Tararua: On Track Fund Application

Required fields are marked with an asterisk (*).

Applicant Details

Name * Please note, we have received multiple reports of crashes from the form. To avoid this you can send an email with your application to Info@tararuadc.govt.nz.

Contact Phone *

Applicant Property Details

Address *

NZBN

Is this claim for *

Work already completed
Work to be completed
Both

Explain in detail what damage you experienced and what critical work you are undertaking/ or have undertaken * Please include estimated total value of damage

Supplementary photography (before and after of the damage) * File size limit of 50MB. Please upload max 5 images.

State details of any assistance you have already received or will receive from any other agency (including insurance claims)

Proof of insurance Please note without the date, insurance logo and claim information, this may be declined

Grants applied for/obtained

Estimated cost of work This is the amount you are looking to claim

Quote if possible OR Receipt of work undertaken

Supplementary photographs (before and after the work) File size limit of 50MB. Please upload max 5 images.

Any additional information you would like to provide

Availability

As part of this process we may send out an evaluator to have a chat and validate the application claim.

Best time to contact to set up a viewing

Best form of contact

Phone Number
Email

Bank Details

Please enter your bank account details below and attach proof of your account number (deposit slip, copy of bank statement or download from online banking)

Bank account number

Bank account name

Proof of account number Examples include bank statement, bank deposit slip, screenshot from your online banking, letter from the bank, ATM printout

Declaration

I certify that the information provided in this application is correct and if I provide false information, I understand that my application will be null and void. I give permission for Tararua District Council to verify the information provided with any other agencies that may be involved *

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