and any unsaved information will be lost. Navigate between sections of the form by using the tabs at the top of the form or by clicking 'Continue' or 'Go Back' at the bottom of each page.
Sharing the form
The form can be viewed by more than one person by sharing the form's unique tracking code. However, sharing the form increases the risk of losing unsaved information. The reason for this is that only one person at any one time has saving permission for the application form. If the form is shared, save regularly as the last person that accesses the form has the saving permission. It is recommended that the form tracking code is not shared widely so as to avoid inadvertent loss of information.
Attachments
InstructionsAttach
File:
All attachments marked as required must be attached before your application can be submitted. Files with "" extension types can be uploaded. Total file size of all attachments in the application cannot exceed 20MB. Please note that there is a size limit of 2MB per attachment.We recommend scanning (not at a high resolution) multiple attachments such as letters, financial statements etc in black and white and creating a single attachment.
Submitting your form
Applications may be submitted at any time up until . You will be provided with a receipt to confirm that your submission has been successful. Please keep this receipt for your records by using the “Download the form and receipt” link or by emailing yourself a copy of the receipt and submission. Both of these options are available in the “To keep a copy of the completed form” box on the Submission Complete page. If you have any enquiries relating to submission of your form, you will need to provide your receipt number.

Eligibility

Australian Small Business Advisory Services Program Application Form
Applications may be submitted at any time up until .
Please save your form regularly and take note of the tracking code. Fields marked with  * are required.

Eligibility

This section will help you determine whether you are eligible to apply for the program.
Is your organisation an entity incorporated in Australia?
This includes an incorporated trustee applying on behalf of a trust, an incorporated for profit organisation or an incorporated not for profit organisation.
Is your organisation a trading corporation, where your trading activities: * form a sufficiently significant proportion of the corporation’s overall activities as to merit it being described as a trading corporation; or are a substantial and not merely peripheral activity of the corporation
Is your organisation a partnership or trust?
Note that an incorporated trustee may apply on behalf of a trust. (see above)
Is your organisation a Commonwealth, state/ territory or local government agency, body or government business enterprise?
Does your organisation have an ABN?
For trustees applying on behalf of a trust, this refers to the ABN of the trust.
Is your organisation registered for GST?
For trustees applying on behalf of a trust, this refers to GST registration of the trust.
Are you able to provide evidence from your governing or managing board (or support from the owner or chief executive officer if there is no board) that the project is supported, and that you can complete the project and meet the costs of the project not covered by grant funding?
Will your project provide digital advisory services to small businesses across the metropolitan and regional parts of one of the following three coverage areas?
You can only apply for funding to service one coverage area. You are not required to be located in the coverage area you intend to service. The program will not fund proposals that plan to cover only part of a coverage area.
Will your project provide digital advisory services to small businesses that improve, support and enhance their digital competency, including but not limited to the following priority digital capabilities? * Websites and selling online Social media and digital marketing Using small business software, and Online security and data privacy For more details refer to the program guidelines.
Will your project provide up to 24 hours of digital advisory services for each small business client over the period of the project which may include assessment of digital business needs and development of a digital engagement plan?
Will your project provide digital advisory services to small businesses through a combination of channels and formats?
Including: direct one-on-one advisory support delivered face to face, or remotely online or over the phone interactive webinars, and face to face workshops
Will your project include eligible activities and eligible expenditure?
Refer to Appendix A and B of the program guidelines.
Do you agree to meet the program’s service requirements throughout the duration of the program?
To be eligible you must agree to meet the following service requirements: recruit qualified and experienced business advisors to deliver the digital advisory services promote your digital advisory services to small businesses located in all parts of the selected coverage area provide an online client booking service undertake regular client satisfaction surveys to evaluate the effectiveness of your services in the selected coverage area meet the data collection and reporting obligations of the program engage with small business stakeholders and relevant government agencies to promote ASBAS services and learn about additional support services available to small businesses outside of the program and, where appropriate, refer your clients to these services.
You are not eligible to apply for the program. Please refer to the program guidelines.

Contact details

Australian Small Business Advisory Services Program Application Form
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Primary contact

The primary contact is the person authorised to act on behalf of the applicant.
Please enter either a phone or mobile number *
Provide the postal address of the primary contact.
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Country *
Please enter the country’s two letter code. You can find the two letter code by clicking this link to the ISO resource and selecting 'Country codes' above the search field.
Is the applicant the primary contact’s employer?
Please provide a contact for the applicant organisation
Please enter either a phone or mobile number *
Please provide the postal address for the contact of the applicant organisation
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Country *
Please enter the country’s two letter code. You can find the two letter code by clicking this link to the ISO resource and selecting 'Country codes' above the search field.

Feedback

How did the applicant hear about the program? *

Applicant information

Australian Small Business Advisory Services Program Application Form
Applications may be submitted at any time up until .
Please save your form regularly and take note of the tracking code. Fields marked with  * are required.

Joint application

Joint applications by one or more entities are acceptable, provided you have a lead applicant who is the main driver of the project and is eligible.
Is this a joint application?
The lead applicant must complete this form. If you are unsure whether your application should be a joint application please contact us on 13 28 46 or at business.gov.au.
Please list all the project partner organisations for this application, starting with the lead applicant. If the lead applicant is a trustee of a Trust, enter the Trust’s ABN. Lead applicant details will automatically fill to other sections of the form.You must attach a letter of support from each of the project partner organisations involved in the proposal.
Each letter of support should include: details of the partner organisationan overview of how the partner organisation will work with the lead organisation and any other partner organisations in the group to successfully complete the projectevidence from your project partner’s board (or chief executive officer or equivalent if there is no board) that the project is supportedan outline of the relevant experience and/ or expertise the partner organisation will bring to the groupthe roles/ responsibilities the partner organisation will undertake, and the resources it will contribute (if any)details of a nominated management level contact officer.Please enter the ABN of all partners in the joint application and click the Validate button to retrieve their registration details.

You will be required to provide a copy of the Trust documents showing the relationship of the Incorporated Trustee to the Trust.
The entity name refers to the name that appears on all official documents or legal papers. The entity name may be different from the business name.
Your business may have registered one or more business names. If you operate under a business or trading name you can enter alternate name(s) here. If your business or trading name is not listed here select ‘Other’.
If you have not registered your business name but trade under another name enter it here.
Please upload a copy of the Trust documents showing the relationship of the Incorporated Trustee to the Trust
File:
Letter of support
File:
Select which type of entity the organisation is: *
To be eligible the company must be incorporated in Australia under the Corporations Act 2001, have an ABN and an ACN and be non-tax-exempt.
For trustees applying on behalf of a trust, you must enter the details of the trustee acting in its capacity as a trustee on behalf of a trust.
If you have more than 10 project partners, provide in one attachment, a list of additional project partner details with their letters of support here.
Additional partners
File:
Are there international project partners?

International project partners

Please enter details of all international project partners

International project partner

Type of applicant

In this section you must indicate what type of entity you operate under.
Select which type of entity your organisation is: *
To be eligible the company must be incorporated in Australia under the Corporations Act 2001, have an ABN and an ACN and be non-tax-exempt.
For trustees applying on behalf of a trust, you must enter the details of the trustee acting in its capacity as a trustee on behalf of a trust.

Applicant details

These details have been populated from the lead applicant details entered above.
You will be required to provide a copy of the Trust documents showing the relationship of the Incorporated Trustee to the Trust.
The entity name refers to the name that appears on all official documents or legal papers. The entity name may be different from the business name.
Your business may have registered one or more business names. If you operate under a business or trading name you can enter alternate name(s) here. If your business or trading name is not listed here select ‘Other’.
If you have not registered your business name but trade under another name enter it here.
Please upload a copy of the Trust documents showing the relationship of the Incorporated Trustee to the Trust
File:

Trust and trustee details

These details have been populated from the lead applicant details entered above.
You will be required to provide a copy of the Trust documents showing the relationship of the Incorporated Trustee to the Trust.
The entity name refers to the name that appears on all official documents or legal papers. The entity name may be different from the business name.
Your business may have registered one or more business names. If you operate under a business or trading name you can enter alternate name(s) here. If your business or trading name is not listed here select ‘Other’.
If you have not registered your business name but trade under another name enter it here.
Please upload a copy of the Trust documents showing the relationship of the Incorporated Trustee to the Trust
File:
You will be required to provide a copy of the Trust documents showing the relationship of the Incorporated Trustee to the Trust.
The entity name refers to the name that appears on all official documents or legal papers. The entity name may be different from the business name.
Your business may have registered one or more business names. If you operate under a business or trading name you can enter alternate name(s) here. If your business or trading name is not listed here select ‘Other’.
If you have not registered your business name but trade under another name enter it here.
Please upload a copy of the Trust documents showing the relationship of the Incorporated Trustee to the Trust
File:

ANZSIC details

What is the applicant’s main business activity under the Australian and New Zealand Standard Industrial Classification (ANZSIC)?
The Australian and New Zealand Standard Industrial Classification (ANZSIC) is a classification system used by government to group data about organisations based on their primary business activity.The ANZSIC codes and titles are available from the Australian Bureau of Statistics (ABS) website.Phone 13 28 46 if you require assistance.

Address details

Provide your organisation's street address (Australian head office)
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Your Terms of Use and Privacy Policy must be publicly available. You must explicitly state in your applications Terms of Use that by using your application, users are bound by Google’s Terms of Service. You must notify users in your Privacy Policy that you are using the Google Maps API(s) and incorporate by reference the Google Privacy Policy.
Once you have complied with Google's policy you should hide this note.
Google Places - start entering your address to search Google Places and, if found, the form will autofill the fields below. If not found, please enter the address details directly in the fields below.
Country *
Please enter the country’s two letter code. You can find the two letter code by clicking this link to the ISO resource and selecting 'Country codes' above the search field.
Is the postal address the same as the organisation's street address entered above?
Provide your postal address
This widget uses Google Places. In order to use it you need to comply with the Google Place API Policy. To summarise

Your Terms of Use and Privacy Policy must be publicly available. You must explicitly state in your applications Terms of Use that by using your application, users are bound by Google’s Terms of Service. You must notify users in your Privacy Policy that you are using the Google Maps API(s) and incorporate by reference the Google Privacy Policy.
Once you have complied with Google's policy you should hide this note.
Google Places - start entering your address to search Google Places and, if found, the form will autofill the fields below. If not found, please enter the address details directly in the fields below.
Country *
Please enter the country’s two letter code. You can find the two letter code by clicking this link to the ISO resource and selecting 'Country codes' above the search field.

Website address

Project site address

Will the project’s activities occur solely at the above listed head office address?
A project site address must be a street address, not a postal address.

Site address

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Your Terms of Use and Privacy Policy must be publicly available. You must explicitly state in your applications Terms of Use that by using your application, users are bound by Google’s Terms of Service. You must notify users in your Privacy Policy that you are using the Google Maps API(s) and incorporate by reference the Google Privacy Policy.
Once you have complied with Google's policy you should hide this note.
Google Places - start entering your address to search Google Places and, if found, the form will autofill the fields below. If not found, please enter the address details directly in the fields below.
Country *
Please enter the country’s two letter code. You can find the two letter code by clicking this link to the ISO resource and selecting 'Country codes' above the search field.

Latest financial year figures

Has the applicant existed for a complete financial year? *
We collect the following data from all applicants across all grant programs. We use this data to better understand your organisation and to help us develop better policies and programs.All amounts in the table below must show a whole dollar value e.g. $1 million should be presented as $1,000,000. The turnover value must be that of the entity that is making the grant application (the ‘applicant’), regardless of whether the entity belongs to a consolidated group for tax purposes.These fields are mandatory and entering $0 is acceptable if applicable.
FY
Sales revenue (turnover) *
Total revenue from the sale of goods and services, as reported in the applicant’s Business Activity Statement (BAS).
Export revenue *
Total revenue from export sales, as reported in the applicant's Business Activity Statement (BAS).
R&D expenditure *
Expenditure on Research and Development, i.e. creative work undertaken on a systematic basis in order to increase the stock of knowledge, including knowledge of man, culture and society, and the use of this stock of knowledge to devise new applications.
Taxable income *
Taxable income or loss as per the Applicant's Business Income Company Tax Return Form.
Employees, including working proprietors and salaried directors (headcount) *
Number of individuals who are entitled to paid leave (sick and holiday), or generate income from managing the business.
Independent contractors (headcount) *
Number of individuals engaged by the business under a commercial contract (rather than an employment contract) to provide employee-like services on site.

Ultimate holding company

Does the applicant have an ultimate holding company?
You will be required to provide a copy of the Trust documents showing the relationship of the Incorporated Trustee to the Trust.
The entity name refers to the name that appears on all official documents or legal papers. The entity name may be different from the business name.
Your business may have registered one or more business names. If you operate under a business or trading name you can enter alternate name(s) here. If your business or trading name is not listed here select ‘Other’.
If you have not registered your business name but trade under another name enter it here.
Please upload a copy of the Trust documents showing the relationship of the Incorporated Trustee to the Trust
File:

Support from your Board

Please upload evidence of conditional support from your Board (or if there is no Board, support from the owner or chief executive officer) that the business can complete the project and meet the project costs not covered by grant funding.
Evidence
File:

Project details and funding

Australian Small Business Advisory Services Program Application Form
Applications may be submitted at any time up until .
Please save your form regularly and take note of the tracking code. Fields marked with  * are required.

Coverage area

You will be required to provide services to small businesses located in the metropolitan and regional parts of your selected coverage area. You can only apply for funding to service one coverage area. You are not required to be located in the coverage area you intend to service. The program will not fund proposals that plan to cover only part of a coverage area. Subject to demand, you must offer advisory services proportionately across the metropolitan and regional areas, i.e. not only in major cities and regional centres. A map of the coverage areas and a breakdown of the number of small businesses per coverage area is included at Appendix D of the program guidelines.
Your project activities will occur in the following coverage area you selected:

Project title and description

If your application is successful, the following project details will be published on the departmental website.
Provide a project title *
Example project title: Australia-China Joint Research Centre in Low Emission Energy Production
Provide a brief project description for publication on our website *
Ensure your project description focuses on your project’s key activities and outcomes. Explain what it is you are going to do and how it will benefit your business.Example project description: Transition Pty Ltd is an injection moulding company that manufactures plastic products and now intends to extend its business into the healthcare sector by manufacturing sterile plastic equipment for medical use.

Project outcomes

Briefly tell us about your intended project outcomes. Explain what it is you are going to do and what benefits it will bring to your organisation and to Australian small businesses. This information will not be published.
You may attach up to 3 A4 pages for diagrams supporting your project.
Attachment(s)
File:

Project plan

You must provide a plan of the project activities you will conduct including timetable and budget for all significant activities.
Project plan
File:

Project duration

Project key activities

Provide details on your key project activities.
Create new milestones as appropriate. The start date of milestone 1 is the expected project start date. The end date of your last milestone activity will be the project end date.

Activity

Establish the digital advisory services including: development of content development of communication channels for the delivery of advisory services promotional activities directed at driving small business participation in the services development of client surveys to seek feedback on provided advisory services develop online client booking service develop a system to collect data on all advisory services that you provide under the program
Recruit qualified and experienced business advisors who have: a minimum of two years of experience providing digital advice to small or medium sized businesses a formal qualification in a business or information technology related discipline management, consulting or advisory experience up to date knowledge on finance, marketing, and sales issues relevant to small businesses knowledge and experience providing advice across most of the priority digital capabilities
In your selected coverage area deliver: improvements, support and enhancements to small businesses’ digital competencies including but not limited to the priority digital capabilities up to 24 hours of services for each small business client over the period of the project which may include assessment of digital business needs and development of a digital engagement plan through a combination of channels and formats including: direct one-on-one advisory support delivered face to face, or remotely online or over the phone interactive webinars, and face to face workshops referrals to other appropriate business advisory services
You must record names and ABNs of participating small businesses and meet targets for services delivered including the number of: small businesses who accessed advisory services across metropolitan and regional parts of the selected coverage area direct one-on-one advisory support services delivered face to face, or remotely online or over the phone across the metropolitan and regional parts of the selected coverage area interactive webinars or webchats delivered to small businesses in the selected coverage area workshops delivered face to face service hours provided to each small business business advisors providing advisory services in the selected coverage area business assessment services provided to small businesses digital engagement plans prepared for small businesses completed follow up contact with assisted small businesses, where applicable client satisfaction surveys undertaken

Project budget

Provide details on your eligible project costs over the life of the project. *Ensure the figures you enter here align and are justified by your detailed project budget that you attach at merit criterion three.Total costs cannot exceed the grant amount for each coverage area. Refer to Appendix D in the program guidelines.Amounts must be GST inclusive, less any GST credits that you can claim.
Cost Item
FY1
FY2
FY3
FY4
Total
RowTitle
Subtotal eligible expenditure
Ineligible costs
Total project costs

Grant amount

The program grant amount is prefilled from the Total Project costs entered in the Project budget table.

Source of funding

Complete the fields below to show how the applicant will fund the eligible project costs. Amounts must be GST exclusive. Note: the minimum grant amount under the program is $5,000 and the maximum grant amount is $1 million.
The project cannot be funded by this grant in conjunction with any other Commonwealth grant. The total government grant percentage including non-Commonwealth government funding cannot exceed 100%.

Other government contribution sources

If a figure greater than $0 was entered in Other non-Commonwealth Government Funding in the table above, provide details of the other government grant funding.

Contribution source

Your contribution

To describe your funding strategy for the project complete the table below and provide the following attachments.
Fund type
Amount ($AUD)
Description on the source of funding
Cash flow
Loans
Equity
Other
Total
Please upload the following: Evidence of conditional support from your Board (or if there is no Board, support from the owner or chief executive officer) that the business can complete the project and meet the project costs not covered by grant funding. Evidence to support the project funding strategy.An Accountant Declaration to confirm your business can fund its share of the project costs. You must use the template provided as an Appendix in the program guidelines.
Evidence
File:

Service delivery fee

You must charge participating small businesses a small contribution fee. The level of fees are to be determined by you, but must be considered low cost in comparison with general market rates.
Enter the fee rates you propose to charge participating small businesses to access your digital advisory services.

Fee item

Fee item description *
For example: interactive webinar, face to face meeting, phone meeting, workshop etc.

Applicant bank account details

If your application is successful we will transfer funds directly into your bank account. Provide your relevant bank account details here.

Supporting documents

Examples of supporting documents are equipment supplier quotes, contractor quotes, invoices etc. You do not need to submit these with this application form. However, if your application is successful you will be required to submit these documents before the grant agreement is finalised. You can find more details in the program guidelines.

Conflict of interest

Do you have any perceived or existing conflicts of interest to declare?
Refer to the program guidelines for further information on your conflict of interest responsibilities.

Merit criteria

Australian Small Business Advisory Services Program Application Form
Applications may be submitted at any time up until .
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To be competitive, you will need to address all merit criteria in your application. We will assess your application against each merit criterion using the weighting indicated. We will only award funding to applications that score highly against all merit criteria, as these represent best value for money. You must attach mandatory attachments, where indicated. You may also attach any other documents that support your application and/or claims made in relation to the merit criteria.

Merit criterion one (30 points)

Extent that your proposed advisory services will improve the digital capability of small businesses in the selected coverage area *
You should demonstrate: how your proposed service and delivery format mix (including the anticipated number of one-on-one advisory support hours, number of interactive webinars and number of workshops to be delivered) will meet demand and improve digital capability of small businesses in the selected coverage area your strategy to promote and market your services to small businesses in the selected coverage area the customer journey for a small business accessing your services including how they will discover, access and participate in the services the reach of your services across metropolitan and regional small businesses in the selected coverage area and the number of businesses that you anticipate assisting including through each service delivery format
Attach up to 3 documents in support of this criterion.
Supporting documentation
File:

Merit criterion two (40 points)

Capacity, capability and resources to deliver the project *
You should demonstrate this through identifying: your track record managing similar projects your access to personnel with the right skills and experience, including management and technical staff your access to any capital equipment, technology, intellectual property, administrative systems, including record keeping practices, data collection, information sharing and reporting and required regulatory or other approvals your ability to comply with relevant policies and laws to ensure the privacy and security of client data a sound project plan to manage and monitor the project and risks.
Project plan
File:

Merit criterion three (30 points)

Financial capability and governance *
You should demonstrate this through identifying: a detailed project budget that identifies the costs of all key project activities/services, including the costs of promotional activities, the development of content, travel and end of project financial audit, and demonstrates that costs are commensurate with the level of service to be provided your ability to fund the running costs of your organisation external to the project and any project costs that are not covered by the grant how your organisation meets appropriate governance standards.
Project budget
File:

Supporting documents

Australian Small Business Advisory Services Program Application Form
Applications may be submitted at any time up until .
Please save your form regularly and take note of the tracking code. Fields marked with  * are required.

Supporting documents

If you wish to include additional documents, these should be limited to those directly relevant to, and in support of, your application
File:

Applicant declaration

Australian Small Business Advisory Services Program Application Form
Applications may be submitted at any time up until .
Please save your form regularly and take note of the tracking code. Fields marked with  * are required.

Privacy and confidentiality provisions

I acknowledge that this is an Australian Government program and that the department will use the information I provide in accordance with the following: Australian Government Public Data Policy Statement Commonwealth Grants Rules and Guidelines program guidelines applicable Australian laws.
Accordingly, I understand that the department may share my personal information provided in this application within this department and other government agencies: 1.for purposes directly related to administering the program, including governance, research and the distribution of funds to successful applicants and2.to facilitate research, assessment, monitoring and analysis of other programs and activities unless otherwise prohibited by law.I understand that where I am successful in obtaining a grant, the financial information that I provide for the purposes of payment will be accessible to departmental staff to enable payments to be made through the department’s accounts payable software system.I understand that information that is deemed ‘confidential’ in accordance with the guidelines may also be shared for a relevant Commonwealth purpose.The department will publish information on individual grants in the public domain, including on the department’s website, unless otherwise prohibited by law.

Applicant declaration

I declare that I have read and understood the program guidelines, including the privacy, confidentiality and disclosure provisions.I declare that the proposed project outlined in this application and any associated expenditure has been endorsed by the applicant’s Board or person with authority to commit the applicant to this project.I declare that the applicant will comply with, and require that its subcontractors and independent contractors comply with, all applicable laws.I declare that the information contained in this application together with any statement provided is, to the best of my knowledge, accurate, complete and not misleading and that I understand that giving of false or misleading information is a serious offence under the Criminal Code 1995 (Cth).I acknowledge that I may be requested to provide further clarification or documentation to verify the information supplied in this form and that the department may, during the application process, consult with other government agencies, including state and territory government agencies, about the applicant’s claims and may also engage external technical or financial advisors to advise on information provided in the application.I acknowledge that if the department is satisfied that any statement made in an application is incorrect, incomplete, false or misleading the department may, at its absolute discretion, take appropriate action. I note such action may include excluding an application from further consideration; withdrawing an offer of funding; using the information contained in the application for a fraud investigation that would be consistent with the Australian Government’s Investigations Standard and Commonwealth Fraud Control Framework and for management purposes and/or terminating any grant agreement between the Commonwealth and the recipient including recovering funds already paid.I agree to participate in the periodic evaluation of the program undertaken by the Commonwealth.I declare that I am authorised to complete this form and acknowledge that by including my name in this application I am deemed to have signed this application.I approve the information in this application being communicated to the department in electronic form.