Agent for political party

Reporting a gift received

State

Registered political party details

Agent full name*

Political party *

Reporting a Gift-In-Kind received from an individual

Name *

Email Address

Street*

Suburb*

State*

Postcode*

Gift-In-Kind Particulars

Description of Gift Received *

Amount*

Date made *

Is this Individual the source of the Gift-In-Kind? *

Yes

No

As the donor is not the source of the Gift-In-Kind you have received, you need to disclose the below details about the source.

The source of the above Gift-In-Kind is...

Name*

Street*

Suburb*

State*

Postcode*

Names and residential or business addresses of the trustees of the fund or other persons responsible for the funds of the foundation*

Is this amount a political donation? *

Yes

No

Unknown

$0.00

Current Total