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Australian Government Farm Finance:Concessional Loan Scheme 2013–14

APPLICATIONComplete Applications close 5.00 pm 30 April 2014

Rural Business Development Corporation

C/- Department of Agriculture and Food WALocked Bag 4

BENTLEY DELIVERY CENTRE WA 6983

Freecall: 1800 198 231Fax: 9367 4265

ABN: 84 524 088 562Email: [email protected]

Website: www.agric.wa.gov.au/farmfinance

1. Guidelines and assessment checklistIMPORTANT – Please ensure you have read and understood the Scheme Guidelines Document. That document outlines the Eligibility Criteria you must satisfy (Clause 8) and the Loan Assessment Criteria that your request for a Farm Finance: Concessional Loan will be assessed by (Clauses 9 & 10).

Before you commence filling out this Application, please go through theAssessment Checklist (Appendix A) at the end of this form.

If you have any doubts, please contact our office to discuss your eligibility before progressing application.

If you believe you may qualify, please complete every section of the application form and forward it with all necessary attachments as listed in bold on p. 7, to the Rural Business Development Corporation.

Incomplete Applications (including missing attachments) will cause delays and may result in your application being declined. Approved applicants will be funded in the order their COMPLETED applications enter the assessment queue, until Scheme funds are committed. An application may have been received, but it will not be considered to be in the assessment queue until ALL required information has been received. ALL required information to make the application complete must be received by 5.00 pm 30 April 2014.

2(a) Farm business details

ACN

ABN

GST Registered? Yes No Client or File Ref No. (if known):

Sole Trader Partnership Trust CompanyPlease tick entity type

Full businesstrading entity name

Postal address

Town Postcode

Please tick if the road address of your farm is the same as your postal addressRoad address

Town Postcode

How long has the Applicant been continuously farming? years (since )Have you applied for and/or received a FFCLS loan in any other State? .................................. Yes No

V 2 – 190214 RBDC FFCLS – of 7

http://www.agric.wa.gov.au/farmfinance

mailto:[email protected]

Is there any unsatisfied judgement entered, or a judgement likely to be entered, in a court against the Applicant or Applicant company of which you are/were, a shareholder/officer, and, if a company, is the Company in liquidation (voluntarily/otherwise), or has a Receiver and Manager been appointed? ................................ Yes No

V 2 – 190214 RBDC FFCLS – of 7

2(b) Members of the farm businessPlease list all adult persons actively involved in the farm business and their position (e.g. business partner, director, trustee, beneficiary, etc.).If there is insufficient room, please copy this page and attach it to your application.

Title Surname Given names Date of birth Position

*Aust.permanentresident

% time worked on farm

/ / %

/ / %

/ / %

/ / %

/ / %

/ / %

/ / %

/ / %

* Please nominate above which of the Applicant members are at least an Australian permanent resident?

2(c) Primary contact person for the farm business with respect to this application from 2 (b) above

Title Surname Given names

Telephone Mobile Fax

Email

2(d) Key business contacts

Bank or Financier:Contact person Telephone Mobile

Firm / company Email

Farm consultant:Contact person Telephone Mobile


Accountant:Contact person Telephone Mobile


2(e) Electronic funds transfer details (for to and from fund transfers) – must be an Australian bank account number

Name of farm business’ bank

Address of bank

RBDC FFCLS – of 7

Name of farm business bank account

BSB Account number

The minimum repayment is the interest component, on a six monthly basis, each 15 March and 15 September.

RBDC FFCLS – of 7

2(f) Farming property description

Property name

Total area of farm (ha) Total arable area (ha)

Pick your main industry: Apple and pear growing Aquaculture Beef cattle farming

Dairy cattle farming Deer farming Grain growing

Grain-sheep/beef cattle farming Grape growing Pig farming

Sheep-beef cattle farming Sheep farming Stone fruit growing

Vegetable growing Other

The property is located* km in a direction from the town of

In the Shire of in the State of

* If you have a number of properties spread over a wide area (or even in another state), please attach details to this application form.-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Owned Hectares Year purchased Current market value ($)

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Commencement date ExpiryLeased Hectares / / / /

Lease payment (PA) ($) Options

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Commencement dateSharefarmed Hectares / / Expiry / /

----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

To be purchased(include copy of signed sales contract)

Hectares Purchase date

Finance date

Settlement date

Purchase price ($) / / / / / / $

3. Summary of proposed project(Note: Also include these costs in your cashflow projections)

Purpose of loan from your Five year Business Case and Management Plan Cost ($) $

$

$

$

$

Important note:Please attach copy / copies of relevant information as applicable:– Pro-forma invoices / quotes– Offer and Acceptance agreement/s– Any other documents pertaining to purchase/s (e.g. make, model, engine numbers, etc.)– Management Plan and Business Case for 5 years

(A) Total $

Funding: How do you plan to fund the above requirements? (Detail below) Amount ($)

Cash contribution: .............................................................................................................................. $ Other loans(please detail):

$

$

$

Farm Finance Concessional Loan (min. $50,000 to max. $200,000) $

RBDC FFCLS – of 7

TOTALS (A) MUST EQUAL (B) (B) Total $

RBDC FFCLS – of 7

4(a) Property title details (also include off-farm property(s))

Title descriptionName of registered owner(s) Estimated market

value $Title Location name or Lease number

Title Location / Plan number

Area ha of each title

(i) $ (ii) $ (iii) $ (iv) $ (v) $ (vi) $ (vii) $ (viii) $ (ix) $ (x) $ (xi) $ (xii) $

Add additional page if necessary $ Total ha Total $

Non-farm properties(i) $ (ii) $ (iii) $ (iv) $

Total $

Note: Please describe ALL non-farm properties, e.g. town building block, brick and tile home, commercial property, etc. Including address(es):

For lease and sharefarming properties, please provide a signed copy of your agreements:

Other known property encumbrances (e.g. caveats, trading, mining lease, biosecurity, covenants):

4(b) Security offered for consideration – Optional (do not need to complete if not known)All loan recipients are required to provide ‘best and most appropriate’ security for this loan. This security could be in the form of a first or subsequent mortgage over land, or a specific security agreement (a security charge on a specific item of equipment).

If known, what security is available to secure the requested Farm Finance: Concessional loan?

Is the security in names other than the applicants (i.e. parents)? Yes No Please provide details

RBDC FFCLS – of 7

5. Statement of Assets and Liabilities (For cropping businesses this should as at your last annual review with your bank; all others should be as at date of application)

Complete one combined Statement for all BUSINESS and PERSONAL Assets and Liabilities, including those held individually or jointly with partners, other persons or associated entities. The Statement must include all assets and all debts of all members of the business.

ASSETS (Show present fair market value) LIABILITIES (Current amount owing)

FARM ASSETS FARM LIABILITIESFarm land (including improvements)

Land ha @ $ /ha = $ Base limit $ Overdraft balance $

Land ha @ $ /ha = $ Term loans (incl. commercial bills and fixed interest loans)

Land ha @ $ /ha = $ $

SUB TOTAL OF FARM LAND ASSETS $ $

Town/residential property for farm use ........................... $ $

Livestock ........................................................................ $ $

Plant, machinery, and vehicles ...................................... $ Other loans

Shares/debentures/deposits .......................................... $ $

Grain (harvested, stored and unsold) ............................. $ $

Seed on hand, fertiliser .................................................. $ Stock firm ......................................................................... $

Other produce/materials on hand (e.g. wool) ................. $ HP, leasing and chattel mortgage ..................................... $

Farm Management Deposits .......................................... $ Creditors (A/C’s payable) .................................................. $

Cash at bank .................................................................. $ Taxation liability ................................................................ $

Accounts receivable ....................................................... $ TOTAL FARM LIABILITIES $

TOTAL FARM ASSETS NON FARM LIABILITIESPersonal loans ..................................................................

Margin loans (e.g. shares) ................................................

$ $

NON FARM ASSETS (business and personal) $

Other real estate (show address and market value below) Real estate loans (show details) $

$ $

$ $

Complying Superannuation (current estimated value) ...... $ Credit card/s ..................................................................... $

Other assets Other liabilities

Non-farm vehicles/boats/caravans/vintage, etc. ............... $ $

$ $

TOTAL NON FARM ASSETS $ TOTAL NON FARM LIABILITIES $

TOTAL ASSETS $ TOTAL LIABILITIES $

EQUITY $

Please have your main financial institution’s relationship or account manager sign this page with their bank stamp. We also require EACH of your financial institutions to complete and sign the separate ‘Schedule of Accounts’ form.

I, of (name and office / branch of the financial institution)

I do hereby confirm that this Statement is consistent with information known to us. ________________________________________________Signature and date

RBDC FFCLS – of 7Bank stamp

here

6. Consent and Statutory Declaration

For the purposes of this application:I/We authorise the Rural Business Development Corporation / Department of Agriculture and Food, Western Australia (RBDC/DAFWA) to seek any additional relevant information it considers appropriate to process this application (including information from my solicitors, accountants, commercial lenders and insurance companies, and any credit reporting agencies), and I/we request and authorise any person or entity to supply to the RBDC/DAFWA all such information the RBDC/DAFWA requests from it;I/We have read and understand the Privacy Statement at Appendix B on how information provided in my/our application or collected in relation to me/us or the application or our security providers may be used and disclosed, and I/we consent to and authorise all such uses and disclosures;I/We have read and understand the Farm Finance: Concessional Loan Scheme – Scheme Guidelines document and obtained clarification where needed, and I/we agree to those Guidelines applying to my/our application and any loan or finance provided to me/us in response to the application;I/We solemnly and sincerely declare that the information, shown in this application and attachments, and any subsequently provided, is true and correct in every particular, and discloses full details of the financial position of the applicant/s, the applicant partnership, the applicant company and/or the applicant Trust/beneficiaries and I/we make this declaration under the Oaths, Affidavits and Statutory Declarations Act 2005.

INDIVIDUAL DECLARATION:All sole traders, partners, and trustees of trusts are to sign. Each Director must also sign and have witnessed this individual declaration, in their capacity as individuals.

This declaration is true and I/we know that it is an offence to make a declaration knowing that it is false in a material particular.

at (place) By (Applicants):

(date) (Signature of person making the declaration)

Name:

in the presence of:(Signature of person making the declaration)

(Signature of authorised witness – See Appendix C)Name:

Name of authorised witness

(Signature of person making the declaration)

Name: Qualification ofauthorised witness

(Signature of person making the declaration)

Name:

COMPANY DIRECTORS DECLARATION:The Company’s authorised Directors are to sign this Company declaration.(Note: The Directors must also sign and have witnessed the individual declaration above, in their capacity as individuals.)

Director Director/Secretary

RBDC FFCLS – of 7

7. Supporting documents checklistPlease make sure you fully complete the application form (including signatures) and provide all relevant attachments. Incomplete applications will not be accepted to be assessed, nor enter the assessment queue until ALL information is provided. Missing information will need to be provided within 20 business days of the RBDC’s receipt of your application to retain your place in the assessment queue, and before 5.00pm of 30 April 2014. Failure to provide the missing information within the 20 business days will result in your application losing its place in the assessment queue. In this circumstance, you can still provide the required information, however you will enter the assessment queue as at the date you provided the last of the required information. If missing information is not supplied, the application will be declined. If there is heavy demand for funding, the RBDC will close applications early if commitments reach the $25M available funding set for the 2013–14 financial year. The following information IN BOLD must also be provided to the RBDC with this application so it is considered fully completed: Please tick

1) Tax Returns & Financial Statements for 2010/11, 2011/12 and 2012/13* – Applicant business, personal, and all associated entities:

– Include Profit and Loss Statements, Balance Sheets and depreciation schedules– *Monthly cashflow actual for the 2013 farm year is acceptable if financial statements have not been prepared for

2012/13 .........................................................................................................................................................................................

Yes

2) Monthly cashflow actual for the past farm year ............................................................................................................. Yes

3) Monthly cashflow budget for the current farm year ....................................................................................................... Yes

4) Main Financier Supporting Information Form ................................................................................................................. Yes

5) ‘Schedule of Accounts’ form from EACH main financial institution – not required for equipment financiers ........ Yes

6) Copies of Trust Deeds (if applicable) .............................................................................................................................. Yes

7) Copies of Company Constitution (if applicable) – also known as a ‘Memorandum and Articles of Association’ ... Yes

8) Management Plan/Business Case outlining productivity improvement/s for the next 5 years ................................. Yes

9) Copies of written Lease and or Sharefarming Agreement(s) (if applicable) ................................................................ Yes

10) Copies of all relevant documents such as invoices for plant and machinery (including type, make, model, registration, engine and VIN numbers, etc.), Offer and Acceptance forms for the purchase of land ......................... Yes

11) Details of assets (over $50,000) purchased and sold over the last financial year, this financial year and estimates for the next financial year ................................................................................................................................................... Yes

12) Has each member of the applicant business signed the declaration on p. 6 (partners, directors, beneficiaries, trustees, etc.)? ...................................................................................................................................................................... Yes

13) Have your signatures been witnessed by an ‘authorised witness’ (see the Appendix C for who is an authorised witness) ................................................................................................................................................................................. Yes

14) Where applicable, have the Directors of your company signed the declaration on page 6 on behalf of the company and again in their capacity as individuals? ...................................................................................................... Yes

15) Where applicable, have all adult beneficiaries of the Trust involved in the farm business of the trading entity been listed? ................................................................................................................................................................................................

Yes

16) Have you provided details of other properties on another sheet if there are insufficient room in the form? ............ Yes

17) Has your financial institution signed the Assets and Liabilities statement on page 5? ............................................... Yes

Have you read and understood the Scheme Guidelines document? ............................................................................................ Yes

Have you completed the Eligibility Checklist at Appendix A? ....................................................................................................... Yes

Have you fully completed all sections of the application form? ..................................................................................................... Yes

Have you attached all required information? ................................................................................................................................. Yes

If sending by Australia Post: If sending by courier/hand delivery:Rural Business Development Corporation Rural Business Development CorporationDepartment of Agriculture and Food Department of Agriculture and FoodLocked Bag 4 3 Baron-Hay CourtBENTLEY DELIVERY CENTRE WA 6983 SOUTH PERTH WA 6151

Further information is available at website: www.agric.wa.gov.au/farmfinance Email enquiries: [email protected] telephone: Freecall: 1800 198 231

Please note that COMPLETE applications must be received by 5 pm 30 April 2014

(Applications for the second round of funding during the 2014–15 year will open on 1 July 2014)

Farm Finance is an Australian Government initiative that aims to build the ongoing financial resilience of farm businesses through the provision of concessional loans. The Concessional Loans Scheme in Western Australia will assist farm businesses

RBDC FFCLS – of 7

http://www.agric.wa.gov.au/farmfinance

that are considered viable in the longer term, that are experiencing debt servicing difficulties, by providing loans for them to undertake productivity enhancement activities.

RBDC FFCLS – of 7

Appendix A

Australian Government Farm Finance Concessional Loan Scheme (FFCLS)

These Assessment Criteria come from Clauses 8, 9 and 10 of the Scheme Guidelines document. Please read the Scheme Information document in full.

The following questions are mostly those that the RBDC considers when assessing your application.

Please read through these and indicate ‘Yes’ or ‘No’ as to how you believe you may be considered. You may not be able to consider/answer all questions, but it will help you decide if you should fill out and put together a full application.

In general, if you can answer ‘Yes’ to all items (except criteria 15 and 16), it may be a good indication that you could be eligible for an Australian Government Farm Finance Concessional Loan Scheme loan.

Part one of the assessment process is the Eligibility for Assessment Criteria (Clause 8)Yes No

1. Have you provided all requested documents and signatures? ..................................................

2. Is FFCLS funding still available (check DAFWA/RBDC website)? ............................................

3. Will the application be lodged prior to the closing date and time (subject to funding .................still being available)?

4. Have you (the applicant) owned and operated the farm business for at least ...........................the past five consecutive years; and

5. Are you operating as a sole trader, trust, partnership or private company; and ........................

6. Involved within the agricultural, horticultural, pastoral, apicultural or .........................................aquacultural industries; and

7. Wholly located in Australia; and .................................................................................................

8. Registered for tax purposes in Australia with an Australian Business Number (ABN), .............and registered for GST; and

9. Not a public company under the meaning of The Corporations Act 2001 (Cth) ........................

10. Has each of the applicants been through a ‘Verification of Identity’ with their main bank / .......financier?

11. Is at least one Applicant member of the farm business a farmer who, under normal ................circumstances, contributes at least 75 per cent of his or her labour and derivesat least 50 per cent of his or her income from the farm business?

12. Is the majority of the applicant’s farm business (business operations, income, ........................and land/lease holdings) conducted in the state of Western Australia

13. Is at least one member of the farm business at least an ‘Australian Permanent .......................Resident’?

14. If a lessee/sharefarmer (in part or wholly), does the applicant have a signed ...........................lease or sharefarming agreement?

Page 1 of 2

Yes No

15. Is the applicant or its members under external administration or bankruptcy? That is, is .........there any unsatisfied judgement entered, or a judgement likely to be entered, in a court against the Applicant or Applicant company of which you are / were, a shareholder / officer, and, if a company, is the Company in liquidation (voluntarily / otherwise), or has a Receiver and Manager been appointed?

16. Has the applicant applied for or been a loan recipient under the Farm Finance: ......................Concessional Loan Scheme in any other (state or territory) jurisdiction?

17. Do all members of the farm business (including partners, shareholders, beneficiaries .............etc.) have net non-farm assets totalling less than $421,500 (excluding complying superannuation funds); and

18. Do all members of the farm business (including partners, shareholders, beneficiaries, ............etc.) have liquid assets totalling less than $400,000 (e.g. farm management deposits, shares, cash at bank, etc.)

Part two of the assessment process is the Loan Assessment Criteria (Clause 10)Yes No

19. Is the application for eligible productivity enhancement activities only ......................................(see Clause 9)

20. Has the farm business taken all reasonable steps to service its farm business debt ................

21. Has the farm business experienced and is continuing to experience difficulties .......................servicing its debt; and

22. Does the farm business have a financial need for a concessional loan; and ............................

23. Does the farm business have the capacity to repay the concessional loan and ........................have sound prospects for a return to commercial viability within the term of the concessional loan; and

24. Does the farm business have the ongoing support of its current commercial ...........................lender(s) for the availability of additional necessary carry-on finance; and

25. Do you have the ongoing support of commercial lender(s) with the ..........................................concessional loan assistance?

26. Will the requested concessional loan amount be less than the total eligible (long term) ...........debt of the farm business?

27. Will you be able to provide the RBDC with ‘best and most appropriate’ security ......................to secure the amount of the proposed loan?

Page 2 of 2

Appendix B

Privacy statementInformation provided by Applicants or their security providers or collected by RBDC, DAFWA and/or the Australian Government in relation to Applicants, their applications or their security providers (Information) may be used by RBDC, DAFWA and/or the Australian Government for administration of the Concessional Loans Scheme and assessment of an Application. RBDC or DAFWA may provide Information to the Australian Government for the purpose of RBDC meeting its reporting requirements under its agreements with the Australian Government in relation to the Concessional Loans Scheme or for the purpose of the Australian Government overseeing, managing and conducting any further investigations it may require in relation to the Scheme or its Farm Finance initiative, and the Australian Government may use Information for these purposes. RBDC, DAFWA and/or the Australian Government may disclose Information to any party engaged in the assessment or evaluation of the Concessional Loans Scheme in any Australian jurisdiction, and any such party may use the Information for such assessment or evaluation.

RBDC, DAFWA and/or the Australian Government may:

1. Obtain from credit reporting agencies credit reports or consumer credit reports containing personal credit information about Applicants and/or their security providers, for the purposes of assessing applications or establishing, administering or enforcing loans under the Scheme or securities provided for those loans or related purposes including collecting overdue payments;

2. Obtain from, and provide to, credit reporting agencies and other credit providers or creditors (whose names may be disclosed in a credit report or provided by Applicants or their security providers) personal information about Applicants and/or their security providers, for the purposes of obtaining credit reports or consumer credit reports, allowing credit reporting agencies to create and maintain credit information files on Applicants and/or their security providers, assessing applications or establishing or administering loans under the Scheme or securities provided for those loans or related purposes; and

3. Provide Information and credit reports or consumer credit reports to their legal representatives and other advisers for the purposes of assessing applications, establishing, administering or enforcing loans under the Scheme or securities provided for those loans, obtaining legal or other advice in relation to any such matters or related purposes;

4. Provide personal information about Applicants to their security providers and prospective security providers, for the purposes of establishing, administering or enforcing loans under the Scheme or securities provided for those loans or related purposes including collecting overdue payments, and enabling those prospective security providers to obtain advice in relation such securities and decide whether to provide such securities.

Provision of Information (personal or otherwise) constitutes the Applicant’s and their security providers’ consent to RBDC, DAFWA and/or the Australian Government, and the other above parties, using the Information for the above mentioned purposes and any other incidental or related purpose.

Page 1 of 2

The RBDC, DAFWA and/or the Australian Government will store personal information collected through the Application, supporting documentation, the Concessional Loan Agreement and supporting security documents, and any Scheme administration, monitoring and evaluation activities in compliance with their respective obligations under the Privacy ACT 1988 (Cth). You may access or correct your personal information at any time by contacting RBDC by email or in writing to the address provided at the front of this application form.

Marketing research

How did you hear about the Farm Finance Concessional Loan Scheme?

Newspaper advertisement .....................................................................................................

Australian Government Department of Agriculture website ..................................................

DAFWA/RBDC website .........................................................................................................

WA Government website .......................................................................................................

Email or e-newsletter .............................................................................................................

Word of mouth .......................................................................................................................

Other

Page 2 of 2

Appendix C

Page 6 of 7 of this Application Form requires the applicants and its applicant members to sign the form as a Statutory Declaration.

The signatures must be witnessed by an Authorised Witness. If signed at different times, see Note 1 below.

A list of Authorised Witnesses is on the next page, of this Appendix C, under the heading of Schedule 2.

NOTES

1. If more than one declarant, each signature must have a separate attestation.

2. No person under eighteen years of age may be a witness.

3. A complete list of authorised witnesses for statutory declarations is contained in Schedule 2 of the Western Australian Oaths, Affidavits and Statutory Declarations Act 2005, or any person before whom, under the Statutory Declarations Act 1959 of the Commonwealth, a statutory declaration may be made.

4. The Western Australian Oaths, Affidavits and Statutory Declarations Act 2005 contains special provisions about authorised witnesses for statutory declarations made outside Western Australia.

Page 1 of 4

Schedule 2 — Authorised Witnesses for Statutory DeclarationsItem Formal description Informal description

1. A member of the academic staff of an institution established under any of the following Acts – • Curtin University of Technology Act 1966; • Edith Cowan University Act 1984; • Murdoch University Act 1973; • University of Notre Dame Australia Act 1989; • University of Western Australia Act 1911; • Vocational Education and Training Act 1996.

Academic(post-secondary institution)

2. A member of any of the following bodies –• Association of Taxation and Management Accountants

(ACN 002 876 208); • CPA Australia (ACN 008 392 452); • The Institute of Chartered Accountants in Australia

(ARBN 084 642 571); • National Institute of Accountants (ACN 004 130 643); • National Tax & Accountants’ Association Limited

(ACN 057 551 854).

Accountant

3. A person who is registered under the Architects Act 2004. Architect

4. An Australian Consular Officer within the meaning of the Consular Fees Act 1955 of the Commonwealth.

Australian Consular Officer

5. An Australian Diplomatic Officer within the meaning of the Consular Fees Act 1955 of the Commonwealth.

Australian Diplomatic Officer

6. A bailiff appointed under the Civil Judgments Enforcement Act 2004.

Bailiff

7. A person appointed to be in charge of the head office or any branch office of an authorised deposit-taking institution carrying on business in the State under the Banking Act 1959 of the Commonwealth.

Bank manager

8. A member of Chartered Secretaries Australia Limited (ACN 008 615 950).

Chartered secretary

9. A person who is registered under the Health Practitioner Regulation National Law (Western Australia) in the pharmacy profession.

Chemist

10. A person who is registered under the Health Practitioner Regulation National Law (Western Australia) in the chiropractic profession.

Chiropractor

11. A person registered as an auditor or a liquidator under the Corporations Act 2001 of the Commonwealth.

Company auditor or liquidator

12. A judge, master, magistrate, registrar or clerk, or the chief executive officer, of any court of the State or the Commonwealth.

Court officer

13. A member of the Australian Defence Force who is –• an officer within the meaning of the Defence Force Discipline Act

1982 of the Commonwealth; • a non-commissioned officer within the meaning of that Act with 5

or more years of continuous service; or • a warrant officer within the meaning of that Act.

Defence force officer

14. A person registered under the Health Practitioner Regulation National Law (Western Australia) in the dental profession whose name is entered on the Dentists Division of the Register of Dental Practitioners kept under that Law.

Dentist

15. A person who is registered under the Health Practitioner Regulation National Law (Western Australia) in the medical profession.

Doctor

Page 2 of 4

Item Formal description Informal description15A. A person appointed under the Parliamentary and Electorate Staff

(Employment) Act 1992 section 4(1)(b)(i) or (2)(b)(i) Electorate officer of a member of State Parliament

16. A member of the Institution of Engineers, Australia, other than at the grade of student.

Engineer

17. The secretary of an organisation of employees or employers that is registered under one of the following Acts –• Industrial Relations Act 1979; • Workplace Relations Act 1996 of the Commonwealth.

Industrial organisation secretary

18. A member of the National Insurance Brokers Association of Australia (ACN 006 093 849).

Insurance broker

19. A Justice of the Peace. Justice of the Peace

19A. A person who is a member of the Authority’s staff within the meaning given to that term by the Land Information Authority Act 2006 section 3.

Landgate officer

20. An Australian lawyer within the meaning of that term in the Legal Profession Act 2008 section 3.

Lawyer

21. The chief executive officer or deputy chief executive officer of a local government.

Local government CEO or deputy CEO

22. A member of the council of a local government within the meaning of the Local Government Act 1995.

Local government councillor

23. A member of the Australasian Institute of Chartered Loss Adjusters (ACN 074 804 167).

Loss adjuster

24. An authorised celebrant within the meaning of the Marriage Act 1961 of the Commonwealth.

Marriage celebrant

25. A member of either House of Parliament of the State or of the Commonwealth.

Member of Parliament

26. A minister of religion registered under Part IV Division 1 of the Marriage Act 1961 of the Commonwealth.

Minister of religion

27. A person registered under the Health Practitioner Regulation National Law (Western Australia) in the nursing and midwifery profession.

Nurse

28. A person registered under the Health Practitioner Regulation National Law (Western Australia) in the optometry profession.

Optometrist

29. A registered patent attorney under the Patents Act 1990 of the Commonwealth.

Patent attorney

30. A person registered under the Health Practitioner Regulation National Law (Western Australia) in the physiotherapy profession.

Physiotherapist

31. A person registered under the Health Practitioner Regulation National Law (Western Australia) in the podiatry profession.

Podiatrist

32. A police officer. Police officer

33. The person in charge of an office established by, or conducted by an agent of, Australia Post within the meaning of the Australian Postal Corporation Act 1989 of the Commonwealth.

Post office manager

34. A person registered under the Health Practitioner Regulation National Law (Western Australia) in the psychology profession.

Psychologist

35. A public notary within the meaning of the Public Notaries Act 1979. Public notary

36. An officer of the Commonwealth public service. Public servant (Commonwealth)

37. A person who is employed under the Public Sector Management Act 1994 Part 3.

Public servant (State)

Page 3 of 4

Item Formal description Informal description38. The holder of a licence under the Real Estate and Business Agents

Act 1978. Real estate agent

39. The holder of a licence under the Settlement Agents Act 1981. Settlement agent

40. The Sheriff of Western Australia and any deputy sheriff appointed by the Sheriff of Western Australia.

Sheriff or deputy sheriff

41. A licensed surveyor within the meaning of the Licensed Surveyors Act 1909.

Surveyor

42. A person employed as a member of the teaching staff within the meaning of the School Education Act 1999 or as a teacher of a non-government school within the meaning of that Act.

Teacher

43. A member, registrar or clerk, or the chief executive officer, of any tribunal of the State or the Commonwealth.

Tribunal officer

44. A registered veterinary surgeon within the meaning of the Veterinary Surgeons Act 1960. Or any person before whom, under the Statutory Declarations Act 1959 of the Commonwealth, a statutory declaration may be made.

Veterinarian

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