RESIGNATION OR CHANGE OF A NOMINATED 
PERSON FOR AN UNINCORPORATED BODY
Charitable Collections Act 2003
Charitable Collections Regulation 2003
		
PURPOSE 

This form is to be used for the purposes of notification of the resignation or change of the nominated person for an unincorporated body under the Charitable Collections Act 2003 (the Act).  You can access the legislation at www.legislation.act.gov.au.  You may also obtain further information and forms at www.ors.act.gov.au.
	
PRIVACY

The Act authorises the Director-General to collect the personal information required by this form for the purposes of issuing a licence under Division 4.1 of the Act.  Pursuant to Section 41 of the Act, the Director-General must keep a Register of Licenses that is available for inspection by the public. The Director-General prevents any unreasonable intrusion into a person’s privacy in accordance with the Privacy Act 1988 (C’wlth).  The Director-General may provide additional information to law enforcement agencies and authorised organisations that have legal authority to request information under prescribed circumstances.
	
CONTACT
	
Office of Regulatory Services Shopfront
255 Canberra Avenue, Fyshwick ACT 2609	Office of Regulatory Services Postal Address
GPO Box 158, Canberra ACT 2601	
Opening Hours 9:00am to 4:30pm Monday to Friday	Website www.ors.act.gov.au      Email ors.bil@act.gov.au 	
General Enquiries (02) 6207 0562
	Fax Number (02) 6207 0424
	
INSTRUCTIONS FOR COMPLETION 
•	Complete this form using blue or black pen only.
•	Please print; ensuring writing is clear and legible. 
•	This office will not accept lodgement of this form if it is not completed in full.	
IMPORTANT INFORMATION
•	Licensees should be aware of their responsibilities under the Charitable Collections Act 2003.  
•	The nominated person is the contact person between the licensee and the Office of Regulatory Services.
•	If a licence is issued to an unincorporated body, the nominated person for the body in relation to the licence 
is taken to be the licensee.
•	If at any time there is not a nominated person for the unincorporated body in relation to the licence, the executive officers of the body are jointly and severally taken to be the licensee.
•	Licenses cannot be transferred to another entity.
•	The Licensee must return the original licence to the Director-General for amendment.
	
TRANSLATING AND INTERPRETING SERVICE
If you require further information or require advice, a language assistance service is available by phoning the Translating and Interpreting Service (TIS) on 13 14 50.	

                  

RESIGNATION OR CHANGE OF A NOMINATED 
PERSON FOR AN UNINCORPORATED BODY
Charitable Collections Act 2003
Charitable Collections Regulation 2003	

NAME OF LICENSEE	LICENCE NUMBER	LICENCE ATTACHED	
		 Yes	 No	

 Resignation	 Change	Effective Date                       /            /	

DETAILS OF RESIGNATION OR CHANGE OF NOMINATED OFFICER	

TITLE (eg. Ms, Mr, Dr)	FULL NAME 	POSITION HELD WITHIN ORGANISATION (EG. Exec Officer)	
			
ADDRESS (Property name, unit, flat, room no, street number, street name, city/suburb/town, postcode)	

SIGNATURE OF OUTGOING OFFICER	

Applicants Name in Full

Applicant Signature                                      Date       /     /
   /	Signed in my presence

Witnesses Name in Full

Witness Signature                                            Date       /      /

DETAILS OF NEW NOMINATED OFFICER	

TITLE (eg. Ms, Mr, Dr)	FULL NAME OF NOMINATED PERSON 	POSITION HELD WITHIN ORGANISATION (EG. Exec Officer)	
			
ADDRESS (Property name, unit, flat, room no, street number, street name, city/suburb/town, postcode)	
	
PHONE CONTACT	FAX CONTACT	EMAIL CONTACT	

SIGNATURE OF NEW NOMINATED OFFICER	

Applicant’s Name in Full

Applicant Signature                                      Date        /     /        	Signed in my presence

Witness’ Name in Full

Witness’ Signature                                         Date    /    /