A2
Form 702

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

APPLICATION TO AMALGAMATE ASSOCIATIONS

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

NOTE: THIS FORM IS USED TO APPLY FOR THE AMALGAMATION OF ASSOCIATIONS INCORPORATED UNDER THE ASSOCIATIONS INCORPORATION ACT 1991.  AN INCORPORATED ASSOCIATION CANNOT APPLY TO AMALGAMATE WITH ANY ORGANISATION OTHER THAN ANOTHER ASSOCIATION INCORPORATED UNDER THE ACT.

1. AMALGAMATING ASSOCIATIONS AND AUTHORISED APPLICANTS 
(show full name and residential address of each applicant – must  reside in ACT)
(a)  	Association Name and Number:	     	
		     	Inc.	A	     	
	Applicant:	     	

(b)  	Association Name and Number:	     	
		     	Inc.	A	     	
	Applicant:	     	
Before applying for amalgamation, Section 26(1) of the Act requires that the members of each amalgamating association pass a special resolution under Section 70 of the Act, to approve the terms of the amalgamation and the statement of the objects of the new association to be formed by the amalgamation, and the rules being adopted by the new association.  
A copy of the objects of the new association must be attached to this application.  If the new association has adopted rules other than the Model Rules contained within the Associations Incorporation Regulation 1991, a full copy of these rules together with a completed Rules Reference Schedule must also be attached.
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).
The public record of each amalgamating association must be up to date before the application for amalgamation may be lodged.	
2.  NAME OF NEW ASSOCIATION TO BE FORMED BY AMALGAMATION	NEW ASSOCIATION NUMBER

     	
     	

(office use only – assigned upon amalgamation)
A	     	

3.  NAME AND RESIDENTIAL ADDRESS OF INAUGURAL PUBLIC OFFICER (must be 18 years or older and reside in ACT)
     	

4.  PREFERRED POSTAL ADDRESS 
     	

5.  ADDRESS AND HOURS OF REGISTERED OFFICE  (optional)	
     	From:	      :      	
     	To:	      :      	

An association is not required to have a registered office.  If a registered office is established, it must be located at a physical address in the ACT and be open for at least 3 consecutive hours between 9.00 am and 5.00 pm Monday to Friday (excluding public holidays). 

6. NAME AND RESIDENTIAL ADDRESS OF INAUGURAL COMMITTEE (if insufficient space, attach list with remaining information) 
Full Name	Address	Position Held	
     	     	     	
     	     	     	
     	     	     	
     	     	     	
     	     	     	
     	     	     	
     	     	     	

7.  INAUGURAL RULES OF ASSOCIATION (select only one)
If the association has adopted the Model Rules from the Associations Incorporation Regulation 1991, place an 'X' here: 		
If the association has drawn up and adopted its own set of rules in place of adopting the Model Rules, place an 'X' here: 		

8.  DEEDS AND TRUSTS
Do any legal, financial or property deeds or trusts exist which affect this association?  	Yes  /  No	If yes, a certified copy of each legal, financial or property deed or trust document which affects this association must be attached.	

9.  STATEMENT BY APPLICANTS 
I confirm that all of the particulars shown on this form and the accompanying documents are true and correct, that I have been authorised to apply for amalgamation of the associations identified at Item 1, and that the associations have passed a special resolution in line with S.26(1) and S.70 of the Act agreeing to the amalgamation.  I have read the "Privacy Statement" and "Important Information" shown below.	
					
	Signature		Signature		
					
	Full Name		Full Name		

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 amalgamation of two or more associations creates a legal entity, under the management of the committee members.  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