Application Form Register of Corporate Donors Electoral Act 1997, as amended

Transcription

1 Updated Cpate Don application fm Application Fm Register of Cpate Dons Electal Act 1997, as amended Contact Details: Standards in Public Office Commission 18 Lower Leeson Street Dublin 2 Telephone: (01) sipo@sipo.ie Website: October 2018 Más mian leat comhfhreagras agus foirmeacha as Gaeilge a fháil le do thoil déan teagmháil linn.

2 Updated Cpate Don application fm Application Fm Register of Cpate Dons Electal Act 1997, as amended Pri to completing the application, please read the attached Explanaty Note. Part 1: Name of Cpate Don: Address: Phone number: Part 2: Name of the responsible person f ganisation, management, financial affairs of Cpate Don: Address: Mobile:

3 Updated Cpate Don application fm Part 3: Statement of the purposes f which Cpate Don was fmed The statement can be attached to the application. Part 4: List of each member, shareholder, trustee of the Cpate Don as of 31 December preceding application. This list be attached to the application. Part 5: In the case of a Cpate Don which was fmed on befe 1 January of the year preceding the application, the applicant must furnish the following: i. Copy of its statement of accounts f that year and ii. If applicable, a copy of the annual rept f that year These can be attached to the application.

4 Updated Cpate Don application fm Part A of Statuty Declaration (To be completed in full by the Cpate Don) I (Cpate Don)..., do solemnly and sincerely declare that the attached Application f Register of Cpate Dons and accompanying infmation is, to the best of my knowledge and belief, crect in every material respect and that I took all reasonable action in der to be satisfied as to its accuracy and I make this solemn declaration conscientiously believing the same to be true and by virtue of the Statuty Declarations Act Signature of Cpate Don... Part B of Statuty Declaration (to be completed in full by the witness). When completing this part the witness needs to state whether the person making the statuty declaration is known to him/her has been identified to him/her by another person by one of the documents referred to below Declared befe me (name of witness in capital letters here)..., a notary public/ commissioner f oaths/ peace commissioner/ practising solicit (delete as appropriate) by... (Insert name of the responsible person) who is personally known to me, who is identified to me by... who is personally known to me, whose identity has been established to me befe the taking of this Declaration by the production to me of Passpt no.... issued on [date of issue]... by the authities of [issuing state]...which is an authity recognised by the Irish Government National identity card no.... issued on [date of issue]...by the authities of [issuing state]...( which is an EU Member State, the Swiss Confederation a Contracting Party to the EEA Agreement )

5 Updated Cpate Don application fm Aliens Passpt no.... issued on [date of issue]... by the authities of [issuing state]... which is an authity recognised by the Irish Government refugee travel document no....issued on [date of issue]... by the Minister f Justice and Equality travel document (other than refugee travel document) no.... issued on [date of issue]... by the Minister f Justice and Equality Signature of witness... Categy of witness*... Place of Signature... Date... *In der to qualify, the witness must be a Commissioner f Oaths, Notary Public, Peace Commissioner, practicing Solicit.