Request for Amendment Donor to Political Party Disclosure

Return – Organisations FINANCIAL YEAR 2014–15

Completing the Return: • This request for amendment should be used to amend a 2014–15 Donor to Political Party Disclosure Return – Organisations lodged with the AEC. • This request for amendment is to be completed with reference to the Financial Disclosure Guide for Donors to Political Parties. • Further information is available at www.aec.gov.au. • This request for amendment will be available for public inspection from Monday 1 February 2016 at www.aec.gov.au. • Any supporting documentation included with this request for amendment may be treated as part of a public disclosure and displayed on the AEC website. • The information on this request for amendment is collected under the Commonwealth Electoral Act 1918. NOTE: This form is for the use of organisations only. Please use the form Request for Amendment - Donor to Political Party Disclosure Return – Individuals if you are completing a return for an individual. Details of organisation that made the donation

Name

Address

Suburb/Town State Postcode

ABN ACN

2014–15 Return details Is this the first amendment Yes No How many other Request for to the return? Amendments have been lodged? Details of person completing this return Name Capacity or position Postal address

Suburb/town State Postcode Telephone number ( ) Fax number ( ) Email address

Request and Certification I request the Electoral Commission amend the Donor to Political Party Return – Organisations as detailed in this request for amendment. I certify that the information contained in this request for amendment and its attachments is true and complete to the best of my knowledge, information and belief. I have made due and reasonable inquiries of the organisation on whose behalf I am authorised to complete this form. I understand that giving false or misleading information is a serious offence.

Signature Date

Enquiries and returns Funding and Disclosure Phone: 02 6271 4552 should be addressed to: Australian Electoral Commission Fax: 02 6293 7655 PO Box 6172 Email: [email protected] Kingston ACT 2604

Office use only Date received DAR_1 (07/15) – Page 1 of 5 How to complete this form: • If you are amending an existing entry, complete the ‘Original Entry’ item as it appeared on the original return and then write the amendment in full at the ‘Amended Entry’ item. • If adding a completely new entry, write N/A in the ‘Original Entry’ item and complete the ‘Amended Entry’ item in full. • Amounts should be reported on a GST inclusive basis.

Part 1a: Other business names

No change to previous information OR Provide details of changes or amendments to the information previously provided.

Original Entry Trading name

Amended Entry Trading name

Original Entry Trading name

Amended Entry Trading Name

Part 1b: Related bodies corporate No change to previous information OR Provide details of changes or amendments to the information previously provided.

Original Entry Name Postal address

Suburb/town State Postcode

ABN ACN

Amended Entry Name Postal address

Suburb/town State Postcode

ABN ACN

Original Entry Name Postal address

Suburb/town State Postcode

ABN ACN

Amended Entry Name Postal address

Suburb/town State Postcode

ABN ACN

If insufficient space, please attach additional sheets.

DAR_1 (07/15) – Page 2 of 5 Part 2: Donations made No change to previous information OR Provide details of changes or amendments to the information previously provided.

Value of Party details Date of donation donation** (GST inclusive)

Original Name/Party code $ .00 Entry Postal address Suburb/Town State Postcode Amended Name/Party code $ .00 Entry Postal address Suburb/Town State Postcode Original Name/Party code .00 Entry Postal address Suburb/Town State Postcode Amended Name/Party code .00 Entry Postal address Suburb/Town State Postcode Original Name/Party code $ .00 Entry Postal address Suburb/Town State Postcode Amended Name/Party code $ .00 Entry Postal address Suburb/Town State Postcode Original Name/Party code $ .00 Entry Postal address Suburb/Town State Postcode Amended Name/Party code $ .00 Entry Postal address Suburb/Town State Postcode Original Name/Party code $ .00 Entry Postal address Suburb/Town State Postcode Amended Name/Party code $ .00 Entry Postal address Suburb/Town State Postcode

If insufficient space, please attach additional sheets. **Donation is a gift within the meaning of the Commonwealth Electoral Act 1918.

DAR_1 (07/15) – Page 3 of 5

Part 3: Donations received No change to previous information OR

Provide details of changes or amendments to the information previously provided.

Value of Received from Date of donation donation** (GST inclusive)

Original Name/Party code $ .00 Entry Postal address Suburb/Town State Postcode Amended Name/Party code $ .00 Entry Postal address Suburb/Town State Postcode Original Name/Party code $ .00 Entry Postal address Suburb/Town State Postcode Amended Name/Party code $ .00 Entry Postal address Suburb/Town State Postcode Original Name/Party code $ .00 Entry Postal address Suburb/Town State Postcode Amended Name/Party code $ .00 Entry Postal address Suburb/Town State Postcode Original Name/Party code $ .00 Entry Postal address Suburb/Town State Postcode Amended Name/Party code $ .00 Entry Postal address Suburb/Town State Postcode Original Name/Party code $ .00 Entry Postal address Suburb/Town State Postcode Amended Name/Party code $ .00 Entry Postal address Suburb/Town State Postcode If insufficient space, please attach additional sheets. **Donation is a gift within the meaning of the Commonwealth Electoral Act 1918.

DAR_1 (07/15) – Page 4 of 5 Registered Political Party and Branch Codes AUS-IND CODE Party / Branch AMEP Australian Motoring Enthusiast Party PROG Australian Progressives ALP-ACT Australian Labor Party (ACT Branch) ASP Australian Sex Party ALP-NSW Australian Labor Party (N.S.W. Branch) SOV Australian Sovereignty Party Australian Labor Party (Northern Territory SPRT Australian Sports Party ALP-NT Branch) VCE Australian Voice Party ALP-QLD Australian Labor Party (State of Queensland) BTA Bullet Train for Australian Labor Party (South Australian ALP-SA Branch) CDP Christian (Fred Nile Group) ALP-TAS Australian Labor Party (Tasmanian Branch) CEC Citizens Electoral Council of Australia ALP-VIC Australian Labor Party (Victorian Branch) COK Coke in the Bubblers Australian Labor Party (Western Australian CAL Country Alliance ALP-WA Branch) CLP-NT Country Liberals (Northern Territory) ALP Australian Labor Party (ALP) DLRA Drug Law Reform Australia CLR-NSW Country Labor Party FUT Future Party

HEM Help End Marijuana Prohibition (HEMP) Party FFP-QLD – QLD JLN Jacqui Lambie Network FFP-SA Family First Party – SA John Madigan’s Manufacturing and Farming JMMFP FFP-VIC Family First Party – VIC Party FFP Family First Party KAP Katter’s

LDP Liberal Democratic Party Australian Greens, Australian Capital Territory GRN-ACT Branch NMP Natural Medicine Party GRN-NSW The Greens NSW XEN Nick Xenophon Group GRN-NT Australian Greens, Northern Territory Branch NCP Non-Custodial Parents Party (Equal Parenting) GRN-QLD Queensland Greens ONA One Nation GRN-SA Australian Greens (South Australia) – (Empowering the SOL People) GRN-TAS Australian Greens, Tasmanian Branch ODR Outdoor Recreation Party (Stop the Greens) GRN-VIC Australian Greens, Victorian Branch PUP Palmer United Party GRN-WA The Greens (WA) Inc PIR GRN-FED Australian Greens RPA Republican Party of Australia

LIB-ACT of Australia – ACT Division RUA Rise Up LIB-NSW Liberal Party of Australia, NSW Division SPA Secular Party of Australia LNP-QLD Liberal National Party of Queensland SUN Seniors United NSW LIB-SA Liberal Party of Australia (S.A. Division) SFP Shooters and Fishers Party LIB-TAS Liberal Party of Australia – Tasmanian Division SMK Smokers Rights Party LIB-VIC Liberal Party of Australia (Victorian Division) SAL Socialist Alliance LIB-WA Liberal Party (W.A. Division) Inc. SEP Socialist Equality Party LIB Liberal Party of Australia ARTS The WIKI The Wikileaks Party NAT-SA National Party of Australia (S.A.) Inc. UNP Uniting Australia Party NAT-VIC National Party of Australia – Victoria VEP Voluntary Euthanasia Party NAT-NSW National Party of Australia – N.S.W. NAT-WA National Party of Australia (WA) Inc NAT National Party of Australia

SPP #Sustainable Population Party 21C 21st Century Australia AJP Animal Justice Party AFP-NSW Australia First Party (NSW) Incorporated FNP Australia’s First Nations Political Party ACH Australian Christians CYC Australian Cyclists Party ADVP Australian Defence Veterans Party AEQ Australian Equality Party

DAR_1 (07/15) – Page 5 of 5