RES
Form 700

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

APPLICATION FOR RESERVATION OF 
ASSOCIATION NAME

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

1.  NAME AND RESIDENTIAL ADDRESS OF APPLICANT
(Person authorised under S.37(1) to apply for reservation – must reside in ACT)	
     	

Section 37(1) of the Act requires that an application for reservation of an association name be lodged by an authorised applicant.  Section 37(8) of the Act outlines the requirements for an authorised applicant.  Under Section 37(8), if the purpose of this application is to reserve a name for an existing incorporated association which intends to apply for a change of name, the authorised applicant must be the public officer of the association.	

2. ASSOCIATION NAME TO BE RESERVED
     	

3. PURPOSE OF RESERVATION (select one only)			
If the name is being reserved for a new association, place a 'X' here:		and leave Item 4 blank.	
If the name is being reserved for an existing incorporated association which will later apply for a change of name, place a 'X" 	
here:		and show the association's current name and association number at Item 4.	
If the name is being reserved for two or more existing incorporated associations which will later apply to amalgamate, place a 'X" 	
here:		and show each association's name and association number at Item 4.	

4. CURRENT ASSOCIATION(S) NAME AND NUMBER (if applicable)
     	A	     	
     	Inc.			
     	A	     	
     	Inc.			

5.  DATE OF APPLICATION
     	

6.  STATEMENT BY APPLICANT 			
I confirm that all of the particulars shown on this form are true and correct, that I am the applicant authorised under Section 37 of the Act to apply for reservation of the name shown at Item 2 above, and that I have read the "Privacy Statement" and "Important Information" appearing overleaf.	
							
	Signature		Name		Date		

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 public officer is responsible for acting as a point of contact between the association and the community, and is expected to be able to represent the association in dealings with this office.  The Act prohibits any person from serving as a committee member or the public officer 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 on the obligations of incorporated associations can be found in the Associations Kit available from the Registrar-General's Office, and on-line at www.rgo.act.gov.au. 

LOCATION
255 Canberra Avenue
Fyshwick  ACT   2609

OFFICE HOURS
9.00am 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