COVID-19 RELIEF WEB APPLICATION FORM

ITC De-listing Application for Individuals

ITC De-listing Application for Legal Entities

Restructuring & ITC De-listing Application for Individuals

Restructuring & ITC De-listing Application for Legal Entities

Restructuring & Instalment Holiday Application for Individuals

Restructuring & Instalment Holiday Application for Legal Entities

Instalment Holiday Application for Legal Entities

Instalment Holiday Application for Individuals

GENERAL INFORMATION

Please make sure you have read and understood the following information before completing the application. Complete all sections. Incomplete applications will not be processed. The application must be submitted on this form. No faxes and or Emails will be accepted.

Are you an Individual or Corporate Client?

Applicant Type {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Select a COVID-19 Relief Package below

ITC DE-LISTING {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

RESTRUCTURING {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

INSTALMENT HOLIDAY {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Application Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

ITC DE-LISTING

This choice allows for the removal of ITC listings made by Agribank against the applicants name. To qualify for this option the applicant needs to:

Pay a minimum of 10% of ALL their current arrears balances.
As soon as proof of payment is received, the de-listing will be processed within 72 hours.

LOAN RESTRUCTURING & ITC DE-LISTING

This choice allows for the complete restructuring of the Agribank loans held by the applicant. The applicant will also be de-listed from ITC. To qualify for this option the applicant needs to:

Pay a minimum of 20% of ALL their current arrears balances.
Provide a Reset Plan to restructure their operations to ensure a sustainable business.

Once this application is approved, please submit proof of payment of required amount for restructuring to be performed on the Total Outstanding Balance of affected loans.

INSTALMENT HOLIDAY

Clients are always encouraged to make payments where possible. However, this choice allows for the postponement of the next, upcoming instalment(s) of Agribank loans held by the applicant for a period of 12 months. The current installment, inclusive of interest, will be capitalised. To qualify for this option the applicant needs to:

Provide an explanation of how the COVID-19 Lockdown affected their farming business.

Company Details

Company Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Type of Legal Entity {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Specify {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Registration No {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Tax / VAT No {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Social Security Commission No {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

NAMFISA No {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Sector {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

{binding MembersOfCompanyName_Label }

Member {binding ItemNumber}

First Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Surname {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

ID Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Birthday {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Mobile {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Is this member liable to sign as a co-signor or guarantor? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Primary Applicant

First Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Middle Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Surname {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

ID Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Birthday {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Photo {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

Spouse

First Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Middle Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Surname {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

ID Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Birthday {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Photo {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

Contact Information

Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Mobile {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Website {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Fax {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Communication Preference {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Next of KIN (Not Living with You)

KIN Relationship {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

KIN Full Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

KIN Mobile {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

KIN Postal Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

KIN Residential Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Postal Address

PO Box {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Private Bag {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Private Bag {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Postal Town {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Postal Country {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Postal Code {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Physical Address

Physical Address is on a Farm {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Street Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Street No {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Farm Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Farm No {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Resident Suburb {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Resident Town {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Resident District {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Resident Region {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Resident Country {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Personal Profile

Occupation {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Level of Education {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Annual Salaried Income {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Farming Profile

Farm Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Farm No {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

{binding AnnualFarmingIncomePrimaryFarmingActivity_Label, source = {{ $context.parentContext.dataItem }} } {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Specify {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

{binding AnnualFarmingIncomeSecondaryFarmingActivity_Label, source = {{ $context.parentContext.dataItem }} } {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Specify {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Total Farming Income {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Farm Employee(s) Profile

# of Full Time Farm Employees (Current) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

# of Seasonal Farm Employees (Current) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

After implementing your Reset Plan...

# of Full Time Farming Employees (Plan) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

# of Seasonal Farm Employees (Plan) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Primary Applicant - Employment Details

Employer Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Employer Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Employer Fax {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Employer Postal Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Employer Physical Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Secondary Applicant (Spouse) - Employment Details

Employer Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Employer Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Employer Fax {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Employer Postal Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Employer Physical Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

KYC01 Information - Company

This form must be completed by natural persons who enter into a relationship with the Agricultural Bank of Namibia. This includes natural persons associated with entities such as Companies, Close corporations, Trusts and Partnerships and all individuals acting on behalf of an entity.

Please download and complete the document here and bring along when visiting Agribank:

Download

KYC01 Information - Individual

Please download and complete the document here and bring along when visiting Agribank:

Download

Enhanced Due Diligence Form

If you are a Political Exposed Person or a Foreigner, please download and complete the Enhanced Due Diligence Form below and bring along when visiting Agribank:

Download

KYC Documentation Uploads

Upload ID Documents {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

Upload Marriage Certificate {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

Upload Signed KYC Documents {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

Banking Details

Bank Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Banking Country {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Account Holder Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Account Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Branch Code {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

IBAN / Swift Code {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Account No {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Provide the details of your primary contact at your current bank below.

Bank Manager Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Bank Manager Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Bank Manager Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

ASSETS

FIXED ASSETS - PROPERTIES

Farm Properties

Farm Name

Number

District

Farm Size

Value

Farm {binding ItemNumber}

Farm Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

District {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Farm Size {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Value {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Town Properties

Erf No

Town

Property Size

Value

Property {binding ItemNumber}

Erf No {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Town {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Property Size {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Value {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

MOVABLE ASSETS

Infrastructure

Description

Year

Value

Item {binding ItemNumber}

Description {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Year {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Value {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Livestock

Livestock Type

Sub-Type

Unit Price

Quantity

Value

Item {binding ItemNumber}

Unit Price {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Quantity {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Value {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Other

Description

Due Date

Value

Item {binding ItemNumber}

Description {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Due Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Value {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Liabilities

BONDED FIXED PROPERTIES

Bond Holder Name

Interest Rate

Annual Commitment

Balance Owing

Item {binding ItemNumber}

Bond Holder Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Interest Rate {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Annual Commitment {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Balance Owing {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

ENCUMBERED MOVABLES (Vehicles, Tractors, Livestock etc.)

Item

Creditor

Interest Rate

Annual Commitment

Balance Owing

Item {binding ItemNumber}

Item {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Creditor {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Interest Rate {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Annual Commitment {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Balance Owing {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

OTHER DEBTS

Item

Creditor

Interest Rate

Annual Commitment

Balance Owing

Item {binding ItemNumber}

Item {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Creditor {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Interest Rate {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Annual Commitment {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Balance Owing {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Total Annual Commitments {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Debt Ratio

Add your own Balance Sheet {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

INCOME

Farming Income

Livestock Type

Sub-Type

Unit Cost

Quantity

Annual Income

Item {binding ItemNumber}

Unit Cost {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Quantity {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Annual Income {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Other Income

Description

Annual Income

Item {binding ItemNumber}

Description {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Annual Income {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

EXPENSES

Farming Annual Expenses

Expense Description

Annual Cost

Item {binding ItemNumber}

Expense Description {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Annual Cost {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Non-Farming Expenses

Expense Description

Annual Cost

Item {binding ItemNumber}

Expense Description {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Annual Cost {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

% Production Expense {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Financials

Upload 6 Months of Banking Statements {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

Upload Cash Flow Forecast {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

Upload your Own Income Statement {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

COVID-19 Impact Assessment

Market Impact of the COVID-19 Lockdown

The food supply chain is a complex web that involves producers, consumers, agricultural inputs, processing and storage, transportation and marketing. On this page, we want to better understand how the COVID-19 Lockdown impacted your farming business.

The Market

The supply and demand of agriculture products might have been impacted in various ways during the lockdown.

Auctions & Abatoirs {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Retailers & Street Vendors {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Transport & Logistics {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Labour Workforce

Number of Permanent Labourers {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Number of Temporary Labourers {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

How was the labour workforce affected? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Further Elaboration

Any other impacts {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Additional Supporting Documents {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

Indicate your loss of income {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

When do you expect to recover your business? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Proof Documentation for the indicated loss {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

The Reset Plan

Your Reset Plan demonstrates how you will restructure your business to ensure that it will become an sustainable business.

What NEW Agricultural generating income activities will you introduce? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Additional Revenue Streams

Activity

Quantity

Income

Activity {binding ItemNumber}

Activity {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Quantity {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Income {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

What Farming Expenses will you reduce? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Farming Expense Reduction Measures

Item

Annual Cost

Item {binding ItemNumber}

Item {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Annual Cost {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

What NEW Investments will you require for this Reset Plan? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Investment List

Item

Investment

Item {binding ItemNumber}

Item {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Investment {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Attached a cash flow projection to demonstrate viability of the farming business with existing and new activities.

Attach Cashflow Projection {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

Interested in Agribank Support on your RESET PLAN? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Agribank Support on your Reset Plan

{binding WantAStimulusLoanForParentSectionTotalInvestment_Label, source = {{ $context.parentContext.dataItem }} } {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

If you are in good standing with Agribank or your Arrears Restructuring has first been approves, you can apply for a COVID-19 STIMULUS Package. Your Agribank branch will contact you with more information.

Interested in Agribank Technical Support? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

If you are in good standing with Agribank or your Arrears Restructuring has first been approved, Agribank can provide a site visit to your farm and provide advice on the implementation of your Reset Plan. If selected, the Bank will make an appointment with you.

Appointment

Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Authorised Applicant Signature {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Authorised Co-Applicant Signature {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Application Status {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}