Agent for political party

Reporting a gift received

State

Registered political party details

Agent full name*

Political party *

Reporting a Fundraising Contribution received from a trust fund or foundation

Name of contributor *

Email Address

Street*

Suburb*

State*

Postcode*

Fundraising Contribution Particulars

Description of Gift Received *

Amount*

Date contributed *

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

Committee member / Trustee

Name*

Address*

Is this Trust Fund or Foundation the source of the Fundraising Contribution? *

Yes

As the donor is not the source of the Fundraising Contribution you have received, you need to disclose the below details about the source.

The source of the above Fundraising Contribution 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

Unknown

Was this amount received by or for an electoral committee for an electoral district? *

Yes

Which electoral district was the committee established for? *

$0.00

Current Total