Political Party Disclosure Return
		FINANCIAL YEAR 2013-14

The due date for lodging this return is 20 October 2014
Completing the Return:
•	This return is to be completed by the person who is appointed as the party’s agent with the AEC. 
•	This return is to be completed with reference to the Financial Disclosure Guide for Political Parties.
•	Amounts should be reported on a GST inclusive basis.
•	Further information is available at www.aec.gov.au.
•	This return will be available for public inspection from Monday 2 February 2015 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. 

Name of political party	     	

Party agent details	
Name of party agent	     	
Postal address of party agent	     	
	Suburb/town	     	State      	Postcode      	
Telephone number	(   )       	Fax number	(   )       	
Email address	     	

Party agent’s certification	
	I certify that the information contained in this return 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 political party on whose behalf I am agent for the purposes of Part XX of the Act. I understand that giving false or misleading information is a serious offence		
OR	I certify that the information contained in this return and its attachments is true and complete to the best of my knowledge, information and belief, except for the particulars detailed in the ‘Notice of Incomplete Return’ form (attached).I have made due and reasonable inquiries of the political party on whose behalf I am agent for the purposes of Part XX of the Act. I understand that giving false or misleading information is a serious offence.

Agent’s signature				
		Date	     	

Enquiries and returns 
should be addressed to: 	Funding and Disclosure
Australian Electoral Commission
PO Box 6172
Kingston ACT 2604	Phone:	02 6271 4552
Fax:	02 6293 7655
Email:	fad@aec.gov.au	

Office use only
Date received		

Part 1a: Total receipts for financial year 1 July 2013 to 30 June 2014	
This is the gross amount of all cash and non-cash benefits received by, or on behalf of, the political party, during the 2013–14 financial year. It includes all amounts received for the financial year.
	$      	.00	
		
Part 1b: Amount calculated to be the value of gifts-in-kind	
This is the amount calculated to be the value of gifts-in-kind which was included in the ‘total receipts’ amount reported at Part 1a.	$     	.00	

Part 2: Amounts of more than $12 400 received in financial year 1 July 2013 to 30 June 2014	
Details of any person or organisation from whom receipts (including loans) of more than $12 400 were received during the 2013–14 financial year.
For each person or organisation, the following details must be disclosed:
•	full name and address of the person or organisation from whom receipts of more than $12 400 were received
•	amount that was received. Each amount received should be recorded as either a ‘Donation’ or ‘other receipt’.
For loans of more than $12 400 (other than those from a financial institution) received between 1 July 2013 and 30 June 2014, the terms and conditions of the loan(s) must be attached.	

Received from	Amount received
(GST inclusive)	Donation or other receipt*	
Name 	     	$      	.00	     	
Postal address	     		
Suburb/town	     	State     	Postcode     		
Name 	     	$      	.00	     	
Postal address	     		
Suburb/town	     	State     	Postcode     		
Name 	     	$      	.00	     	
Postal address	     		
Suburb/town	     	State     	Postcode     		
Name 	     	$      	.00	     	
Postal address	     		
Suburb/town	     	State     	Postcode     		
Name 	     	$      	.00	     	
Postal address	     			
Suburb/town	     	State     	Postcode     			
Name 	     	$      	.00	     	
Postal address	     			
Suburb/town	     	State     	Postcode     			
Name 	     	$      	.00	     	
Postal address	     			
Suburb/town	     	State     	Postcode     			
	
If insufficient space, please attach additional sheets.	Total	$      	.00		
*	Please indicate whether this was a ‘Donation’ or ‘other receipt’. The AEC contacts donors to ensure they are aware of their disclosure obligations and unnecessary contact with other persons is avoided if the nature of the receipt is shown. 

Part 3: Total payments for financial year 1 July 2013 to 30 June 2014	
This is the gross amount of payments made by, or on behalf of, the political party, during the 2013–14 financial year. It includes all payments made for the financial year.
	$      	.00	
	
Part 4: Total debts as at 30 June 2014	
This is the gross amount of all debts owed by, or on behalf of the political party as at 30 June 2014. It is the total amount outstanding as at 30 June 2014.
	$      	.00	
		
Part 5: Debts of more than $12 400 as at 30 June 2014	
Details of any person or organisation for which the party owes a debt of more than $12 400 which is outstanding as at 30 June 2014.
For each person or organisation, the following details must be disclosed:
•	full name and address details of the person, organisation or entity that the debt is owed
•	amount that is owed
•	whether the debt is owed to a financial institution or non-financial institution.	

Creditor details	Amount owed
(GST inclusive)	Financial or 
Non-financial institution	
Name 	     	$      	.00	     	
Postal address	     		
Suburb/town	     	State     	Postcode     		
Name 	     	$      	.00	     	
Postal address	     		
Suburb/town	     	State     	Postcode     		
Name 	     	$      	.00	     	
Postal address	     		
Suburb/town	     	State     	Postcode     		
Name 	     	$      	.00	     	
Postal address	     		
Suburb/town	     	State     	Postcode     		
Name 	     	$      	.00	     	
Postal address	     		
Suburb/town	     	State     	Postcode     		
Name 	     	$      	.00	     	
Postal address	     			
Suburb/town	     	State     	Postcode     			
Name 	     	$      	.00	     	
Postal address	     			
Suburb/town	     	State     	Postcode     			
Name 	     	$      	.00	     	
Postal address	     			
Suburb/town	     	State     	Postcode     			

If insufficient space, please attach additional sheets.
	Total	$      	.00		

Links

State Government legislation may place requirements on political parties in addition to federal requirements. Check with your state electoral commission about requirements in your state.

New South Wales – Election Funding Authority*
http://www.efa.nsw.gov.au/

Victorian Electoral Commission
http://www.vec.vic.gov.au/

Electoral Commission of Queensland*
http://www.ecq.qld.gov.au/

Western Australian Electoral Commission*
http://www.waec.wa.gov.au/

Electoral Commission of South Australia
http://www.ecsa.sa.gov.au/

Tasmanian Electoral Commission
http://tec.tas.gov.au/

Australian Capital Territory Electoral Commission*
http://www.elections.act.gov.au/

Northern Territory Electoral Commission*
http://www.nt.gov.au/nteo

*denotes an organisation that operates a funding and disclosure scheme separate from the Commonwealth disclosure scheme as at June 2014.