Associated Entity Disclosure Return
2016–17 FINANCIAL YEAR		
Section 314AEA(1) requires associated entities to furnish a return within 16 weeks after the end of the financial year.
The due date for lodging this return is 20 October 2017.
Completing the return:
•	This return is to be completed by the financial controller of the entity.
•	This return is to be completed with reference to the Financial Disclosure Guide for Associated Entities.
•	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 Thursday 1 February 2018 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 s 314AEA of the Commonwealth Electoral Act 1918. 

Name of associated entity	     	
Postal address	     	
	Suburb/town
	     	State      	Postcode      	
With which political party, or parties, is the entity associated?
	     	
	     	
Financial controller details	
Name of financial controller	     	
Capacity or position	     	
Postal address	     	
	Suburb/town	     	State      	Postcode      	
Telephone number	(   )          	Fax number	(   )          	
Email address	     	

Financial controller’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 enquiries of the organisation on whose behalf I am authorised to complete this form. I understand that submitting an incomplete, false or misleading return is an offence under section 315 of the Commonwealth Electoral Act 1918.
		
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 organisation on whose behalf I am authorised to complete this form. I understand that submitting an incomplete, false or misleading return is an offence under section 315 of the Commonwealth Electoral Act 1918.
		
Signature				
		Date	     	

Enquiries and returns 
should be addressed to: 	Funding and Disclosure
Australian Electoral Commission
Locked Bag 4007
Canberra ACT 2601	Phone:	02 6271 4552
Fax:	02 6293 7655
Email:	fad@aec.gov.au	

Office use only
Date received		

Part 1a: Other business names
	
Do you operate or conduct business under any other names?
	No						
	Yes			List other trading names	
				     	
				     	
				     	
				     	

Part 1b: Related bodies corporate
	
Subsection 287(6) of the Commonwealth Electoral Act 1918 deems bodies corporate related under the provisions of the Corporations Act 2001 to be a single entity for disclosure purposes. The parent company of the group, therefore, should lodge under its name a return consolidated across the entire group.	
Do you have any related bodies corporate?	No						
	Yes			List any related bodies corporate you are lodging on behalf of	
	Name	     	
	Postal address	     	
	Suburb/town	     	State      	Postcode     	
	Name	     	
	Postal address	     	
	Suburb/town	     	State      	Postcode     	

Part 1c: Unions
	
Are you a union? 	No				
	Yes			List any branches you are lodging on behalf of	
	Name	     	
	Postal address	     	
	Suburb/town	     	State      	Postcode    	
	Name	     	
	Postal address	     	
	Suburb/town	     	State      	Postcode     	
	Name	     	
	Postal address	     	
	Suburb/town	     	State      	Postcode     	
	Name	     	
	Postal address	     	
	Suburb/town	     	State      	Postcode     	
	Name	     	
	Postal address	     	
	Suburb/town	     	State      	Postcode     	
 If insufficient space, please attach additional sheets.

Part 2a: Total receipts for financial year 1 July 2016 to 30 June 2017	
This is the gross amount of all cash and non-cash benefits received by, or on behalf of, the associated entity, during the 2016–17 financial year. It includes all amounts received for the financial year.
	$      	.00	
		
Part 2b: 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 2a.	$     	.00	
				
Part 3: Amounts of more than $13,200 received in financial year 1 July 2016 to 30 June 2017	
Details of any person or organisation from whom receipts (including loans) of more than $13,200 were received during the 2016–17 financial year.
For each person or organisation, the following details must be disclosed:
•	full name and address details** of the person or organisation from whom more than $13,200 of money or gifts‑in-kind were received
•	amount that was received. Each amount received should be recorded as either a ‘donation’ or ‘other receipt’.
For loans of more than $13,200 (other than those from a financial institution) received between 1 July 2016 and 30 June 2017 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     		

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.
** Name and address details
•	If the gift was from an unincorporated association (other than a registered industrial organisation), the name of the association and the name and addresses of all the executive committee members are required.
•	If the gift was from a trust, the name of the trust, and the name and addresses of all the trustees are required.

Part 4: Total payments for financial year 1 July 2016 to 30 June 2017	
This is the gross amount of payments made by, or on behalf of, the associated entity during the 2016–17 financial year. It includes all payments made for the financial year.	$      	.00	
		
Part 5: Total debts as at 30 June 2017	
This is the gross amount of all debts owed by, or on behalf of, the associated entity as at 30 June 2017. It is the total amount outstanding as at 30 June 2017.	$      	.00	
		
Part 6: Debts of more than $13,200 as at 30 June 2017	
Details of any person or organisation for which the associated entity owes a debt, of more than $13,200, which is outstanding as at 30 June 2017.
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     		

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

Part 7: Capital contributions	
Where an associated entity paid an amount during the financial year, to or for the benefit of one or more political parties and the amount was paid out of funds generated from capital of the associated entity the associated entity must disclose deposits of capital received since 16 June 1995, or since the last disclosure of capital was made in a disclosure return (whichever is later).

Where the above criteria is met, the following details must be disclosed:
•	full name and address of the person who contributed capital; and
•	total amount of the person’s contribution to that capital, up to the end of the financial year.
No minimum disclosure threshold applies. Gross amounts are required – capital contributions and any refund or payment from funds generated should not be netted off.
Where capital contributions have been disclosed in a previous return, they are not required to be disclosed again.
	
Contributor details	Gross amount contributed		
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 associated entities in addition to federal requirements. 
Check with your state electoral commission about requirements in your state.

NSW Electoral Commission*
http://www.elections.nsw.gov.au/

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

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

Western Australian Electoral Commission*
https://www.elections.wa.gov.au/

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

Tasmanian Electoral Commission
https://www.tec.tas.gov.au/

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

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

*denotes an organisation that operates a funding and disclosure scheme separate from the Commonwealth disclosure scheme as at 30 June 2017.