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Request for Amendment Donor to Political Party Disclosure

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Request for Amendment Donor to Political Party Disclosure Request for Amendment Donor to Political Party Disclosure Return – Individuals FINANCIAL YEAR 2008-2009 Completing the Return: • This request for an amended return should be used by by individuals who made a gift or donation to a registered political party (or a State branch), or to another person or organisation with the intention of benefiting a registered political party, to amend a 2008-2009 Donor to Political Party Return – Individuals, lodged with the AEC. • Further information is available at www.aec.gov.au. • This return will be available for public inspection from Monday 1 February 2010 at www.aec.gov.au. • Any supporting documentation included with this return may be treated as part of a public disclosure and displayed on the AEC website. • The information on this return is collected under the Commonwealth Electoral Act 1918. NOTE: this form is for the use of individuals only. Please use the form Request for Amendment - Donor to Political Party Disclosure Return – Organisations if you are completing a return for an organisation. Details of person who made the donation Name 2008-2009 Return details Is this the first amendment Yes No How many other Request for to the return? Amendment have been made? 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 – Individuals as detailed in this form. I certify that the information contained in this request and its attachments is true and complete. 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 6271 4555 PO Box 6172 Email: [email protected] Kingston ACT 2604 Office use only Date received Registration No D/ /A DAR_3 (07/09) – Page 1 of 4 1. Donations made No change to previous information OR Provide details of changes or amendments to the information previously provided. Note: All amounts are GST inclusive. How to complete this table: If you are amending an existing entry, write out both the original entry and the amended entry in full. If adding a completely new entry, write N/A in the ‘Original Entry’ line. Party details Date of donation Value of donation 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. DAR_3 (07/09) – Page 2 of 4 2. Donations received No change to previous information OR Provide details of changes or amendments to the information previously provided. Note: All amounts are GST inclusive. How to complete this table: If you are amending an existing entry, write out both the original entry and the amended entry in full. If adding a completely new entry, write N/A in the ‘Original Entry’ line. Received from Date of donation Value of donation 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. DAR_3 (07/09) – Page 3 of 4 Registered Political Party and Branch Codes CODE Party / Branch DEM-FED Australian Democrats LIB-FED Liberal Party of Australia DEM-NSW Australian Democrats – NSW LIB-NSW Liberal Party of Australia – NSW DEM-VIC Australian Democrats – VIC LIB-VIC Liberal Party of Australia – VIC DEM-QLD Australian Democrats – QLD LNP-QLD Liberal National Party of Queensland DEM-WA Australian Democrats – WA LIB-WA Liberal Party (WA Division) Inc. DEM-SA Australian Democrats – SA LIB-SA Liberal Party of Australia – SA DEM-ACT Australian Democrats – ACT LIB-TAS Liberal Party of Australia – TAS LIB-ACT Liberal Party of Australia – ACT GRN-FED Australian Greens GRN-NSW The Greens NSW NAT-FED National Party of Australia GRN-VIC The Australian Greens – VIC NAT-NSW National Party of Australia – NSW GRN-QLD Queensland Greens NAT -VIC National Party of Australia – VIC GRN-WA The Greens (WA) Inc NAT-WA National Party of Australia (WA) Inc. GRN-SA Australian Greens – SA NAT -SA National Party of Australia (SA) Inc. GRN-TAS Australian Greens – TAS GRN-ACT Australian Greens – ACT ONA-FED One Nation GRN-NT Australian Greens – NT ONA-VIC One Nation – VIC ONA-QLD One Nation – QLD ALP-FED Australian Labor Party ONA-WA One Nation – WA ALP-NSW Australian Labor Party – NSW ONA-SA One Nation – SA ALP-VIC Australian Labor Party – VIC ALP-QLD Australian Labor Party – QLD FLP-FED Australian Fishing and Lifestyle Party ALP-WA Australian Labor Party – WA CAR-FED Carers Alliance ALP-SA Australian Labor Party – SA CEC-FED Citizens Electoral Council of Australia ALP-TAS Australian Labor Party – TAS CCC-FED Climate Change Coalition ALP-ACT Australian Labor Party – ACT COM-FED Communist Alliance Conservatives for Climate and Environment ALP-NT Australian Labor Party – NT CCE-FED Incorporated CDP-FED Christian Democratic Party (Fred Nile CLR-FED Country Labor Party Group) HOV-FED Hear Our Voice CDP-WA Christian Democratic Party (Fred Nile Group) – WA LDP-FED Liberal Democratic Party NCP-FED Non-Custodial Parents Party (Equal Parenting) DLP-FES Democratic Labor Party of Australia CLP-NT Northern Territory Country Liberal Party DLP-NSW Democratic Labor Party – NSW NDP-FED Nuclear Disarmament Party of Australia DLP-QLD Democratic Labor Party – QLD PUA-FED Pauline’s United Australia Party DLP-WA Democratic Labor Party – WA SOL-FED Senator On-Line FFP-FED Family First Party SAL-FED Socialist Alliance FFP-NSW Family First Party – NSW SEP-FED Socialist Equality Party FFP-VIC Family First Party – VIC ASP-FED The Australian Shooters Party FFP-QLD Family First Party – QLD FPY-FED The Fishing Party FFP-WA Family First Party – WA WWW-FED What Women Want (Australia) FFP-SA Family First Party – SA YNP-FED Young National Party of Australia DAR_3 (07/09) – Page 4 of 4 .
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