Request for Amendment - Political Party Disclosure Return
FINANCIAL YEAR 2020-21	
Completing the Return:
•	This request for amendment should be used to amend a 2020-21 Political Party Disclosure Return lodged with the AEC.
•	This request for amendment is to be completed with reference to the Financial Disclosure Guide for Political Parties.
•	Requests for amendment to a 2020-21 return will be available for public inspection from Tuesday 1 February 2022 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(2) of the Commonwealth Electoral Act 1918 (Electoral Act).

Name of political party	     	

2020-21 Return details		
Is this the first amendment 
to the return?	Yes			No			How many other Request for 
Amendments have been lodged?	     		

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

Party agent’s request and certification	
I request the Electoral Commission amend the Political Party Disclosure Return 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 political party on whose behalf I am agent for the purposes of Part XX of the Electoral Act.
I understand that submitting a false or misleading return is an offence under Division 137.1 of the Criminal Code Act 1995.
	
Agent’s signature				
		Date	     	

How to complete this form:
•	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.

Part 1a: Total receipts for financial year 1 July 2020 to 30 June 2021		
No change to previous information	   OR	
Previous total receipts	$      		.00	Amended total receipts	$      	.00	

Part 1b: Amount calculated to be value of gifts-in-kind		
No change to previous information	   OR	

Previous gifts-in kind	$      		.00	Amended gifts-in kind	$      	.00	

Part 2: Amounts of more than $14,300 received in financial year 1 July 2020 to 30 June 2021	
No change to previous information	   OR	
Provide details of changes or amendments to the information previously provided.	

Received from	Amount received (GST inclusive)	Donation or Other Receipt*	
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.

*	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 2020 to 30 June 2021	
No change to previous information	   OR	
Previous total payments	$      		.00	Amended total payments	$      	.00	

Part 4: Total debts as at 30 June 2021	
No change to previous information	   OR	
Previous total debts	$      		.00	Amended total debts	$      	.00	

Part 5: Debts of more than $14,300 as at 30 June 2021	
No change to previous information	   OR	
Provide details of changes or amendments to the information previously provided.	

Creditor details	Amount owed 
(GST inclusive)	Financial or 
Non-financial institution	
Original 
Entry	Name	     	$      	.00	       	
	Street/postal 	     				
	Suburb/Town	     	State    	Postcode     	
	
Amended 
Entry	Name	     	$      	.00	       	
	Street/postal 	     				
	Suburb/Town	     	State    	Postcode     		
Original 
Entry	Name	     	$      	.00	       	
	Street/postal 	     				
	Suburb/Town	     	State    	Postcode     	
	
Amended 
Entry
	Name	     	$      	.00	       	
	Street/postal 	     				
	Suburb/Town	     	State    	Postcode     		
Original 
Entry	Name	     	$      	.00	       	
	Street/postal 	     				
	Suburb/Town	     	State    	Postcode     	
	
Amended 
Entry	Name	     	$      	.00	       	
	Street/postal 	     				
	Suburb/Town	     	State    	Postcode     		
Original 
Entry	Name	     	$      	.00	       	
	Street/postal 	     				
	Suburb/Town	     	State    	Postcode     	
	
Amended 
Entry	Name	     	$      	.00	       	
	Street/postal 	     				
	Suburb/Town	     	State    	Postcode     		

	
If insufficient space, please attach additional sheets.

Part 6: Discretionary benefits	
No change to previous information	   OR	
Provide details of changes or amendments to the information previously provided.
Note: All amounts are GST inclusive.	

Received from	Date of discretionary benefit	Value of discretionary benefit)	
Original 
Entry	Name	     	     	$      	.00	
Amended 
Entry	Name	     	     	$      	.00	
Original 
Entry	Name	     	     	$      	.00	
Amended 
Entry

	Name	     	     	$      	.00	
Original 
Entry	Name	     	     	$      	.00	
Amended 
Entry	Name	     	     	$      	.00	
Original 
Entry	Name	     	     	$      	.00	
Amended 
Entry	Name	     	     	$      	.00	
Original 
Entry	Name	     	     	$      	.00	
Amended 
Entry	Name	     	     	$      	.00	
Original 
Entry	Name	     	     	$      	.00	
Amended 
Entry	Name	     	     	$      	.00	

If insufficient space, please attach additional sheets.