Commonwealth Numbered Regulations Commonwealth Numbered RegulationsNote: See section 13A.
Part 1 -- Qualification checklist for Forms C, CA, D and DA
QUALIFICATION CHECKLIST RELATING TO SECTION 44 OF THE CONSTITUTION
... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ..
[ Candidate's name ]
You may fill out this checklist to demonstrate your eligibility to be elected to the Parliament. This nomination paper (including this checklist) is made public under section 176 of the Commonwealth Electoral Act 1918 .
Information relating to the requirements under section 44 of the Australian Constitution is provided as part of the nomination form. In responding to the questions below, you are encouraged to familiarise yourself with the requirements of the Australian Constitution. Further, if you have any doubts about your eligibility to nominate, or about any of the questions below, you may wish to seek independent legal advice.
1. Are you an Australian citizen by birth?
YES
NO
If 'no', provide the following details:
| Country of Birth | Citizenship at Birth | Date of Birth | Date of Australian naturalisation |
|
|
|
|
|
2. Were any of your parents or grandparents born outside Australia?
YES
NO
If 'yes', provide the following details, if known:
|
| Mother | Father |
|
Country of Birth |
|
|
| Date/Year of Birth |
|
|
|
| Maternal Grandmother | Maternal Grandfather |
| Country of Birth |
|
|
| Date/Year of Birth |
|
|
|
| Paternal Grandmother | Paternal Grandfather |
| Country of Birth |
|
|
|
Date/Year of Birth |
|
|
3. Was your spouse or any former spouse born outside Australia (if applicable)?
YES
NO
N/A
If 'yes', provide the following details:
| Relationship | Country of Birth | Date/Year of Birth | Spouse citizenship status at time of marriage |
|
|
|
|
|
|
|
|
|
|
4. Have you taken any steps to assure yourself that you have not acquired citizenship of another country by descent, marriage or other means?
YES
NO
If 'yes', provide details:
| Steps taken to assure yourself you have not acquired citizenship of another country by descent, marriage or other means |
|
|
[Particulars of, and documents related to, the steps taken to assure yourself may be provided to the Australian Electoral Commission, for publication, as additional information to support your statement]
5. Are you now a subject or citizen of any country other than Australia?
YES
NO
6. Have you ever been a subject or citizen of any country other than Australia?
YES
NO
If 'yes', have you renounced or lost that status in accordance with the laws of that country/ies?
YES
NO
If 'yes', provide the following details:
| Country | Method of renunciation or manner in which foreign citizenship was lost | Date |
|
|
|
|
[Particulars of, and documents related to, the date and manner in which your citizenship was renounced or was otherwise lost may be provided to the Australian Electoral Commission, for publication, as additional information to support your statement]
If you have not renounced or lost that status in accordance with the laws of that country/ies, is there any reason why you are not disqualified by reason of section 44(i)? (For example, despite your having taken reasonable steps to renounce your citizenship of a country, the laws of the country do not allow you to renounce that citizenship.)
YES
NO
If 'yes', provide the following details:
| Basis on which you contend that you are not disqualified by reason of section 44(i) |
|
|
[Particulars of, and documents related to, your contention that you are not disqualified by reason of section 44(i) may be provided to the Australian Electoral Commission, for publication, as additional information to support your statement]
7. Are you under sentence, or subject to be sentenced, for an offence for which you have been convicted that is punishable under an Australian law by one or more years imprisonment?
YES
NO
If 'yes', is there any reason as to why you are not disqualified by reason of section 44(ii)?
YES
NO
If 'yes', provide the following details:
| Basis on which you contend that you are not disqualified by reason of section 44(ii) |
|
|
[Particulars of, and documents related to, your contention that you are not disqualified by reason of section 44(ii) may be provided to the Australian Electoral Commission, for publication, as additional information to support your statement]
8. Are you currently an undischarged bankrupt or insolvent?
YES
NO
9. Do you hold an office of profit under the Crown, other than an office expressly exempt from section 44(iv)? (Offices of profit include, for example, many public service jobs.)
YES
NO
If 'yes', provide the following details:
| Details of your office(s) of profit |
|
|
[Particulars of, and documents related to, your office(s) of profit may be provided to the Australian Electoral Commission, for publication, as additional information to support your statement]
10. Do you have a direct or indirect financial interest in any contract or other agreement with the Commonwealth public service, other than as a member and in common with the other members of an incorporated company consisting of more than twenty-five persons?
YES
NO
If 'yes', provide the following details:
| Details of your direct or indirect financial interest(s) |
|
|
[Particulars of, and documents related to, your direct or indirect financial interest(s) may be provided to the Australian Electoral Commission, for publication, as additional information to support your statement]
11. Are you disqualified for any other reason under the Australian Constitution or the Commonwealth Electoral Act 1918 ?
YES
NO
The questions above relate to the most common causes of disqualification under the Australian Constitution, and include those most recently considered by the High Court of Australia. This is not comprehensive, and you should, as always, take your own steps to assure yourself that you are not affected by any other legal disqualification.
I confirm the information in the checklist provided above, and any additional information provided in support of my statements, to be true and correct, to the best of my knowledge.
[ Signature of candidate ] [ Date ]
I agree to the Australian Electoral Commission publishing this checklist in its entirety.
[ Signature of candidate ] [ Date ]
Particulars and documents provided as additional information to support your statement are published by the Australian Electoral Commission on its website.
Part 2 -- Qualification checklist for Form CC
QUALIFICATION CHECKLIST RELATING TO SECTION 44 OF THE CONSTITUTION
... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ..
[ Candidate's name ]
You may fill out this checklist to demonstrate your eligibility to be elected to the Parliament if you are one of the persons nominated above. This nomination paper (including this checklist) is made public under section 176 of the Commonwealth Electoral Act 1918 .
Information relating to the requirements under section 44 of the Australian Constitution is provided as part of the nomination form. In responding to the questions below, you are encouraged to familiarise yourself with the requirements of the Australian Constitution. Further, if you have any doubts about your eligibility to nominate, or about any of the questions below, you may wish to seek independent legal advice.
1. Are you an Australian citizen by birth?
YES
NO
If 'no', provide the following details
| Country of Birth | Citizenship at Birth | Date of Birth | Date of Australian naturalisation |
|
|
|
|
|
2. Were any of your parents or grandparents born outside Australia?
YES
NO
If 'yes', provide the following details, if known:
|
| Mother | Father |
|
Country of Birth |
|
|
| Date/Year of Birth |
|
|
|
| Maternal Grandmother | Maternal Grandfather |
| Country of Birth |
|
|
| Date/Year of Birth |
|
|
|
| Paternal Grandmother | Paternal Grandfather |
| Country of Birth |
|
|
|
Date/Year of Birth |
|
|
3. Was your spouse or any former spouse born outside Australia (if applicable)?
YES
NO
N/A
If 'yes', provide the following details:
| Relationship | Country of Birth | Date/Year of Birth | Spouse citizenship status at time of marriage |
|
|
|
|
|
|
|
|
|
|
4. Have you taken any steps to assure yourself that you have not acquired citizenship of another country by descent, marriage or other means?
YES
NO
If 'yes', provide details:
| Steps taken to assure yourself you have not acquired citizenship of another country by descent, marriage or other means |
|
|
[Particulars of, and documents related to, the steps taken to assure yourself may be provided to the Australian Electoral Commission, for publication, as additional information to support your statement]
5. Are you now a subject or citizen of any country other than Australia?
YES
NO
6. Have you ever been a subject or citizen of any country other than Australia?
YES
NO
If 'yes', have you renounced or lost that status in accordance with the laws of that country/ies?
YES
NO
If 'yes', provide the following details:
| Country | Method of renunciation or manner in which foreign citizenship was lost | Date |
|
|
|
|
[Particulars of, and documents related to, the date and manner in which your citizenship was renounced or was otherwise lost may be provided to the Australian Electoral Commission, for publication, as additional information to support your statement]
If you have not renounced or lost that status in accordance with the laws of that country/ies, is there any reason why you are not disqualified by reason of section 44(i)? (For example, despite your having taken reasonable steps to renounce your citizenship of a country, the laws of the country do not allow you to renounce that citizenship.)
YES
NO
If 'yes', provide the following details:
| Basis on which you contend that you are not disqualified by reason of section 44(i) |
|
|
[Particulars of, and documents related to, your contention that you are not disqualified by reason of section 44(i) may be provided to the Australian Electoral Commission, for publication, as additional information to support your statement]
7. Are you under sentence, or subject to be sentenced, for an offence for which you have been convicted that is punishable under an Australian law by one or more years imprisonment?
If 'yes', is there any reason as to why you are not disqualified by reason of section 44(ii)?
YES
NO
If 'yes', provide the following details:
| Basis on which you contend that you are not disqualified by reason of section 44(ii) |
|
|
[Particulars of, and documents related to, your contention that you are not disqualified by reason of section 44(ii) may be provided to the Australian Electoral Commission, for publication, as additional information to support your statement]
8. Are you currently an undischarged bankrupt or insolvent?
YES
NO
9. Do you hold an office of profit under the Crown, other than an office expressly exempt from section 44(iv)? (Offices of profit include, for example, many public service jobs.)
YES
NO
If 'yes', provide the following details:
| Details of your office(s) of profit |
|
|
[Particulars of, and documents related to, your office(s) of profit may be provided to the Australian Electoral Commission, for publication, as additional information to support your statement]
10. Do you have a direct or indirect financial interest in any contract or other agreement with the Commonwealth public service, other than as a member and in common with the other members of an incorporated company consisting of more than twenty-five persons?
YES
NO
If 'yes', provide the following details:
| Details of your direct or indirect financial interest(s) |
|
|
[Particulars of, and documents related to, your direct or indirect financial interest(s) may be provided to the Australian Electoral Commission, for publication, as additional information to support your statement]
11. Are you disqualified for any other reason under the Australian Constitution or the Commonwealth Electoral Act 1918 ?
YES
NO
The questions above relate to the most common causes of disqualification under the Australian Constitution, and include those most recently considered by the High Court of Australia. This is not comprehensive, and you should, as always, take your own steps to assure yourself that you are not affected by any other legal disqualification.
I confirm the information in the checklist provided above, and any additional information provided in support of my statements, to be true and correct, to the best of my knowledge.
[ Signature of candidate ] [ Date ]
I agree to the Australian Electoral Commission publishing this checklist in its entirety.
[ Signature of candidate ] [ Date ]
Particulars and documents provided as additional information to support your statement are published by the Australian Electoral Commission on its website.