Document ID: chunk:federal_register_of_legislation:C2025C00152:schedule:1:p5
Version: federal_register_of_legislation:C2025C00152
Segment Type: schedule
Provision Reference: sch 1 (pt 5/12)
Character Range: 932367–934962

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]

Name of candidate
as enrolled

Surname or family name  Christian or  Form in which Christian or given
                        given names   names to appear on ballot paper

Residential address     Occupation

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]