A3
Form 703

Lodged By:
Name:
Address:
E-mail: 
Telephone (BH):

APPLICATION FOR CHANGE OF ASSOCIATION NAME

		 PRIVACY COLLECTION STATEMENT (PRIVACY ACT 1988 (C’WLTH)) OVERLEAF 

NOTE: THE ASSOCIATION IS NOT REQUIRED TO AMEND THE RULES OF THE ASSOCIATION SOLELY DUE TO THE ADOPTION OF A NEW NAME.  IF THE ASSOCIATION DOES CHOOSE TO AMEND THE RULES TO SHOW THE NEW NAME, SEPARATE NOTICE OF THE AMENDED RULES MUST BE LODGED WITH THIS OFFICE IN ACCORDANCE WITH THE ACT.

1. ASSOCIATION NAME AND NUMBER (show existing name here)
     	
     	Inc.	A	     	

2. PROPOSED NEW ASSOCIATION NAME
     	
     	Inc.	

In order to adopt a new association name, Section 38(1) of the Act requires that the members of the association pass a special resolution to apply to the Registrar-General for consent to adopt the proposed new name.

Section 70 of the Act requires the special resolution to be passed at a general meeting of the association, of which at least 21 days notice has been given to the members, accompanied by notice of the intention to pass the resolution as a special resolution.  The special resolution must be passed by a majority of at least 75% of the votes of those members who are entitled to vote and who vote in person at the general meeting (or by proxy at the general meeting where proxy voting is allowed under the rules of the association).	

3.  DATE OF SPECIAL RESOLUTION
     	

4.  STATEMENT BY COMMITTEE MEMBERS 			
As a current committee member of this association, I confirm that the particulars shown on this form are true and correct and that the special resolution passed by the members to adopt the proposed new name met the requirements of S.38(1) and S.70 of the Act as outlined above.  I have read the 'Privacy Statement' and 'Important Information' shown overleaf.	
					
	Signature		Signature		
					
	Name		Name		
					
	Position		Position		

PRIVACY STATEMENT

Section 9 of the Associations Incorporations Act 1991 provides for the Registrar-General to collect the information for the purpose of establishing and maintaining the register of incorporated associations.  The register is available for search pursuant to Section 11 of the Act, to any person upon payment of a fee.  The register is also made available to a range of government agencies for law enforcement, administrative and statistical purposes.

IMPORTANT INFORMATION

The committee members are held accountable for ensuring that the association operates in compliance with applicable laws, including the Associations Incorporation Act 1991 (the Act) and the Associations Incorporation Regulation 1991  (the Regulation). The Act prohibits any person from serving as a committee member if he/she is insolvent or bankrupt, without leave from the ACT Supreme Court under S.63 of the Act.  A search should be conducted of the records held by the Insolvency and Trustee Service Australia (ITSA) before accepting the nomination of a person as a committee member.  For more information or to conduct a search, visit the ITSA website at www.itsa.gov.au. Further information can be found in the Associations Kit available from the Registrar-General's Office, and on-line at www.rgo.act.gov.au. 

LOCATION
B1 Level, Allara House, 
50 Allara Street, 
CANBERRA CITY

OFFICE HOURS
8.30am to 4.30pm Monday to Friday
(excluding public holidays)

CONTACT NUMBERS
Phone	(02) 62070435 or 
	(02) 62070474  
Fax 	(02) 62070487

POSTAL ADDRESS
PO Box 225
CIVIC SQUARE   ACT   2608