Contact details
Organisation name:
Your name:
Phone number:
Email address:
Postal address:
Property details
Property address:
Rates reference number:
Does the organisation own the property?
Yes
No
Attach a copy of the lease
What are the nature of improvements?
Examples of improvements include offices, drop-in centre, club rooms, halls, meeting spaces and clubs.
Community benefit details
Please tell us how the property is being used and what its value or role is within the community:
When were your doors first open?
Is any portion of the property being used for a purpose other than the ones listed above?
Yes
No
Describe the other uses on the site:
Are there any sub-leases on the property?
Yes
No
Attach a copy of the sub-lease
Is this organisation recognised by Inland Revenue Department as a Charitable Trust?
Yes
No
Please provide your registration number:
Supporting documents
Financial accounts:
We need to see your latest accounts. They must be from within the last 12 months, complete and if audited, if available.
Copy of deed or constitution document
Site plan:
A site plan outlining how each space is used can be helpful to help us understand the uses across the site. This does not have to be an official site plan and can be hand drawn – we only use this to understand your site better.
Any supporting documentation:
Any material that can help build a picture of the services you provide will help us assess your application. This may include material like website addresses, brochures, articles or anything that supports your position.
Any additional supporting information:
Declaration
Name
Position
The organisation/applicant named is a not-for-profit organisation and no finances go to individual members of the society or association, other than to paid officers (required).
The information provided in this application is true, to the best of my knowledge (required).
Contact Information