Document ID: chunk:federal_register_of_legislation:C2019A00002:clause:1_83:p1
Version: federal_register_of_legislation:C2019A00002
Segment Type: clause
Provision Reference: sch 1 cl 83 (pt 1/6)
Character Range: 33212–36039

83  After Form DA in Schedule 1
Insert:

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):

Other relevant details relating to your knowledge of your parents' and grandparents' places of birth

       [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