Form 1. Proposal to create, change the boundaries
of, or
abolish a district [r. 8]
Local Government Act 1995
Local Government (Constitution) Regulations 1998
Proposal to create, change the boundaries of, or abolish a district 1
To: The Local Government Advisory Board.
1. The affected electors, whose names, details and
signatures are set out in the attached list, propose that an order should be
made under section 2.1 of the Local Government Act 1995 in relation to the
district of [ name of district proposed to be created, affected or abolished
].
2. A summary of the purposes of the proposed order
is as follows:
[ Here set out summary ]
3. The following documents are attached to and
form part of this proposal:
•
a statement setting out clearly the nature of the proposal and
the effects of the proposal on local governments; and
• a plan illustrating any proposed
changes of the boundaries of a district.
4. This proposal is served on behalf of the listed
signatories by —
Name:
Signature:
Contact address:
Phone No.:
Date:
__________________________________
1 Under clause 2(1)(d) of Schedule 2.1 to the
Local Government Act 1995 a proposal that an order be made under section 2.1
of the Act to create, change the boundaries of, or abolish a district can be
made to the Local Government Advisory Board by affected electors
who —
• are at least
250 in number; or
• are at least
10% of the total number of affected electors.
[Form 1 continued]
List of affected electors (form of each page of signatories)
We, the undersigned, propose that an order be made under section 2.1 of the
Local Government Act 1995 for the purposes summarized in item 2 of this
proposal in relation to the district named in item 1.
Full name of affected elector 2 |
Address which entitles, or would entitle, you to vote in the elections of the
local government of the district proposed to be created, affected or abolished
|
Signature of affected elector |
Date |
| | | |
| | | |
_____________________________
2 An “elector” is one of the
following —
• a resident
owner or occupier enrolled to vote at State elections;
• an owner of
rateable property (e.g. an absentee land owner or an owner of business
premises, vacant land or other non-residential property);
• an occupier of
rateable property (e.g. tenant of business premises or other non-residential
property).
An “affected elector” is —
• an elector
whose eligibility as an elector comes from residence, or ownership or
occupation of property, in the area directly affected by the proposal; or
• a person who
would be an elector if the area directly affected by the proposal became, or
became part of, a district.
Form 2. Request for poll on a recommended
amalgamation [r. 9]
Local Government Act 1995
Local Government (Constitution) Regulations 1998
Request for a poll on a recommended amalgamation 1
To: The Minister for Local Government.
1. The electors of the district of [ name of
district whose electors are making the request ], whose names, details and
signatures are set out in the attached list, request that the recommendation
of the Local Government Advisory Board that the districts of [ names of the 2
or more districts to be abolished or amalgamated] be abolished and
amalgamated, be put to a poll of electors of the districts.
2. This request is served on behalf of the listed
signatories by —
Name:
Signature:
Contact address:
Phone No.:
Date:
List of electors (form of each page of signatories)
We the undersigned, electors of the district of [ name of district whose
electors are making the request ], request that the recommended abolition and
amalgamation of the districts of [ names of the 2 or more districts to be
abolished or amalgamated ] be put to a poll of electors of those districts
under the Local Government Act 1995 .
Full name of elector 2 |
Address which entitles you to vote in the elections of the local government of
a district recommended for amalgamation |
Signature of elector |
Date |
| | | |
| | | |
_____________________________
1 Under clause 8 of Schedule 2.1 to the
Local Government Act 1995 , a request asking for a recommendation of the Local
Government Advisory Board that districts be abolished and amalgamated to be
put to a poll of electors of the districts can be made to the Minister for
Local Government by —
• at least 250
of the electors of one of the districts; or
• at least 10%
of the electors of one of the districts.
2 An “elector” is one of the
following —
• a resident
owner or occupier enrolled to vote at State elections;
• an owner of
rateable property (e.g. an absentee land owner or an owner of business
premises, vacant land or other non-residential property);
• an occupier of
rateable property (e.g. tenant of business premises or other non-residential
property).
Form 3. Submission about changes to wards, name or
representation [r. 10]
Local Government Act 1995
Local Government (Constitution) Regulations 1998
Submission about changes to wards, name or representation 1
To: The 2 Mayor/President of [ name of local
government ].
1. The affected electors of the district of [ name
of district ], whose names, details and signatures are set out in the attached
list, submit that an order should be made under the Local Government Act 1995
for the following purpose:
[Here set out the
purpose]
for the following reasons:
[Here set out the reasons]
[Attach any
other relevant documentation, including a map if appropriate]
2. This submission is served on behalf of the
listed signatories by —
Name:
Signature:
Contact address:
Phone No.:
Date:
________________________________
1 Under clause 3 of Schedule 2.2 to the
Local Government Act 1995 , a submission that an order be made under the Act
about wards, the name of a district or ward or the number of councillors for a
district or ward can be made to the local government concerned by affected
electors who —
• are at least
250 in number; or
• are at least
10% of the total number of affected electors.
2 Delete the one that does not apply.
[Form 3 continued]
List of affected electors (form of each page of signatories)
We the undersigned, submit that an order should be made under the Local
Government Act 1995 for the purpose set out in item 1 of this submission in
relation to the [ name of local government ].
Full name of affected elector 3 |
Address which entitles you to vote in the elections of the local government to
which this submission relates |
Signature of affected elector |
Date |
| | | |
| | | |
__________________________
3 An “elector” is one of the
following —
• a resident
owner or occupier enrolled to vote at State elections;
• an owner of
rateable property (e.g. an absentee land owner or an owner of business
premises, vacant land or other non-residential property);
• an occupier of
rateable property (e.g. tenant of business premises or other non-residential
property).
An “affected elector” is an elector
whose eligibility as an elector comes from residence, or ownership or
occupation of property, in the area directly affected by the submission.
Form 4. Proposal to change the method of filling
the
office of mayor or president [r. 10AD]
Local Government Act 1995
Local Government (Constitution) Regulations 1998
Proposal to change the method of filling the office of mayor or president 1
To: The 2 Mayor/President of [ name of local
government ].
1. The method of filling the office of 2
mayor/president currently used by the [ name of local government ] is 2
election by electors of the district/election by the council from amongst the
councillors.
2. The electors of [ name of district ], whose
names, details and signatures are set out in the attached list, propose that
the method of electing the mayor/president of the [ name of local government ]
be changed to 2 election by the council from amongst the councillors/election
by electors of the district.
3. A summary of the reasons for the proposed
change is as follows:
[ Here set out summary ]
4. This proposal is served on behalf of the listed
signatories by —
Name:
Signature:
Contact address:
Phone No.:
Date:
[Form 4 continued]
List of electors (form of each page of signatories)
We the undersigned, propose that the method of filling the office of 2
mayor/president of the [ name of local government ] be changed to 2 election
by the council from amongst the councillors/election by electors of the
district.
Full name of elector 3 |
Address which entitles you to vote in the elections of the local government to
which this proposal relates |
Signature of elector |
Date |
| | | |
| | | |
_____________________________
1 Under section 2.11(1) of the
Local Government Act 1995 , the method of filling the office of mayor or
president of a local government is either —
• election by
the electors of the district; or
• election by
the council from amongst the councillors.
Under section 2.12 of the Act, a proposal to
change from one method to the other method can be made to the local government
by electors of the district who —
• are at least
250 in number; or
• are at least
10% of the total number of electors of the district.
2 Delete the one that does not apply.
3 An elector is one of the following —
• a resident
owner or occupier enrolled to vote at State elections;
• an owner of
rateable property (e.g. an absentee land owner or an owner of business
premises, vacant land or other non-residential property);
• an occupier of
rateable property (e.g. tenant of business premises or other non-residential
property).
[Form 4 amended: SL 2023/102
r. 21.]
[Forms 5 and 6 deleted: Gazette 20 Jan 2006 p. 381.]
Form 7. Declaration by elected member of council
[r. 13(1)(c)]
Local Government Act 1995
Local Government (Constitution) Regulations
1998
Declaration by elected member
I,
.........................................................................................................................................
of 1
.....................................................................................................................................,
having been elected to the office of 2 mayor/deputy mayor/president/deputy
president/councillor of the 3
...............................................................................................,
declare that I take the office upon myself and will duly, faithfully,
honestly, and with integrity, fulfil the duties of the office for the people
in the district according to the best of my judgment and ability, and will
observe the code of conduct adopted by the 3 ................................
under section 5.104 of the Local Government Act 1995 .
Declared at ............................................ on
....................................................................
by
.............................................................
Before me:
.............................................................
‑‑_____________________________
1 Insert your residential address.
2 Delete those that do not apply.
3 Insert the name of the local government.
[Form 7 inserted: Gazette 21 Aug 2007
p. 4187; amended: SL 2021/15 r. 7.]
Form 8. Declaration by commissioner
[r. 13(1)(d)]
Local Government Act 1995
Local Government (Constitution) Regulations
1998
Declaration by commissioner
I,
.......................................................................................................................................
of 1
....................................................................................................................................,
having been appointed to the office of commissioner
of the 2
..............................................................................................................................,
declare that I take the office upon myself and will duly, faithfully,
honestly, and with integrity, fulfil the duties of the office according to the
best of my judgment and ability.
Declared at ............................................ on
.................................................................
by
..................................................................
Before me:
...................................................................
___________________________
1 Insert your residential address.
2
Insert the name of the local government.
[Form 8 inserted: Gazette 21 Aug 2007
p. 4188.]