Annual Donor Disclosure Return Amendment – Individuals
FINANCIAL YEAR 2022-23	
Completing the Return:
•	This request for amendment should be used to amend a 2022-23 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 2024 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.
	
2022-23 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.