Agent for third party organisation

Reporting electoral expenditure incurred

Local

Your details

Agent full name*

Third party organisation *

Address*

ABN

ACN

Electoral expenditure

Supplier name*

Street*

Suburb*

State*

Postcode*

Expenditure Particulars

Description of goods or services*

Purpose of the expenditure*

Amount*

Date of expenditure*

Event*

Was the expenditure incurred to benefit/support or oppose a particular candidate, group of candidates, or political party in the election?*

Yes No

This expenditure was incurred to

Was the expenditure incurred to support or oppose an issue at the election?*

Yes No

This expenditure was incurred to

$0.00

Current Total