Commonwealth Consolidated Acts

COMMONWEALTH ELECTORAL ACT 1918 - SCHEDULE 1

Section   152

FORM A

COMMONWEALTH OF AUSTRALIA

To the Australian Electoral Officer for the State of [ here insert name of State ].

GREETING.

We command you to cause election to be made according to law of [ here insert number ] Senators for our State of [ here insert name of State ] to serve in the Senate of the Parliament of the Commonwealth of Australia. And we appoint the                                           day of                                           20               as the day for the close of the Rolls. And we appoint the                             day of                                           20               , at twelve o'clock noon to be the day and time before which nominations of Senators at and for the said election are to be made. And we appoint the                                           day of                                           20               , to be the day on which the poll is to be taken in the event of the said election being contested. And we command you to certify the names of the Senators elected and to return this our writ with the certificate attached to our Governor in and over our said State on or before the                             day of                             20               .

Witness [ here insert the title of the Governor of the State issuing the writ ] at [ here insert place ] in our said State the                                           day of                                           in the year of our Lord Two thousand and              

Section   152

FORM AA

COMMONWEALTH OF AUSTRALIA

To the Australian Electoral Officer for the Territory of [ here insert name of Territory ].

GREETING.

We command you to cause election to be made according to law of 2 Senators for our Territory of [ here insert name of Territory ] to serve in the Senate of the Parliament of the Commonwealth of Australia from and after the date of their election. And we appoint the                                                         day of                             20               as the day for the close of the Rolls. And we appoint the                                           day of                                           20               , at twelve o'clock noon to be the day and time before which nominations of Senators at and for the said election are to be made. And we appoint the                                                         day of                             20               , to be the day on which the poll is to be taken in the event of the said election being contested. And we command you to certify the names of the Senators elected and to return this our writ with the certificate attached to our Governor - General in and over our said Commonwealth of Australia on or before the                                           day of                                           20               .

Witness [ here insert the Governor - General's title ] at [ here insert place ] the
day of       in the year of our Lord Two thousand and    

Section   152

FORM B

Writ for the Election of [ here insert members or a member, as the case requires ] of the House of Representatives.

COMMONWEALTH OF AUSTRALIA

To, Electoral Commissioner.

GREETING.

We command you that you cause [ here insert elections or election, as the case requires ], to be made according to law of [ here insert Members of the House of Representatives or one Member of the House of Representatives for the Electoral Division of [ here insert name of Division ], as the case requires ], to serve in the Parliament of our Commonwealth of Australia and we appoint the following dates for the purposes of the said, [ elections or election as the case requires ]

1.   For the close of the Rolls the     day of     20   .

2.   For nomination     the     day of     20   .

3.   For taking the poll at the different polling places in the event of the election being contested                             the                             day of                             20               .

4.   For the return of the writ on or before   the day of   20   .

Witness [ here insert the Governor - General's title or Speaker's title, as the case requires ] at [ here insert place ] the                                           day of                                           in the year of our Lord Two thousand and                                          

Section   166

FORM C

Nomination of a Senator

To the Electoral Commissioner.

We, electors on the electoral roll for [ name of State or Territory ] and entitled to vote at the election of Senators for that [State/Territory], hereby nominate the person named below as a Senator for that [State/Territory] to serve in the Senate of the Parliament of the Commonwealth.

Dated         20   .

Nominators

Candidate

I, the candidate named above, state that:
  Please tick [  ]

• I am an Australian citizen   Yes [   ]   No [   ]
• I am at least 18 years of age   Yes [   ]   No [   ]
• I am an elector or qualified to be an elector   Yes [   ]   No [   ]
• I am not, by virtue of section   44 of the Constitution,   Yes [   ]   No [   ]
  incapable of being chosen or of sitting as a Senator

and I declare that:

• I am qualified under the Constitution and the laws of the Commonwealth to be elected as a Senator;
• I am not, and do not intend to be, a candidate in any other election to be held on the same day as the election to which the above nomination relates;
• I consent to act as a Senator for the above [State/Territory] if elected.

I wish my Christian or given names to appear on the ballot paper in the form shown above.

  [ Signature of candidate ]

Section   166

FORM CA

Nomination of a Senator

To the Electoral Commissioner.

I, [ name ], the registered officer [ or deputy registered officer] of the [ name of registered political party ] hereby nominate the person named below as a Senator for [ name of State or Territory ] to serve in the Senate of the Parliament of the Commonwealth.

I wish/do not wish the logo of the [ name of registered political party ] entered in the Register to appear on the ballot paper.

Dated         20   .

  [ Signature ]

Candidate

I, the candidate named above, state that:
  Please   tick [  ]

• I am an Australian citizen   Yes [   ]   No [   ]
• I am at least 18 years of age   Yes [   ]   No [   ]
• I am an elector or qualified to be an elector   Yes [   ]   No [   ]
• I am not, by virtue of section   44 of the   Yes [   ]   No [   ]
  Constitution, incapable of being chosen or
  of sitting as a Senator

and I declare that:

• I am qualified under the Constitution and the laws of the Commonwealth to be elected as a Senator;
• I am not, and do not intend to be, a candidate in any other election to be held on the same day as the election to which the above nomination relates;
• I consent to act as a Senator for the above [State/Territory] if elected.

I wish my Christian or given names to appear on the ballot paper in the form shown above.

  [ Signature of candidate ]

Section   166

FORM CC

Nomination of Senators

To the Electoral Commissioner.

I, [ name ], the registered officer [ or deputy registered officer] of the [ name of registered political party ] hereby nominate the persons named below as Senators for [ name of State or Territory ] to serve in the Senate of the Parliament of the Commonwealth.

I wish/do not wish the logo of the [ name of registered political party ] entered in the Register to appear on the ballot paper.

Dated         20   .

  [ Signature ]

Each of the candidates named below, states that:
  Please tick [  ]

• I am an Australian citizen   Yes [   ]   No [   ]
• I am at least 18 years of age   Yes [   ]   No [   ]
• I am an elector or qualified to be an elector   Yes [   ]   No [   ]
• I am not, by virtue of section   44 of the   Yes [   ]   No [   ]
  Constitution, incapable of being chosen or
  of sitting as a Senator

and declares as follows:

• I am qualified under the Constitution and the laws of the Commonwealth to be elected as a Senator;
• I am not, and do not intend to be, a candidate in any other election to be held on the same day as the election to which the above nomination relates;
• I consent to act as a Senator for the above [State/Territory] if elected.

Each of the candidates named below requests that the Christian or given names of the candidate appear on the ballot paper in the form shown below.

Section   166

FORM D

Nomination of a Member of the House of Representatives

To the Electoral Commissioner

We, electors on the electoral roll for the Division of [ name of Division ] and entitled to vote at the election of a Member of the House of Representatives for that Division, hereby nominate the person named below as a Member of that House for that Division.

Dated         20   .

Nominators

Candidate

I, the candidate named above, state that:
  Please tick [  ]

• I am an Australian citizen   Yes [   ]   No [   ]
• I am at least 18 years of age   Yes [   ]   No [   ]
• I am an elector or qualified to be an elector   Yes [   ]   No [   ]
• I am not, by virtue of section   44 of the   Yes [   ]   No [   ]
  Constitution, incapable of being chosen or
  of sitting as a member of the House of Representatives

and I declare that:

• I am qualified under the Constitution and the laws of the Commonwealth to be elected as a Member of the House of Representatives;
• I am not, and do not intend to be, a candidate in any other election to be held on the same day as the election to which the above nomination relates;
• I consent to act as a Member of the House of Representatives for the above Division if elected.

I wish my Christian or given names to appear on the ballot paper in the form shown above.

  [ Signature of candidate ]

Section   166

FORM DA

Nomination of a Member of the House of Representatives

To the Electoral Commissioner

I, [ name ], the registered officer [ or deputy registered officer] of the [ name of registered political party ] hereby nominate the person named below as a Member of the House of Representatives for the Division of [ name of Division ].

I wish/do not wish the logo of the [ name of registered political party ] entered in the Register to appear on the ballot paper.

Dated         20   .

  [ Signature ]

I, the candidate named above, state that:
  Please   tick [  ]

• I am an Australian citizen   Yes [   ]   No [   ]
• I am at least 18 years of age   Yes [   ]   No [   ]
• I am an elector or qualified to be an elector   Yes [   ]   No [   ]
• I am not, by virtue of section   44 of the   Yes [   ]   No [   ]
  Constitution, incapable of being chosen or
  of sitting as a member of the House of Representatives

and I declare that:

• I am qualified under the Constitution and the laws of the Commonwealth to be elected as a Member of the House of Representatives;
• I am not, and do not intend to be, a candidate in any other election to be held on the same day as the election to which the above nomination relates;
• I consent to act as a Member of the House of Representatives for the above Division if elected.

I wish my Christian or given names to appear on the ballot paper in the form shown above.

  [ Signature of candidate ]

Definition of qualification checklist in subsection   4(1); paragraph   170(1)(d)

FORM DB

QUALIFICATION CHECKLIST RELATING TO YOUR ELIGIBILITY UNDER SECTION   44 OF THE AUSTRALIAN CONSTITUTION

... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ..

[ Candidate's name ]

Please fill out this checklist.

Be aware that completing this checklist does not guarantee that you are eligible to be elected under section   44 of the Australian Constitution or under the Commonwealth Electoral Act 1918 .

If you have any doubts about your eligibility, you should seek independent legal advice.

If you provide information in this checklist that you know is false or misleading, you may commit an offence against the Criminal Code with a maximum penalty of imprisonment for 12 months, $12,600 or both.

You must answer every question in the checklist that has check boxes by marking one, and only one, of the boxes provided. Your nomination will be rejected if you do not mark any of the boxes, or if you mark more than one of the boxes, provided for any of these questions.

Please provide supporting documentation as appropriate. You may provide additional documents if you are unable to fit all your responses in this checklist.

Note: If you answer 'yes' in question 10 then you must provide at least one document in response to question 10a.

You should not include information in this checklist, or in any additional documents you provide, that is inappropriate in any way. If you do, the information may be redacted by the Electoral Commissioner and not published on the Australian Electoral Commission's website.

You may choose to redact information (for example, your own or another person's personal information) from additional documents before providing them. Redactions must be in accordance with any directions of the Electoral Commissioner.

The candidate statement and declaration that you have made elsewhere in this nomination also relate to your eligibility to be elected. In that statement and declaration:

  (a)   you have declared that you are qualified under the Constitution and the laws of the Commonwealth to be elected as a Senator or member of the House of Representatives; and

  (b)   you have stated that you are an Australian citizen.

1.   Do you know the place of birth of each of your parents and grandparents (whether biological or adoptive)?

      YES     NO  

1a.   Please provide any relevant details (for example, why you do not know the place of birth of a parent or grandparent):

[Please provide particulars of, or documents related to, any details provided in response to question 1a. These will be published with this checklist on the Australian Electoral Commission's website.]

2.   Do you have a parent or grandparent that you know was born in another country? This may be a biological or adoptive parent or grandparent. (If you do not know any of your parents' or grandparents' places of birth, please mark the 'N/A' box.)

      YES     NO     N/A  

2a.   If 'yes', please provide the following details, to the extent known:

2b.   Please provide any other relevant details:

[Please provide particulars of, or documents related to, any details provided in response to questions 2a and 2b. These will be published with this checklist on the Australian Electoral Commission's website.]

3.   Have you provided details in question 2a in relation to each parent and grandparent that you know was born in another country?   (If you do not know any of your parents' or grandparents' places of birth, please mark the 'N/A' box.)

      YES     NO     N/A  

3a.   If 'no', please explain why you have not provided those details:

4.   Do you know which citizenships have been held by each of your parents and grandparents (whether biological or adoptive)?

      YES     NO  

4a.   Please provide any relevant details (for example, why you do not know the citizenships held at a particular time by a particular parent or grandparent):

[Please provide particulars of, or documents related to, any details provided in response to question 4a. These will be published with this checklist on the Australian Electoral Commission's website.]

5.   Do you have a parent or grandparent that you know acquired citizenship of another country by descent, naturalisation or other means? This may be a biological or adoptive parent or grandparent. (If you do not know any of your parents' or grandparents' citizenship, please mark the 'N/A' box.)

      YES     NO     N/A  

5a.   If 'yes', please provide the following details, to the extent known:

5b.   Please provide any other relevant details:

[Please provide particulars of, or documents related to, any details provided in response to questions 5a and 5b. These will be published with this checklist on the Australian Electoral Commission's website.]

6.   Have you provided details in question 5a in relation to each parent and grandparent that you know acquired citizenship of another country by descent, naturalisation or other means? (If you do not know any of your parents' or grandparents' citizenship, please mark the 'N/A' box.)

      YES     NO     N/A  

6a.   If 'no', please explain why you have not provided those details:

7.   Do you know which citizenships have been held by each of your current and former spouses and similar partners? (If you do not have a current or former spouse or similar partner, please mark the 'N/A' box.)

      YES     NO     N/A  

7a.   Please provide any relevant details (for example, why you do not know the particular citizenships held at a particular time by a current or former spouse or similar partner):

[Please provide particulars of, or documents related to, any details provided in response to question 7a. These will be published with this checklist on the Australian Electoral Commission's website.]

8.   Do you have a current or former spouse or similar partner who you know is or was a citizen of another country? (If you do not have a current or former spouse or similar partner, or you do not know the citizenship of any of your current or former spouses or similar partners, please mark the 'N/A' box.)

      YES     NO     N/A  

8a.   If 'yes', please provide the following details, to the extent known:

8b.   Please provide any other relevant details (for example, whether you acquired foreign citizenship because of a spouse's foreign citizenship):

[Please provide particulars of, or documents related to, any details provided in response to questions 8a and 8b. These will be published with this checklist on the Australian Electoral Commission's website.]

9.   Have you provided details in question 8a in relation to each current or former spouse or similar partner that you know is or was a citizen of another country? (If you do not have a current or former spouse or similar partner, or you do not know the citizenship of any of your current or former spouses or similar partners, please mark the 'N/A' box.)

      YES     NO     N/A  

9a.   If 'no', please explain why you have not provided those details:

10.   Have you ever been a subject or citizen of any country other than Australia?

      YES     NO     UNKNOWN  

10a.   If 'yes', please provide the following details, to the extent known:

[If you contend that you have renounced or lost your foreign citizenship, you must provide at least one document that you are satisfied supports your contention. (The document may be an official document, or if you have no official document, a statutory declaration.) This will be published with this checklist on the Australian Electoral Commission's website.]

10b.   Please provide any other relevant details (for example, how you lost your foreign citizenship, or why the response to question 10 is unknown):

[In addition to the requirement to provide at least one document mentioned under question 10a, please provide particulars of, or documents related to, any other details provided in response to questions 10a and 10b. These will be published with this checklist on the Australian Electoral Commission's website.]

11.   Are you now a subject or citizen of any country other than Australia?

      YES     NO     UNKNOWN  

11a.   If 'yes', please provide the following details, to the extent known:

11b.   Please provide any other relevant details (for example, why you are prevented from renouncing your foreign citizenship, or why the response to question 11 is unknown):

[Please provide particulars of, and documents related to, any details provided in your response to questions 11a and 11b. These will be published with this checklist on the Australian Electoral Commission's website.]

12.   Are you under sentence or subject to be sentenced, for an offence for which you have been convicted, which is punishable by imprisonment for one year or longer?

NOTE:   A person convicted of an offence with a maximum penalty of imprisonment for one year or longer may be disqualified even if the sentence imposed on the person for the offence is less than the maximum penalty.

      YES     NO  

12a.   If 'yes', please provide any relevant details:

[Please provide particulars of, and documents related to, any details provided in your response to question 12a. These will be published with this checklist on the Australian Electoral Commission's website.]

13.   Are you an undischarged bankrupt or insolvent?

      YES     NO  

13a.   If 'yes', please provide any relevant details:

[Please provide particulars of, and documents related to, any details provided in your response to question 13a. These will be published with this checklist on the Australian Electoral Commission's website.]

14.   Do you hold an office of profit under the Crown, other than an office expressly exempt from section   44(iv) of the Australian Constitution? (Offices of profit under the Crown include, for example, many public sector jobs in Australia.)

      YES     NO     UNKNOWN  

14a.   Please provide any relevant details, to the extent known (for example, the relevant body in which you hold the office of profit and your role, or why the response to question 14 is unknown):

[Please provide particulars of, and documents related to, any details provided in your response to question 14a. These will be published with this checklist on the Australian Electoral Commission's website.]

15.   Do you have a direct or indirect financial interest in any contract or other agreement with the Commonwealth public service? Do not count an interest that is expressly excluded from section   44(v) of the Australian Constitution, such as a shareholding in a company that has 25 or more other shareholders.

NOTE:   Section   44(v) may disqualify you even if you are not a party to the relevant contract or agreement. A disqualifying financial interest may arise, for example, from an agreement between the Commonwealth public service and a trustee of a family trust of which you are a beneficiary.

      YES     NO     UNKNOWN  

15a.   Please provide any relevant details, to the extent known (for example, your direct or indirect financial interests, or why the response to question 15 is unknown):

[Please provide particulars of, and documents related to, any details provided in your response to question 15a. These will be published with this checklist on the Australian Electoral Commission's website.]

16.   Please provide any additional details relating to your qualification under the Australian Constitution or the Commonwealth Electoral Act 1918 :

[Please provide particulars of, and documents related to, any details provided in your response to question 16. These will be published with this checklist on the Australian Electoral Commission's website.]

I confirm the information in the checklist provided above, and any additional information provided in support of my statements, to be true and correct, to the best of my knowledge.

  [ Signature of candidate ]         [ Date ]

Note:   See section   209.

FORM E

(1)   Here, or below the square, insert name of a candidate.

(2)   Here insert name of a registered political party or composite name of registered political parties if to be printed.

(3)   Here, or below the square, insert the name of a registered political party if to be printed.

(4)   Here, or below the square, insert name of a registered political party or word 'Independent' if to be printed.

(5)   Here insert name of State or Territory and year of election.

(6)   Here insert number of vacancies.

(7)   Here insert the logo of a registered political party if to be printed.

*   If the ballot paper has 6 or fewer squares above the line, replace the instruction with "By numbering these boxes in the order of your choice (with number 1 as your first choice)".

** If the ballot paper has 12 or fewer squares below the line, replace the instruction with "By numbering these boxes in the order of your choice (with number 1 as your first choice)".

Section   209

FORM F