Senator Disclosure Return
FINANCIAL YEAR 2021-22		
Section 314AED(3) of the Commonwealth Electoral Act 1918 (Electoral Act) requires a Senator to furnish a return within 20 weeks after the end of the financial year.
The due date for lodging this return is 17 November 2022.
Completing the return:
•	This return is to be completed by a Senator or their representative.
•	This return is to be completed with reference to the Financial Disclosure Guide for Members of the House of Representatives and Senators.
•	Amounts should be reported on a GST inclusive basis.
•	This return will be available for public inspection from 1 February 2023 at www.aec.gov.au.
•	Any supporting documentation included with this return may be treated as part of a public disclosure and displayed on the AEC website.
•	The information on this return is collected under section 314AED of the Electoral Act.	
Senator details	
Name	     	
Completing person’s details	
Name	     	
Postal address	     	
	Suburb/town	     	State	     	Postcode	     	
Telephone number	(   )       	Fax number	(   )       	
Email address	     	
Certification
I certify that the information contained in this return and its attachments is true and complete to the best of my knowledge, information and belief. Where I sign as a representative, I have made due and reasonable inquiries of the Senator on whose behalf I have consented to act as a representative. I understand that submitting an incomplete, false or misleading return is an offence under Division 137.1 of the Criminal Code Act 1995.
	
Signature					
			Date	     	

Part 1: Total of donations received for financial year 1 July 2021 to 30 June 2022	
This is the total value of all donations received for federal purposes^, both above and below the disclosure threshold during the 2021-22 financial year.	$     	
Part 2: Total number of donors	
This is the total number of donors who made the donations included in the calculation of ‘total of donations received’ at Part 1.	     	

Part 3: Details of donations received	
Details of any person or organisation from whom donations of more than $14,500 were received for federal purposes during the 2021-22 financial year.
For each donation received that was more than the disclosure threshold, the following details must be disclosed:
•	full name and address* of the person or organisation from whom the donation was received; and 
•	date each donation was received; and 
•	value or amount of each donation.	
Received from	Date of Donation	Value of donation** 	
Name  	     	     	$     	
Postal address	     			
Suburb/town	     	State	     	Postcode	     			
Name  	     	     	$     	
Postal address	     			
Suburb/town	     	State	     	Postcode	     			
Name  	     	     	$     	
Postal address	     			
Suburb/town	     	State	     	Postcode	     			
Name  	     	     	$     	
Postal address	     			
Suburb/town	     	State	     	Postcode	     			
Name  	     	     	$     	
Postal address	     			
Suburb/town	     	State	     	Postcode	     			
Name  	     	     	$     	
Postal address	     			
Suburb/town	     	State	     	Postcode	     			
If insufficient space, please attach additional sheets.	Total	$     	
* Name and address details
•	If the donation was from an unincorporated association (other than a registered industrial organisation), the name of the association along with the name and address of each member of the executive committee are required.
•	If the donation was from a trust or foundation, the name or description of the trust or foundation along with the names and addresses of the trustees are required.
** In this form donation is a gift within the meaning in section 287(1) of the Electoral Act.
^ Federal purpose is defined in section 287(1) of the Electoral Act.