Annual Donor Disclosure Return Amendment – Individuals
FINANCIAL YEAR 2021-22	
Completing the Return:
•	This request for amendment should be used to amend a 2021-22 Annual Donor Disclosure Return - Individuals lodged with the AEC.
•	This request for amendment is to be completed with reference to the Financial Disclosure Guide for Annual Donors.
•	This request for amendment will be available for public inspection from 1 February 2023 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 s 319A of the Commonwealth Electoral 
Act 1918.

NOTE: This form is for the use of individuals only. Please use the form Annual Donor Disclosure Return – Organisations if you are completing a return for an organisation.
	
2021-22 Return details		
Is this the first amendment 
to the return?	Yes			No			How many other Requests for Amendment have been lodged?	     		
Details of person who made the donation	
Name	     	
Postal address 	     	
	Suburb/town      	State	     	Postcode       	
Telephone number	(   )       	Fax number	(   )       	
Email address		

Request and Certification	
I request the Electoral Commission amend the Annual Donor Disclosure Return – Individuals 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 understand that submitting a false or misleading return is an offence under Division 137.1 of the Criminal Code Act 1995.	
Signature				
		Date	     	

Parts of the form:
•	details of donations made to registered political parties (or State branches) — see Part 1
•	details of donations made to significant third parties — see Part 2
•	details of donations made to MPs and Senators — see Part 3
•	details of donations received — see Part 4
Part 1: Donations made to a registered political party (or State branch)		
No change to previous information	   OR	
Provide details of changes or amendments to the information previously provided.
How to complete this table:
•	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.	
Party details	Date of donation	Value of donation*
(GST inclusive)	
Original 
Entry	Name/Party code	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Amended 
Entry	Name/Party code	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Original 
Entry	Name/Party code	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Amended 
Entry	Name/Party code	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Original 
Entry	Name/Party code	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Amended 
Entry	Name/Party code	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		

If insufficient space, please attach additional sheets.
* In this form donation is a gift within the meaning in section 287(1) of the Electoral Act.

Part 2: Donations made to a significant third party		
No change to previous information	   OR	
Provide details of changes or amendments to the information previously provided.
How to complete this table:
•	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.	
Significant third party details	Date of donation	Value of donation*
(GST inclusive)	
Original 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Amended 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Original 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Amended 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Original 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Amended 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Original 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Amended 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		

If insufficient space, please attach additional sheets.
* In this form donation is a gift within the meaning in section 287(1) of the Electoral Act.

Part 3: Donations made to an MP or Senator		
No change to previous information	   OR	
Provide details of changes or amendments to the information previously provided.
How to complete this table:
•	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.	
MP or Senator details	Date of donation	Value of donation*
(GST inclusive)	
Original 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Amended 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Original 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Amended 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Original 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Amended 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Original 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Amended 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		

If insufficient space, please attach additional sheets.
* In this form donation is a gift within the meaning in section 287(1) of the Electoral Act.

Part 4: Donations received	
No change to previous information	   OR	

Provide details of changes or amendments to the information previously provided.
How to complete this table:
•	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.	
Received from	Date of donation	Value of donation*
(GST inclusive)	
Original 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Amended 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Original 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Amended 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Original 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Amended 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Original 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		
Amended 
Entry	Name	     	     	$       	.00	
	Postal address	     				
	Suburb/Town	     	State    	Postcode     		

If insufficient space, please attach additional sheets.	
* In this form donation is a gift within the meaning in section 287(1) of the Electoral Act.

Registered Political Party and Branch Codes	
CODE 	 Party / Branch	
ALP-ACT	Australian Labor Party (ACT Branch)	
ALP-NSW	Australian Labor Party (N.S.W. Branch)	
ALP-NT	Australian Labor Party (Northern Territory Branch)	
ALP-QLD	Australian Labor Party (State of Queensland)	
ALP-SA	Australian Labor Party (South Australian Branch)	
ALP-TAS	Australian Labor Party (Tasmanian Branch)	
ALP-VIC	Australian Labor Party (Victorian Branch)	
ALP-WA	Australian Labor Party (Western Australian Branch)	
ALP-FED	Australian Labor Party (ALP)	
CLR-NSW	Country Labor Party	

DLP-NSW	Democratic Labour Party (DLP) NSW Branch	
DLP-QLD	Democratic Labour Party (DLP) – Queensland Branch	
DLP-VIC	Democratic Labour Party (DLP) – Victorian Branch	
DLP-WA	Democratic Labour Party (DLP) – WA Branch	
DLP	Democratic Labour Party (DLP) of Australia	

GRN-ACT	Australian Greens, Australian Capital Territory Branch	
GRN-NSW	The Greens NSW	
GRN-NT	Australian Greens, Northern Territory Branch	
GRN-QLD	Queensland Greens	
GRN-SA	Australian Greens (South Australia)	
GRN-TAS	Australian Greens, Tasmanian Branch	
GRN-VIC	The Australian Greens - Victoria	
GRN-WA	The Greens (WA) Inc	
GRN	Australian Greens	

LIB-ACT	Liberal Party of Australia – ACT Division	
LIB-NSW	Liberal Party of Australia, NSW Division	
LNP-QLD	Liberal National Party of Queensland	
LIB-SA	Liberal Party of Australia (S.A. Division)	
LIB-TAS	Liberal Party of Australia – Tasmanian Division	
LIB-VIC	Liberal Party of Australia (Victorian Division)	
LIB-WA	Liberal Party (W.A. Division) Inc.	
LIB-FED	Liberal Party of Australia	
CLP-NT	Country Liberal Party (NT)	

NAT-SA	National Party of Australia (S.A.) Inc.	
NAT-VIC	National Party of Australia – Victoria	
NAT-NSW	National Party of Australia – N.S.W.	
NAT-WA 	National Party of Australia (WA) Inc	
NAT-FED	National Party of Australia	

LDP-ACT	Liberal Democratic Party (ACT Branch)	
LDP-NSW	Liberal Democratic Party (NSW Branch)	
LDP-QLD	Liberal Democratic Party (QLD Branch)	
LDP-SA	Liberal Democratic Party (SA Branch)	
LDP-VIC	Liberal Democratic Party (Victoria Branch)	
LDP-WA	Liberal Democratic Party (WA Branch)	
LDP-FED	Liberal Democratic Party	

AJP	Animal Justice Party	
AFP-NSW	Australia First Party (NSW) Incorporated	
AAHP	Australian Affordable Housing Party	
ABF	Australian Better Families	
ACH	Australian Christians	
CEC	Australian Citizens Party 	
AUD	Australian Democrats	
CAL	Australian Federation Party	
APEP	Australian People’s Party	
PROG	Australian Progressives	
AUVA	Australian Values Party 	
XEN	Centre Alliance	
CDP	Christian Democratic Party (Fred Nile Group)	
DAVI	David Pocock 	
DHJP	Derryn Hinch’s Justice Party	
DPDA	Drew Pavlou Democratic Alliance 	
FIN	Federal ICAC Now	
SOOPA	FUSION: Science, Pirate, Secular, Climate Emergency 	
NMP	Health Australia Party	
ICAN	Independents CAN	
IAP	Indigenous - Aboriginal Party of Australia 	
IMO	Informed Medical Options Party	
JLN	Jacqui Lambie Network	
KAP	Katter's Australian Party (KAP)	
KCBR	Kim for Canberra	
HEM	Legalise Cannabis Australia 	
LAOL	Love Australia or Leave	
NOG	No 5G Party	
ONA	Pauline Hanson’s One Nation	
REAS	Reason Australia	
RPA	Republican Party of Australia	
RPT	Rex Patrick Team	
FUT	Science Party	
SPA	Secular Party of Australia	
SUN	Seniors United Party of Australia	
SFP	Shooters, Fishers and Farmers Party	
SAL	Socialist Alliance	
SEP	Socialist Equality Party	
SPP	Sustainable Australia Party – Stop Overdevelopment / Corruption	
GAP	The Great Australian Party	
TLOC	The Local Party of Australia	
TSBP	The Small Business Party	
TNL	TNL	
TMP	Transport Matters Party	
UAPP	United Australia Party	
VNS	Victorian Socialists	
FLUX	VOTEFLUX.ORG | Upgrade Democracy!	
WAP	WESTERN AUSTRALIA PARTY