Form Mod(PC).2005, Private Company Instructions

Please provide the title of the alternative contact person (e.g., Mr, Ms, Dr).

Please provide the full name of the alternative contact person. Fill only if 'Person named below' is 'Yes'.

Please provide the business name of the alternative contact person, if applicable. Fill only if 'Person named below' is 'Yes'.

Please enter the alternative contact person's position or role in relation to the company. Fill only if 'Person named below' is 'Yes'.

Please provide the first line of the alternative contact person's postal address. Fill only if 'Person named below' is 'Yes'.

Please provide the second line of the alternative contact person's postal address. Fill only if 'Person named below' is 'Yes'.

Please provide the third line of the alternative contact person's postal address. Fill only if 'Person named below' is 'Yes'.

Please enter the postcode for the alternative contact person's postal address. Fill only if 'Person named below' is 'Yes'.

Please provide the daytime phone number for the alternative contact person. Fill only if 'Person named below' is 'Yes'.

Please enter the area code for the alternative contact person's fax number. Fill only if 'Person named below' is 'Yes'.

Please provide the main part of the alternative contact person's fax number. Fill only if 'Person named below' is 'Yes'.

Check this box if someone has gifted, transferred, or sold assets to this company for less than their market value since 9 May 2000 and you need to provide details.

Please provide the monetary value of the contribution. Fill only if 'Yes, Give details of each contribution' is 'Yes'.

Check this box if you (and/or your partner) have NOT gifted, transferred, or sold assets to this company for less than their market value, or provided services without adequate payment, since 9 May 2000.

Check this box if you (and/or your partner) HAVE gifted, transferred, or sold assets to this company for less than their market value, or provided services without adequate payment, since 9 May 2000.

Enter the full name of the authorized officer.

Enter the name of the authorised officer, which will serve as their signature.

Enter the date the form is being completed.

Enter the name of the person the valuer should contact.

Enter the daytime phone number for the contact person. Fill only if 'Person to be Contacted' is filled with the name of a contact person.

Check this box if there are no circumstances affecting the value of the property. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if there are circumstances affecting the value of the property. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Provide a brief reference or identifier for the circumstances affecting property value. Fill only if 'Yes' is 'Yes'.

Provide a detailed explanation of the circumstances affecting the value of the property, including specific examples such as lack of water, fencing, terrain, natural features, or unusual title. Fill only if 'Yes' is 'Yes'.

Check this box if the company has NOT had a change in circumstances since the last financial statements were prepared, and you can proceed to the next question.

Check this box if the company HAS had a change in circumstances since the last financial statements were prepared, and you need to provide details below.

Please provide a brief description of the change in circumstances. Fill only if 'Yes' is 'Yes'.

Please enter the date when the change in circumstances occurred. Fill only if 'Yes' is 'Yes'.

Please provide a detailed explanation of the change in circumstances since the last financial statement. Fill only if 'Yes' is 'Yes'.

Enter the first segment of the Company's Australian Business Number.

Enter the second segment of the Company's Australian Business Number.

Enter the third segment of the Company's Australian Business Number.

Enter the fourth segment of the Company's Australian Business Number.

Please enter the first three digits of the Company Australian Company Number.

Please enter the middle three digits of the Company Australian Company Number.

Please enter the last three digits of the Company Australian Company Number.

Provide the date the company ceased trading. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if the company does not owe money to anyone, including associates, and you will go to question 38. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the full name of the person or associate to whom the company owes money. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the company owes money to anyone, including associates, and you will provide details below. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Provide the date when the company was legally incorporated.

Please enter the full legal name of the company that owns the real estate.

Please enter the first segment of the company's Australian Business Number (ABN).

Please enter the second segment of the company's Australian Business Number (ABN).

Please enter the third segment of the company's Australian Business Number (ABN).

Please enter the fourth segment of the company's Australian Business Number (ABN).

Check this box if the company does not have 100% ownership of the property. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if the company has 100% ownership of the property. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Provide a detailed explanation if the company does not have 100% ownership of the property. Fill only if 'No' is 'Yes'.

Check this box if your role in the private company is not solely as a director, or if you have shares in, or loans to the company.

Enter how many shares you hold in the private company, or if you have loans to the company, enter the total loan amount. Fill only if the 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if your only role in the private company is as a director and you have no shares in, or loans to the company.

Provide details regarding why the company is no longer trading, or specify the date it ceased trading.

Please enter the first segment of the company's Tax File Number.

Please enter the second segment of the company's Tax File Number.

Please enter the third segment of the company's Tax File Number.

Check this box if the company is not still trading (No); this directs you to go to the next question.

Check this box if the company is currently trading.

Please provide the full name of the contact person.

Please provide the business name of the contact person, if applicable.

Please provide the contact person's position or role within the company.

Please provide the first line of the contact person's postal address.

Please provide the second line of the contact person's postal address, if applicable.

Please provide the third line of the contact person's postal address or the suburb/city.

Please provide the postal code for the contact person's address.

Please provide the contact person's daytime phone number.

Please provide the area code or prefix of the contact person's fax number.

Please provide the main part of the contact person's fax number.

Enter the full name of the person or entity that made the contribution. Fill only if 'Yes, Give details of each contribution' is 'Yes'.

Enter the date of birth of the contributor. Fill only if 'Yes, Give details of each contribution' is 'Yes'.

Check this box if the contributor is still living. Fill only if 'Yes, Give details of each contribution' is 'Yes'.

Check this box if the contributor is deceased. Fill only if 'Yes, Give details of each contribution' is 'Yes'.

Check this box if the nature of the contribution was a gift. Fill only if 'Yes, Give details of each contribution' is 'Yes'.

Check this box if the nature of the contribution was a transfer. Fill only if 'Yes, Give details of each contribution' is 'Yes'.

Check this box if the contribution was sold for less than its market value. Fill only if 'Yes, Give details of each contribution' is 'Yes'.

Provide a description of the item, service, or asset that was contributed. Fill only if 'Yes, Give details of each contribution' is 'Yes'.

Enter the date when the contribution was made. Fill only if 'Yes, Give details of each contribution' is 'Yes'.

Enter the monetary value of the contribution. Fill only if 'Yes, Give details of each contribution' is 'Yes'.

Enter the original monetary amount paid for the contribution, if applicable. Fill only if 'Yes, Give details of each contribution' is 'Yes'.

Check this box if the company is not a corporate trustee, or if it is a corporate trustee that also trades in its own right.

Check this box if the company acts solely as a corporate trustee and does not engage in trading activities in its own right.

Check this box if the property is not currently being used for any purpose. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the property is currently used for primary production activities (e.g., farming, agriculture, forestry, or fishing). Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the property is used solely for rural residential purposes. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the property is currently leased to another party. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the property is used for other commercial or business purposes, such as commercial kennels. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the property is used as a hobby farm. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the property is used for a purpose not listed above, and provide details in the space provided. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Specify the 'Other' type of current property use. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Provide a detailed explanation of the property's current use. Fill only if 'Other' is 'Yes'.

Please enter the full name of Director 1. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the date of birth for Director 1. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the first segment of Director 1's Centrelink Reference Number (if known). Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the second segment of Director 1's Centrelink Reference Number (if known). Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the third segment of Director 1's Centrelink Reference Number (if known). Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the fourth segment of Director 1's Centrelink Reference Number (if known). Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the first line of Director 1's permanent address. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the second line of Director 1's permanent address. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the third line of Director 1's permanent address, typically the suburb or city. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the postcode for Director 1's permanent address. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the full name of Director 2. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please provide the date of birth for Director 2. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Enter the first part of the Centrelink Reference Number (CRN) if known. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Enter the second part of the Centrelink Reference Number (CRN) if known. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Enter the third part of the Centrelink Reference Number (CRN) if known. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Enter the fourth part of the Centrelink Reference Number (CRN) if known. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Enter the first line of Director 2's permanent address. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Enter the second line of Director 2's permanent address. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Enter the third line of Director 2's permanent address. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Enter the postcode for Director 2's permanent address. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the full name of Director 3. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the date of birth for Director 3. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the first segment of Director 3's Centrelink Reference Number (if known). Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the second segment of Director 3's Centrelink Reference Number (if known). Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the third segment of Director 3's Centrelink Reference Number (if known). Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the fourth segment of Director 3's Centrelink Reference Number (if known). Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the first line of Director 3's permanent address. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the second line of Director 3's permanent address. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the third line of Director 3's permanent address. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the postcode for Director 3's permanent address. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Enter the number of holders or directors who live on the property.

Check this box if no director or shareholder received any benefit from the company in the last financial year. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if any director or shareholder received any benefit from the company in the last financial year and you need to provide details. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the full name of the director, shareholder, person, or associate who received income. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if you are unable to lodge any of the required documentation and need to provide an explanation.

Provide a detailed explanation if you are unable to lodge any of the required documentation. Fill only if 'Unable to lodge documentation' is checked.

Check this box if you answered Yes at question 15 and/or 33.

Check this box if you answered Yes at question 28.

Check this box if you answered Yes at question 30.

Check this box if you answered Yes at question 31.

Check this box if you answered Yes at question 32.

Check this box if you answered Yes at question 37.

Check this box if you answered Yes at question 42.

Check this box if this document is applicable based on question 47.

Check this box if this document is applicable based on question 48.

Check this box if this document is required based on question 54.

Check this box if you answered Yes at question 68 or 69.

Check this box if you are providing details of your wages from this company because you answered No at question 9. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'No'.

Check this box if you are providing your personal income tax return.

Check this box if you are providing your partner's personal income tax return if they are involved with the company.

Check this box if you are providing the latest income tax return for the company.

Check this box if you are providing the profit and loss statement for the company.

Check this box if you are providing the depreciation schedule for the company, showing depreciation as claimable under Division 40 of the Income Tax Assessment Act 1997.

Check this box if you are providing the balance sheet for the company.

Check this box if you are providing notes to and forming part of the accounts, if applicable.

Check this box if you are providing trading account details for the company, if applicable.

Check this box if you are providing Profit and Loss Statement(s) for all income sources and/or the balance sheet for the company for the current financial year if the most recent completed year is not an accurate reflection of the current circumstances of the company.

Check this box if you are providing additional Profit and Loss Statement(s) because the company derives income from more than one source, if applicable.

Please provide the name of the fund manager for the fifth managed investment. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide the name of the product and any applicable product option for the fifth managed investment. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide the number of units held for the fifth managed investment, if applicable. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide the APIR code for the fifth managed investment, if known. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide the total value of the fifth managed investment. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide the name of the fifth private company. Fill only if 'Yes' is 'Yes'.

Please provide the Australian Business Number (ABN) or Australian Company Number (ACN) for the fifth private company. Fill only if 'Yes' is 'Yes'.

Please enter the name of the fifth public company or its ASX code. Fill only if 'Yes' is 'Yes'.

Please enter the number of shares held in the fifth public company. Fill only if 'Yes' is 'Yes'.

Please provide the type or name of the fifth share class, such as Ordinary, Class A, or Class B. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please provide the total number of shares for the fifth share class. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if the shares in the fifth class are provided with voting rights. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if the shares in the fifth class are entitled to receive dividends. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if the shares in the fifth class are entitled to receive capital distributions upon the company's winding up. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Enter the approximate floor area of the building in square metres. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Enter the approximate age of the building. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Provide details about the exterior construction material of the building, such as brick or timber. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Provide details about the interior construction material of the building, such as plaster or whether it's lined. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Provide details about the roof material, such as metal or tiles. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Describe the general condition of the building, for example, good, fair, or poor. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Enter the total number of flats or units within the complex, if applicable. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Enter the number of bedrooms if the building is residential. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Enter the number of other rooms in the building, excluding laundry, bathrooms, and toilets. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please provide the trading name of the first business. Fill only if 'Yes' is 'Yes'.

Please enter the percentage of income from the first business that is from your personal exertion. Fill only if 'Yes' is 'Yes'.

Please enter the percentage of income from the first business that is from your partner's personal exertion. Fill only if 'Yes' is 'Yes'.

Enter the full name of the director or shareholder who received the benefit. Fill only if 'Yes' is 'Yes'.

Enter the date of birth of the director or shareholder. Fill only if 'Yes' is 'Yes'.

Enter the type of noncash benefit received by the director or shareholder, for example, company assets or personal living expenses paid. Fill only if 'Yes' is 'Yes'.

Enter the monetary value of the benefit received. Fill only if 'Yes' is 'Yes'.

Enter the financial year in which the benefit was paid. Fill only if 'Yes' is 'Yes'.

Enter the specific type of liability being detailed. Fill only if 'Yes' is 'Yes'.

Enter the total monetary amount of this specific liability. Fill only if 'Yes' is 'Yes'.

Enter a description of the asset that secures this liability. Fill only if 'Yes' is 'Yes'.

Enter the current market value of the asset that secures the liability. Fill only if 'Yes' is 'Yes'.

Check this box if the described liability is a collateral security, which serves as fall-back security in the event that the primary security is insufficient. Fill only if 'Yes' is 'Yes'.

Check this box if the described liability is a primary production asset. Fill only if 'Yes' is 'Yes'.

Enter the name of the fund manager for this investment. Fill only if 'Yes' is 'Yes'.

Enter the name of the investment product and any associated product option. Fill only if 'Yes' is 'Yes'.

Enter the number of units held for this investment, if applicable. Fill only if 'Yes' is 'Yes'.

Enter the APIR code for the investment, if known. Fill only if 'Yes' is 'Yes'.

Enter the current monetary value of the investment. Fill only if 'Yes' is 'Yes'.

Please provide a description of the first other asset not listed above. Fill only if 'Yes' is 'Yes'.

Please provide your estimate of the current market value for the first other asset. Fill only if 'Yes' is 'Yes'.

Check this box if the first 'Other (describe)' asset is a primary production asset. Fill only if 'Yes' is 'Yes'.

Provide the name of the first other person or entity who owns the property. Fill only if 'No' is 'Yes'.

Enter the percentage of the property owned by the first other person or entity. Fill only if 'No' is 'Yes'.

Enter the full name of the person or associate to whom the company owes money. Fill only if 'Yes' is 'Yes'.

Provide the date of birth for the named person or associate. Fill only if 'Yes' is 'Yes'.

Enter the total monetary amount that the company owes to the person or associate. Fill only if 'Yes' is 'Yes'.

Provide the interest rate that is paid on the loan, if applicable. Fill only if 'Yes' is 'Yes'.

Please enter the number of private companies the company has involvement in. Fill only if 'Yes' is 'Yes'.

Please enter the full legal name of the first private company. Fill only if 'Yes' is 'Yes'.

Please enter the Australian Business Number (ABN) or Australian Company Number (ACN) for the first private company. Fill only if 'Yes' is 'Yes'.

Provide the full legal name of the first private trust. Fill only if 'Yes' is 'Yes'.

Enter the first segment of the first private trust's Tax File Number. Fill only if 'Yes' is 'Yes'.

Enter the second segment of the first private trust's Tax File Number. Fill only if 'Yes' is 'Yes'.

Enter the third segment of the first private trust's Tax File Number. Fill only if 'Yes' is 'Yes'.

Enter the first segment of the first private trust's Australian Business Number. Fill only if 'Yes' is 'Yes'.

Enter the second segment of the first private trust's Australian Business Number. Fill only if 'Yes' is 'Yes'.

Enter the third segment of the first private trust's Australian Business Number. Fill only if 'Yes' is 'Yes'.

Enter the fourth segment of the first private trust's Australian Business Number. Fill only if 'Yes' is 'Yes'.

Please provide the name of the public company or its ASX code. Fill only if 'Yes' is 'Yes'.

Please enter the total number of shares held in the public company. Fill only if 'Yes' is 'Yes'.

Please provide the type of share class, for example, Ordinary, Class A, or Class B. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the total number of shares issued for this share class. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if the shares in this class are provided with voting rights. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if the shares in this class are entitled to receive dividends. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if the shares in this class are entitled to capital distributions upon the company's winding up. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Enter the full name of the first shareholder, director, person or associate. Fill only if 'Yes' is 'Yes'.

Provide the date of birth for the first shareholder, director, person or associate. Fill only if 'Yes' is 'Yes'.

Enter the total amount of wages the person was entitled to receive. Fill only if 'Yes' is 'Yes'.

Enter the total amount of wages actually paid to the person. Fill only if 'Yes' is 'Yes'.

Enter the total amount of superannuation the person was entitled to receive. Fill only if 'Yes' is 'Yes'.

Enter the total amount of superannuation actually paid on behalf of the person. Fill only if 'Yes' is 'Yes'.

Specify the type of other income received, such as director's fees or bonus shares. Fill only if 'Yes' is 'Yes'.

Enter the total amount of other income paid to the person. Fill only if 'Yes' is 'Yes'.

Indicate the financial year in which the other income was paid. Fill only if 'Yes' is 'Yes'.

Provide the full name of the first shareholder. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the date of birth of the first shareholder. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Provide the Corporate Reference Number (CRN) of the first shareholder, if known. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the first shareholder is also a director. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the first shareholder is related to other shareholders. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the first shareholder is related to other office-holders. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the class of the share for the first shareholder. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the total number of shares held by the first shareholder. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the purchase price per share for the first shareholder. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the date when the shares were purchased by the first shareholder. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the class of share for this shareholding. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the total number of shares for this shareholding. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the purchase price of these shares. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the date when these shares were purchased. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the first trading name under which the company conducts business. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Specify the first type of business the company conducts, using examples such as primary production, retail, commercial, or investment. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please provide the name of the fund manager for this managed investment. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide the name of the product and any associated product option. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide the number of units held in this managed investment, if applicable. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide the APIR code for this investment, if known. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide the monetary value of this investment. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please enter the name of the fourth private company. Fill only if 'Yes' is 'Yes'.

Please provide the Australian Business Number (ABN) or Australian Company Number (ACN) for the fourth private company. Fill only if 'Yes' is 'Yes'.

Enter the full name of the fourth private trust. Fill only if 'Yes' is 'Yes'.

Enter the first section of the fourth private trust's Tax File Number. Fill only if 'Yes' is 'Yes'.

Enter the second section of the fourth private trust's Tax File Number. Fill only if 'Yes' is 'Yes'.

Enter the third section of the fourth private trust's Tax File Number. Fill only if 'Yes' is 'Yes'.

Enter the first section of the fourth private trust's Australian Business Number. Fill only if 'Yes' is 'Yes'.

Enter the second section of the fourth private trust's Australian Business Number. Fill only if 'Yes' is 'Yes'.

Enter the third section of the fourth private trust's Australian Business Number. Fill only if 'Yes' is 'Yes'.

Enter the fourth section of the fourth private trust's Australian Business Number. Fill only if 'Yes' is 'Yes'.

Please provide the name of the fourth public company or its ASX code. Fill only if 'Yes' is 'Yes'.

Please provide the number of shares held in the fourth public company. Fill only if 'Yes' is 'Yes'.

Please enter the type of this share class, for example, Ordinary, Class A, or Class B. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please provide the total number of shares for this class. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if the shares in this class provide voting rights. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if the shares in this class are entitled to receive dividends. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if the shares in this class are entitled to capital distributions upon company wind up. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if the contact person for future requests is the same individual named in question 12.

Check this box if you are providing new contact person details in the fields immediately following this option.

Check this box if the first shareholder will NOT receive this income in the current financial year. Fill only if 'Yes' is 'Yes'.

Check this box if the first shareholder WILL receive this income in the current financial year. Fill only if 'Yes' is 'Yes'.

Check this box if the second shareholder will not receive this income in the current financial year. Fill only if 'Yes' is 'Yes'.

Check this box if the second shareholder will receive this income in the current financial year. Fill only if 'Yes' is 'Yes'.

Provide the first trading name under which the company conducts business. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please provide the date when the income change occurred. Fill only if 'Yes' is 'Yes'.

Please provide detailed information regarding the current income. Fill only if 'Yes' is 'Yes'.

Check this box if the income received by the shareholder, director, person or associate has not changed since the last financial year. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the income received by the shareholder, director, person or associate has changed since the last financial year. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please enter a confirmation or brief note indicating that further details regarding the income change are provided below. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the legal description of the property, such as lot, section, or parish. If the property has more than one title, provide details for each separate title.

Check this box if the company does not hold any managed investments. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the company holds managed investments and you intend to provide further details below. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the details of the managed investment, such as its name, type, or APIR code. Fill only if 'Yes' is 'Yes'.

Check this box if the property is not mortgaged or encumbered. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if the property is mortgaged or encumbered. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Provide details if the property is mortgaged or encumbered. Fill only if 'Yes' is 'Yes'.

Enter the date the loan was issued. Fill only if 'Yes' is 'Yes'.

Enter the interest rate for the loan. Fill only if 'Yes' is 'Yes'.

Enter the total amount of the loan. Fill only if 'Yes' is 'Yes'.

Enter the current outstanding balance of the loan. Fill only if 'Yes' is 'Yes'.

Enter the name of the financial institution or provider of the loan. Fill only if 'Yes' is 'Yes'.

Enter 'No' to indicate that neither you nor your partner has ever held shares in the company.

Check this box if the company does not own any other assets, and proceed to question 36. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please enter the name of the entity or company being referred to in the question regarding asset ownership. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the company owns other assets, and proceed to the next question (question 35). Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the company does not have any other liabilities. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the company has other liabilities and you need to provide details for each. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Provide details for each other liability the company has, such as bank loans, mortgages, or fully drawn advances. Fill only if 'Yes' is 'Yes'.

Check this box if no other assets or properties have been used to secure the loan to purchase this property. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if other assets or properties have been used to secure the loan to purchase this property and you need to provide details. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Provide a brief reference or note indicating details are provided for other assets or properties used to secure the loan. Fill only if 'Yes, other assets used' is 'Yes'.

Provide a description of the asset or the address of the property used to secure the loan. Fill only if 'Yes, other assets used' is 'Yes'.

Enter the estimated market value of the asset or property used as security. Fill only if 'Yes, other assets used' is 'Yes'.

Check this box if the company does not own any real estate. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if the company owns real estate. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please provide the total number of properties the company holds. Fill only if 'Yes' is 'Yes'.

Please enter the date when you signed the declaration.

Please enter the date when your partner signed the declaration. Fill only if 'Do you have a partner?' is 'Yes'.

Check this box if you do not have a partner.

Check this box if you have a partner.

Check this box if the person living on the property (or their partner) is not currently over Age Pension age and receiving or claiming any of the listed pension types. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide any relevant details or status for the Department of Veterans' Affairs Age Service Pension. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the person living on the property (or their partner) is currently over Age Pension age and receiving or claiming any of the listed pension types. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if your role (and/or your partner's) in the business does not involve personal exertion. Fill only if 'Are you (and/or your partner) age pension age or claiming Age Pension?' is 'Yes'.

Check this box if your role (and/or your partner's) in the business involves personal exertion. Fill only if 'Are you (and/or your partner) age pension age or claiming Age Pension?' is 'Yes'.

Check this box if there is no potential commercial use of the property. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if there is potential commercial use of the property. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please specify the type of potential commercial use for the property. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide further details regarding the potential commercial use of the property, such as subdividing, agistment, or hobby farming. Fill only if 'Yes' is 'Yes'.

Check this box if the company does not hold any shares or have any other involvement in other private companies. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the company holds shares or has other involvement in other private companies. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the full legal name of the private company.

Check this box if the company is not a beneficiary of or otherwise involved in a private trust. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the company is a beneficiary of or otherwise involved in a private trust. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the details of each private trust the company is a beneficiary of or otherwise involved in. Fill only if 'Yes' is 'Yes'.

Enter the street number, street name, and any other relevant address details for the property.

Provide the suburb, city, or state of the property.

Enter the postal code for the property's address.

Specify the country where the property is located, if it is not Australia.

Please enter the area of the property in hectares. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the area of the property in acres. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the area of the property in square metres. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the first dimension of the property. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the second dimension of the property. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Enter the date when the property became an asset of the company.

Check this box if the property is not used to produce income. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the property is used to produce income. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please enter the number of the next question to proceed to if the property is not used to produce an income. Fill only if 'No' is 'No'.

Provide full directions to the property or a detailed description for a map if it is hard to locate. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Provide the estimated current market value of the property, including land, buildings, and water assets.

Check this box if the property has NOT been the home property for 20 years or more continuously. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the property HAS been the home property for 20 years or more continuously. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the property is not larger than 2 hectares (5 acres).

Check this box if the property is larger than 2 hectares (5 acres).

Check this box if the property is undeveloped land.

Check this box if the property is a bush block.

Check this box if the property is primarily used as a home office or for business activities.

Check this box if the property is a standalone house.

Check this box if the property is a self-contained flat that is either part of or attached to a main residence.

Check this box if the property is a unit, flat, or townhouse.

Check this box if the property is used as retail premises.

Check this box if the property is used as commercial premises.

Check this box if the property is used as industrial premises.

Check this box if the property is a farm or a hobby farm.

Check this box if the property is a market garden.

Check this box if the property is a residential block that is larger than 2 hectares (5 acres).

Check this box if the property type is not listed above and provide details in the accompanying text field.

Enter the specific type of property if 'Other' was selected from the list. Fill only if 'Other' is 'Yes'.

Provide additional details for the specified 'Other' property type. Fill only if 'Other' is 'Yes'.

The user should check this box if the person, their partner, or a family member does not use the property to support themselves. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

The user should check this box if the person, their partner, or a family member uses the property to support themselves. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter a brief description of how the property is used to support the person, their partner, or a family member. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Provide a detailed explanation of how the property is used to support the person, their partner, or a family member. Fill only if 'Yes' is 'Yes'.

Check this box if the company does not hold any shares or securities in public companies. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the company holds any shares or securities in public companies. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Provide the name of the public company or its ASX code for the shares or securities held. Fill only if 'Yes' is 'Yes'.

Provide a detailed explanation for why the company ceased its trading operations. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if there is no reason preventing the company from using the property to produce an income. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide additional details regarding any reason that prevents the company from using the property to produce an income. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if there is a reason preventing the company from using the property to produce an income. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the property is not producing income because it is a rural residential block. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the property is not producing income because the land is not suitable for commercial or agricultural use. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the property is not producing income due to caring responsibilities. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the property is not producing income due to health reasons. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the property is not producing income because of zoning restrictions. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the property is not producing income due to environmental restrictions. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the property is not producing income for a reason not listed above and provide details. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide a brief identifier or keyword for the 'Other' reason why the property is not being used to produce an income. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide a detailed explanation for the 'Other' reason why the property is not being used to produce an income. Fill only if 'Other' is 'Yes'.

Check this box if the company does not receive any rental income from the lease of the property and wishes to proceed to the next question. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if the company receives rental income from the lease of the property and needs to provide the details below. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please confirm that details regarding the company's rental income are provided. Fill only if 'Yes' is 'Yes'.

Please enter the gross amount of rent received from the property before tax and other deductions. Fill only if 'Yes' is 'Yes'.

Please provide the full legal description and area details for the title on which the residence is situated. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Provide your estimated current market value for plant and equipment. Fill only if 'Yes' is 'Yes'.

Check this box if the 'Plant and equipment' asset is a primary production asset. Fill only if 'Yes' is 'Yes'.

Provide your estimate of the current market value for machinery. Fill only if 'Yes' is 'Yes'.

Check this box if the machinery asset is a primary production asset. Fill only if 'Yes' is 'Yes'.

Provide your estimated current market value for vehicles. Fill only if 'Yes' is 'Yes'.

Check this box if 'Vehicles' should be classified as a primary production asset. Fill only if 'Yes' is 'Yes'.

Please provide your estimate of the current market value for livestock assets. Fill only if 'Yes' is 'Yes'.

Check this box if the company's Livestock is classified as a primary production asset. Fill only if 'Yes' is 'Yes'.

Enter your estimate of the current market value for stock. Fill only if 'Yes' is 'Yes'.

Check this box if 'Stock' is a primary production asset. Fill only if 'Yes' is 'Yes'.

Please provide your estimate of the current market value for licences. Fill only if 'Yes' is 'Yes'.

Check this box if 'Licences' should be considered a primary production asset. Fill only if 'Yes' is 'Yes'.

Provide the estimated current market value of the bank accounts. Fill only if 'Yes' is 'Yes'.

Check this box if bank accounts are a primary production asset. Fill only if 'Yes' is 'Yes'.

Enter the approximate floor area of the building in square metres. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Provide the age of the building in years. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Specify the material used for the exterior construction of the building, for example, brick or timber. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Specify the material used for the interior construction of the building, for example, plaster or whether it is not lined. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Specify the material used for the roof construction of the building, for example, metal or tiles. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Describe the general condition of the building, for example, good, fair, or poor. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Enter the total number of flats or units in the complex, if applicable. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Enter the number of bedrooms in the residential building. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Enter the number of other rooms in the building, excluding laundry, bathroom, and toilet. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Provide the trading name of the second business from which income is derived. Fill only if 'Yes' is 'Yes'.

Enter your percentage of income from personal exertion for the second business. Fill only if 'Yes' is 'Yes'.

Enter your partner's percentage of income from personal exertion for the second business. Fill only if 'Yes' is 'Yes'.

Please enter the full name of the second director or shareholder who received a benefit. Fill only if 'Yes' is 'Yes'.

Please enter the date of birth for the second director or shareholder. Fill only if 'Yes' is 'Yes'.

Please describe the type of benefit received by the second director or shareholder. Fill only if 'Yes' is 'Yes'.

Please enter the monetary value of the benefit received by the second director or shareholder. Fill only if 'Yes' is 'Yes'.

Please enter the financial year in which the benefit was paid to the second director or shareholder. Fill only if 'Yes' is 'Yes'.

Please enter the nature or kind of the liability for this second entry. Fill only if 'Yes' is 'Yes'.

Please provide the total monetary value of this second liability. Fill only if 'Yes' is 'Yes'.

Please specify the asset that secures this second liability. Fill only if 'Yes' is 'Yes'.

Please enter the current market value of the asset securing this second liability. Fill only if 'Yes' is 'Yes'.

Check this box if the second liability is secured by collateral, meaning it is fallback security in case the primary security is insufficient. Fill only if 'Yes' is 'Yes'.

Check this box if the second liability is a primary production asset. Fill only if 'Yes' is 'Yes'.

Provide the full name of the fund manager for this managed investment. Fill only if 'Yes' is 'Yes'.

Enter the name of the managed investment product and any specific product options. Fill only if 'Yes' is 'Yes'.

Enter the total number of units held for this managed investment, if applicable. Fill only if 'Yes' is 'Yes'.

Provide the APIR code for this specific managed investment product, if known. Fill only if 'Yes' is 'Yes'.

Enter the total monetary value of this managed investment. Fill only if 'Yes' is 'Yes'.

Provide a description of this other asset type. Fill only if 'Yes' is 'Yes'.

Enter your estimated current market value for this other asset. Fill only if 'Yes' is 'Yes'.

Check this box if the third listed 'Other (describe)' asset is a primary production asset. Fill only if 'Yes' is 'Yes'.

Please provide the name of the second person or entity that owns the property. Fill only if 'No' is 'Yes'.

Please provide the percentage of the property owned by the second person or entity. Fill only if 'No' is 'Yes'.

Enter the full name of the second person or associate the company owes money to. Fill only if 'Yes' is 'Yes'.

Enter the first component of the second person or associate's date of birth (e.g., day or month). Fill only if 'Yes' is 'Yes'.

Enter the total amount of money owed by the company to the second person or associate. Fill only if 'Yes' is 'Yes'.

Enter the interest rate paid on the loan to the second person or associate, if applicable. Fill only if 'Yes' is 'Yes'.

Please provide the full legal name of the second private company. Fill only if 'Yes' is 'Yes'.

Please enter the Australian Business Number (ABN) or Australian Company Number (ACN) for the second private company. Fill only if 'Yes' is 'Yes'.

Enter the full legal name of the second private trust. Fill only if 'Yes' is 'Yes'.

Enter the first block of digits of the second private trust's Tax File Number (TFN). Fill only if 'Yes' is 'Yes'.

Enter the second block of digits of the second private trust's Tax File Number (TFN). Fill only if 'Yes' is 'Yes'.

Enter the third block of digits of the second private trust's Tax File Number (TFN). Fill only if 'Yes' is 'Yes'.

Enter the first block of digits of the second private trust's Australian Business Number (ABN). Fill only if 'Yes' is 'Yes'.

Enter the second block of digits of the second private trust's Australian Business Number (ABN). Fill only if 'Yes' is 'Yes'.

Enter the third block of digits of the second private trust's Australian Business Number (ABN). Fill only if 'Yes' is 'Yes'.

Enter the fourth block of digits of the second private trust's Australian Business Number (ABN). Fill only if 'Yes' is 'Yes'.

Provide the name of the public company or its ASX code for the second shareholding. Fill only if 'Yes' is 'Yes'.

Enter the total number of shares held for this public company. Fill only if 'Yes' is 'Yes'.

Please provide the type or designation of the second class of shares, for example, Ordinary, Class A, or Class B. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the total number of shares issued for this second share class. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if shares of this class provide voting rights. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if shares of this class are entitled to receive dividends. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if shares of this class are entitled to capital distributions upon the company's winding up. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Enter the full name of the second shareholder, director, person, or associate. Fill only if 'Yes' is 'Yes'.

Provide the date of birth for the second shareholder, director, person, or associate. Fill only if 'Yes' is 'Yes'.

Enter the total amount of wages the second shareholder, director, person, or associate was entitled to receive. Fill only if 'Yes' is 'Yes'.

Enter the total amount of wages paid to the second shareholder, director, person, or associate. Fill only if 'Yes' is 'Yes'.

Enter the total amount of superannuation the second shareholder, director, person, or associate was entitled to receive. Fill only if 'Yes' is 'Yes'.

Enter the total amount of superannuation paid to the second shareholder, director, person, or associate. Fill only if 'Yes' is 'Yes'.

Describe the type of other income received by the second shareholder, director, person, or associate, such as director's fees or bonus shares. Fill only if 'Yes' is 'Yes'.

Enter the total amount of other income paid to the second shareholder, director, person, or associate. Fill only if 'Yes' is 'Yes'.

Provide the financial year in which the other income was paid to the second shareholder, director, person, or associate. Fill only if 'Yes' is 'Yes'.

Please enter the full name of the second shareholder. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please enter the date of birth for the second shareholder. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please enter the Company Registration Number (CRN) for the second shareholder, if known. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the second shareholder is related to any of the company's director(s). Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please enter the class of share for this shareholder, such as Ordinary, Class A, or Class B. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please enter the total number of shares held by this shareholder. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please enter the purchase price of the shares. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please enter the date when the shares were purchased. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the class of share held by the second shareholder. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the total number of shares held by the second shareholder. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the purchase price of the shares held by the second shareholder. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the date when the shares were purchased by the second shareholder. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide the second trading name under which the company conducts business. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please describe the type of business for the second trading name, such as primary production, retail, commercial, or investment. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please provide the type of share class, for example, Ordinary, Class A, or Class B. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide the total number of shares for this class. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the share class provides voting rights. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the share class is entitled to receive dividends. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the share class is entitled to capital distributions upon the company's winding up. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Provide the class or type of the shares held. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the total number of shares held in this class. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Indicate the price at which these shares were purchased. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Specify the date when these shares were acquired. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please enter the full name of Shareholder 4. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please enter the date of birth for Shareholder 4. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please enter the Company Registration Number (CRN) for Shareholder 4, if known. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the shareholder is related to one or more directors. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the shareholder is related to other shareholders. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the shareholder is related to other office-holders. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the class of share for this shareholding. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the total number of shares held in this class. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the purchase price per share for this class of share. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the date when these shares were purchased. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Provide the class of shares held by the shareholder. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the total number of shares held by the shareholder. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the price paid per share for this class of shares. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Provide the date when these shares were purchased. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please enter the full name of Shareholder 5. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please enter the date of birth for Shareholder 5. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please enter the CRN (Company Registration Number) for Shareholder 5, if known. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if Shareholder 5 is related as a Director(s). Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if Shareholder 5 is related to other shareholders. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if Shareholder 5 is related to other office-holders. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Provide the class of share for the second shareholding of Shareholder 5. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Provide the total number of shares for the second shareholding of Shareholder 5. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Provide the purchase price per share for the second shareholding of Shareholder 5. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Provide the date when these shares were purchased for the second shareholding of Shareholder 5. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the specific class or type of share for this shareholding. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the total number of shares held in this class. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the price paid per share for this class of shares. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the date when these shares were purchased. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Provide the full name of Shareholder 6. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Provide the date of birth for Shareholder 6. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Provide the Company Registration Number (CRN) for Shareholder 6, if known. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if Shareholder 6 is related to one or more directors. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Provide the type or class of the second shareholding held by this shareholder. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the total number of shares of the second class held by this shareholder. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the purchase price per share for the second class of shares. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Provide the date when the second class of shares were purchased. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the class of share for this holding. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the total number of shares purchased in this class. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the purchase price per share for this class of share. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the date when these shares were purchased. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide the full name of Shareholder 7. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide the date of birth for Shareholder 7. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide the Company Registration Number (CRN) for Shareholder 7, if known. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if Shareholder 7 is related to a Director(s). Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the class of share for the second shareholding of Shareholder 7. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the number of shares held in this class for the second shareholding of Shareholder 7. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the purchase price per share for the second shareholding of Shareholder 7. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the date when the shares in this class were purchased for the second shareholding of Shareholder 7. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if no shareholder, director, person, or associate received or was entitled to receive any income from the company in the last financial year. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the full name of the shareholder, director, person, or associate who received income from the company. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if any shareholder, director, person, or associate received or was entitled to receive income from the company in the last financial year. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the shareholding for the company has NOT changed in the last 5 years.

Check this box if the shareholding for the company HAS changed in the last 5 years and you need to provide historical details.

Please provide a concise summary or a key detail of the historical shareholding change. Fill only if 'Yes' is 'Yes'.

Please provide comprehensive details regarding the historical shareholding changes, including all relevant information. Fill only if 'Yes' is 'Yes'.

Check this box if you (and/or your partner) have never held shares in the company.

Check this box if you (and/or your partner) have ever held shares in the company.

Enter the name of the fund manager for this managed investment. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the name of the product and the specific product option for this managed investment. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the number of units held for this managed investment, if applicable. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the APIR code for this managed investment, if known. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the total value of this managed investment. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please enter the full legal name of the sixth private company. Fill only if 'Yes' is 'Yes'.

Please enter the Australian Business Number (ABN) or Australian Company Number (ACN) for the sixth private company. Fill only if 'Yes' is 'Yes'.

Please provide the name of the sixth public company or its ASX code. Fill only if 'Yes' is 'Yes'.

Please enter the number of shares held in the sixth public company. Fill only if 'Yes' is 'Yes'.

Provide the numeric month in which the company's taxation returns and financial statements are normally completed.

Provide the trading name for the third business from which income is derived from personal exertion. Fill only if 'Yes' is 'Yes'.

Enter the percentage of income you derive from personal exertion for the third business. Fill only if 'Yes' is 'Yes'.

Enter the percentage of income your partner derives from personal exertion for the third business. Fill only if 'Yes' is 'Yes'.

Enter the full name of the third director or shareholder who received a benefit. Fill only if 'Yes' is 'Yes'.

Enter the date of birth for the third director or shareholder. Fill only if 'Yes' is 'Yes'.

Specify the type of benefit received by the third director or shareholder. Fill only if 'Yes' is 'Yes'.

Enter the monetary value of the benefit received by the third director or shareholder. Fill only if 'Yes' is 'Yes'.

Enter the financial year in which the benefit payment was made. Fill only if 'Yes' is 'Yes'.

Enter the type of the third liability. Fill only if 'Yes' is 'Yes'.

Enter the total monetary amount of the third liability. Fill only if 'Yes' is 'Yes'.

Enter a description of the asset that secures the third liability. Fill only if 'Yes' is 'Yes'.

Enter the current market value of the asset secured against the third liability. Fill only if 'Yes' is 'Yes'.

Check this box if the third liability is secured by collateral. Fill only if 'Yes' is 'Yes'.

Check this box if the asset securing the third liability is a primary production asset. Fill only if 'Yes' is 'Yes'.

Provide the name of the third fund manager for this managed investment. Fill only if 'Yes' is 'Yes'.

Provide the name of the third managed investment product and any applicable product option. Fill only if 'Yes' is 'Yes'.

Provide the number of units held for the third managed investment, if applicable. Fill only if 'Yes' is 'Yes'.

Provide the APIR code for the third managed investment, if known. Fill only if 'Yes' is 'Yes'.

Provide the monetary value of the third managed investment. Fill only if 'Yes' is 'Yes'.

Please provide a description of the third other asset held by the company. Fill only if 'Yes' is 'Yes'.

Please enter your estimate of the current market value for the third other asset. Fill only if 'Yes' is 'Yes'.

Check this box if the asset listed under 'Other (describe)' is a primary production asset. Fill only if 'Yes' is 'Yes'.

Please provide the full name of the third person or entity who owns the property. Fill only if 'No' is 'Yes'.

Enter the percentage of the property owned by the third owner. Fill only if 'No' is 'Yes'.

Enter the full name of the third person or associate. Fill only if 'Yes' is 'Yes'.

Enter the date of birth of the third person or associate. Fill only if 'Yes' is 'Yes'.

Enter the total amount owed to the third person or associate. Fill only if 'Yes' is 'Yes'.

Enter the interest rate paid on the loan, if applicable. Fill only if 'Yes' is 'Yes'.

Provide the full legal name of the third private company. Fill only if 'Yes' is 'Yes'.

Provide the Australian Business Number (ABN) or Australian Company Number (ACN) for the third private company. Fill only if 'Yes' is 'Yes'.

Please enter the first segment of the third private trust's Tax File Number. Fill only if 'Yes' is 'Yes'.

Please enter the second segment of the third private trust's Tax File Number. Fill only if 'Yes' is 'Yes'.

Please enter the third segment of the third private trust's Tax File Number. Fill only if 'Yes' is 'Yes'.

Please enter the first segment of the third private trust's Australian Business Number. Fill only if 'Yes' is 'Yes'.

Please enter the second segment of the third private trust's Australian Business Number. Fill only if 'Yes' is 'Yes'.

Please enter the third segment of the third private trust's Australian Business Number. Fill only if 'Yes' is 'Yes'.

Please enter the fourth segment of the third private trust's Australian Business Number. Fill only if 'Yes' is 'Yes'.

Please provide the name of the third public company or its ASX code. Fill only if 'Yes' is 'Yes'.

Please enter the total number of shares held in the third public company. Fill only if 'Yes' is 'Yes'.

Please provide the class of the third share issued by the company. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please provide the total number of shares for this third class. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if shares of this class are provided with voting rights. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if shares of this class are entitled to receive dividends. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if shares of this class are entitled to capital distributions upon the company's wind up. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the full name of the third shareholder. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide the date of birth for the third shareholder. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please enter the Corporate Register Number (CRN) for the third shareholder, if known. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the third shareholder is related to a Director. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the class of shares (e.g., Ordinary, Class A, Class B) for this shareholding. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the total number of shares held in this class. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the purchase price per share for this shareholding. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Enter the date when these shares were purchased. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide the class of shares held for this shareholding (e.g., Ordinary, Class A, Class B). Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please enter the total number of shares for this particular shareholding. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please enter the purchase price per share for this particular shareholding. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please provide the date when these shares were purchased. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Please enter the third trading name under which the company conducts business. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Please enter the type of business for the third trading name, for example, primary production, retail, commercial, or investment. Fill only if 'Have you (and/or your partner) gifted, transferred or sold assets to this company for less than their market value or provided services to the company and not received adequate payment/consideration since 7:30 pm AEST on 9 May 2000?' is 'Yes'.

Check this box if two or more titles have NOT been amalgamated after 9 May 2006. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if two or more titles HAVE been amalgamated after 9 May 2006. Fill only if 'Is your only role in the private company as a director and you have no shares in, or loans to the company?' is 'No'.

Check this box if the property does not have more than one title document.

Check this box if the property has more than one title document.

Please enter the date the company commenced trading.

Please provide any additional details or a reference related to the company acting as a corporate trustee. Fill only if 'Yes' is 'Yes'.

Please enter the full name of the trust for which the company is acting as a corporate trustee. Fill only if 'Yes' is 'Yes'.

Please provide the URL to find the definition of a partner.

Enter 'No' to indicate you have not gifted, transferred or sold assets to this company for less than their market value and have not provided services to the company without adequate payment/consideration since 7:30 pm AEST on 9 May 2000. Fill only if 'No' is 'No'.

Check this box if there is no written loan agreement, witnessed by a third party, for a loan made to the company from a person or an associate. Fill only if 'Yes' is 'Yes'.

Check this box if there is a written loan agreement, witnessed by a third party, for a loan made to the company from a person or an associate. Fill only if 'Yes' is 'Yes'.

Please enter the first segment of your Centrelink Reference Number.

Please enter the second segment of your Centrelink Reference Number.

Please enter the third segment of your Centrelink Reference Number.

Please enter the fourth segment of your Centrelink Reference Number.

Please enter your date of birth.

Please enter your family name as it appears on your official documents.

Please enter your first given name as it appears on your official documents.

Please enter your second given name if applicable, as it appears on your official documents.

Enter your partner's date of birth. Fill only if 'Yes' is 'Yes'.

Provide your partner's family name. Fill only if 'Yes' is 'Yes'.

Provide your partner's first given name. Fill only if 'Yes' is 'Yes'.

Provide your partner's second given name. Fill only if 'Yes' is 'Yes'.