Document ID: chunk:federal_register_of_legislation:C2025C00152:schedule:1:p11
Version: federal_register_of_legislation:C2025C00152
Segment Type: schedule
Provision Reference: sch 1 (pt 11/12)
Character Range: 947930–951355

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):

Relevant details relating to possible disqualification by reason of section 44(v) of the Australian Constitution

       [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

                                                                                           BALLOT PAPER
                                                                                           HOUSE OF REPRESENTATIVES
                                                                                           [here insert name of State or Territory as appropriate]
Electoral Division of [here insert name of Division].
Number the boxes from 1 to [here insert number of candidates] in the order of your choice

                                                                                             [1 Here insert name of a candidate.
                                                                                              2 Here insert name of a registered political

                                                                                           party, composite name of registered political parties

                                                                                           or "Independent" if to be printed.

                                                                                            3 Here insert logo of a registered party if to be printed.]

Remember. . . . number every box to make your vote count.