Request for Amendment
Third Party Return of Political Expenditure
FINANCIAL YEAR 2014–15		
Completing the Return:
•	This request for amendment should be used to amend a 2014–15 Third Party Return of Political Expenditure lodged with the AEC.
•	This request for amendment is to be completed with reference to the Financial Disclosure Guide for Third Parties incurring Political Expenditure
•	Further information is available at www.aec.gov.au.
•	Requests for amendment to a 2014-15 return 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. 	
Person or organisation covered by this return		
Name 	      	
Postal address	     	
	Suburb/town	     	State     	Postcode	    	
2014–15 Return details		
Is this the first amendment 
to the return?	Yes			No			How many other Request for
Amendments have been lodged?	     		
Person completing this return	
Name (Write ’as above’ 
if completing own return)	     		
Capacity or position 
(e.g. company secretary, self)	     		
Postal address	     	
	Suburb/town	     	State     	Postcode	    	
Telephone number	(   )       	Fax number	(   )       	
Email address	     	

Request and Certification
I request the Electoral Commission amend the Third Party Return of Political Expenditure 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 person/organisation on whose behalf I am authorised to complete this return. I understand that giving false or misleading information is a serious offence.	
				
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 1: Political expenditure for financial year 1 July 2014 to 30 June 2015	
No change to previous information	   OR	
Provide details of changes or amendments to the information previously provided.	
		Previously reported amounts		Amended amounts	
1. 	Public expression of views on a political party, candidate in an election or member of the Commonwealth Parliament by any means.	$      	.00		$      	.00	
					
2. 	Printing, production, publication or distribution of any material (other than that at item 1 or item 5) that is required by section 328, 328A or 328B of the Act to include a name, address or place of business.	$      	.00		$      	.00	
					
3. 	Broadcast of political matter in relation to which particulars are required to be announced under subclause 4(2) of Schedule 2 to the Broadcasting Services Act 1992.	$      	.00		$      	.00	
					
4. 	Carrying out opinion polling or other research relating to a federal election or the voting intentions of electors.	$      	.00		$      	.00	
5. 	Public expression of views on an issue in a federal election by any means 
(other than those at items 1, 2, 3, or 4).	$      	.00		$      	.00	

Part 2: Gifts received for political expenditure for financial year 1 July 2014 to 30 June 2015	
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.
•	All amounts should be reported on a GST inclusive basis.	
Received from	Date of gift	Total amount received
(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     		
If insufficient space, please attach additional sheets.