Collections for Charitable Purposes Application for Licence

Transcription

1 Collections for Charitable Purposes Act 1939 Collections for Charitable Purposes Application for Licence Important Information before you complete the application In considering an application for a Section 6 or 7 licence, the Minister may take into account any matter the Minister thinks fit and must consider whether, having regard to the objectives of the applicant, those objectives would be more effectively or economically be carried out by any other person, society, body or association. In order to affectively assess your application, the following form must be completed and the correct documentation attached. This application will be returned to you, and not assessed, without all the required information and documentation. Supporting documents to be attached New applicants / Where licences have expired Copy of Certificate of incorporation AND Current ASIC extract Evidence of endorsement by the ATO as an income tax exempt charity, an income tax exempt fund and/or a deductible gift recipient Current constitution or trust deed Evidence of consultation with existing charities Copy of the business plan showing the activities or proposed activities of the applicant, the proposed income of the applicant and the expenses and remuneration of employees and office holders Copy of the list of all members of the management committee Latest audited financial statements / signed auditors report & fundraising income and expenditure statement, where licence has expired Signed contract with fundraising agent (if applicable) Minutes from the last Annual General Meeting Any other documents the applicant feels relevant For an existing licensee: Copy of Signed auditors report Fundraising income and expenditure statement Latest audited financial statements Where to lodge this Form In person Customer Service Centre 91 Grenfell Street ADELAIDE SA 5000 Post Licensing Branch GPO Box 2169 ADELAIDE SA 5001 Electronically Scan and all documents to: charities@sa.gov.au More information Ph: Created: October 2015

2 Application for Licence Nature of application New Licence Renew Existing licence CCP Has your Trust Deed/Constitution changed since your last renewal? Office use only Received Licence No Yes No (If yes, you must supply a copy) Category of Licence or Renewal Section 6 Licence - authority to collect or obtain (or attempt to collect/obtain) money or property for a charitable purpose Charitable collector undertaking such activities as direct mail, telemarketing, unsolicited donations, Internet donations, badge/flower/token days, door knock appeals, payroll deduction schemes, donations in memoriam and bequests, grants Section 7 Licence - authority to conduct entertainment and charge admission where proceeds/part proceeds are for a charitable purpose Licence to undertake entertainment for charitable purposes, such as dinners, balls/dances, quiz nights, film nights. If you are unsure as to whether you will be undertaking entertainment for charitable purposes, we recommend that you nominate both Section 6 and 7 as part of your application. Applicant Applicant Details Person authorised to complete and file this application form on behalf of a corporate entity or association Contact Name Position held Phone number Organisation Details Details of the entity applying for the licence Organisation Name Trading Name Trustee Name Premises Address Postal Address ABN Daytime phone Mobile phone Website Page 2 of 8

3 Objectives of the Charity Only completed by new applicants or where the objects of an existing applicant have changed Under the Collections for Charitable Purposes Act 1939 the Minister must consider whether, having regard to the objects of the applicant for a licence, those objects would be more effectively or economically carried out by any other holder of a licence under the Act (or another applicant under the Act). If there is insufficient space to answer the following questions, please provide attachments clearly outlining which question you are answering. State in detail the objects of the applicant and the charitable purposes for which the licence is sought Please provide evidence or examples of how relief will be afforded State why you consider the applicant can carry out the stated objectives more effectively or economically than an existing holder of a licence under the Act Have you approached any existing licensed charities with a view to amalgamating the charitable activities (or proposed charitable activities) with those of the existing licensee in order to achieve more effective and economical fundraising? Please provide supporting evidence showing why the objectives of your organisation could not be more effectively or economically carried out by an existing licensee Page 3 of 8

4 Management of the Charity List Directors, office bearers, members of the management committee, etc: (please provide additional details on an attachment if required) Full Name Residential Address Position held Have you, or any person, company or association who has managerial or financial responsibility for or significant influence over any fundraising carried out (or proposed to be carried out) by the applicant, ever: pleaded guilty to, been convicted of, or had a charge proven for an offence capable of being punished by imprisonment for 3 months or more (whether or not a penalty of imprisonment was imposed)? or been bankrupt within the last 10 years; been subject to any other forms of insolvency administration within the last 10 years; or been externally administered within the last 10 years? NO YES - please provide the name/s of the person/s and the full details of the offence or insolvency/administration Full Name Details of the offence or insolvency/administration Has the applicant had any licence or approval relating to charitable collections refused or suspended (whether in South Australia or elsewhere)? YES NO (tick one) If YES, please provide details on an attachment Page 4 of 8

5 Collection Activities of the Charity To be completed by new applicants, or where the licence has expired, or where an existing licensee has changed their collection activities. Name of any appeal that the organisation intends to conduct (e.g. green hair day) What collection activities will be conducted by the organisation? Seeking bequests Telemarketing Volunteer fundraising Sponsored activities Clothing bins Opportunity shops Other - please specify: Dinner dance / ball / luncheon Film nights Street/door to door collections Internet donations (provide website) Merchandise sales Badge/flower/pin days Do you/will you employ the services of one or more fundraising, telemarketing or collection agent/s, including online donation providers? YES NO If YES, please give details AND a copy of the signed contract/s Name Address Postal Address Daytime phone Licence Number What percentage of individual donations will be paid to the agent? If you will be using more than one agent, provide the above details for each agent (and signed contract/s) as an attachment. Do you/will you use the services of any other fundraiser (eg. Event organiser, marketing firm)? YES NO If YES, please give details (and copies of the contract/s) Organisation Address Postal Address Daytime phone What percentage of individual donations will be paid to this fundraiser? If you will be using more than one fundraiser, provide the above details for each. Page 5 of 8

6 Financial matters of the Charity Auditor Details Section 15(1) of the Collections for Charitable Purposes Act 1939 requires a licensee to have its accounts audited by an approved auditor as detailed below: Registered Company Auditor - RCA Number Member of the Australian Society of Certified Practising Accountants Member of the Institute of Chartered Accountants in Australia A person authorised to audit the accounts of a prescribed association under the Associations and Incorporations Act 1985 (provide copy of approval) Auditor s Name Business Name Business Address Postal Address ABN Daytime phone Date when the organisations financial year ends Day Month Audited financial statements for preceding financial period attached Amount of money or value of goods expected to be raised in the first 12 months of being licensed $ How will the money raised from collections be distributed to beneficiaries? (eg money transferred to a research body, building a treatment centre, providing support services, etc) If there is more than one beneficiary / group, details must be provided in relation to: list each type of beneficiary / group the amount each beneficiary / group will receive how each beneficiary will use or distribute the funds Business Plan (for new applicants only) A Business Plan is attached to this application detailing: The activities or proposed activities of the applicant Proposed income of the applicant, expenses and remuneration of employees and office holders Page 6 of 8

7 Declaration The following declaration must be signed by the applicant (if an individual), or by the person authorised to complete and lodge this application (if the applicant is a corporate entity or association). I declare that the information contained in this application is true and correct in every particular. I acknowledge that under Section 15C of the Collections for Charitable Purposes Act 1939 it is an offence to make a statement that is false or misleading in any information provided under the Act. I authorise the Minister to make further enquiries as the Minister deems necessary to assess the suitability and fitness of the applicant to hold a licence under the Collections for Charitable Purposes Act 1939 and for the purpose of deciding whether the objects of the applicant would be more effectively or economically carried out by an existing licensee (or other applicant for a licence). For the purpose of the inquiries referred to in the preceding paragraph, I consent to the Minister disclosing (where the Minister deems it necessary to do so) - o any information in this application to an agency of the South Australian government; or an agency of the government of the Commonwealth or of another State or Territory, being an agency responsible for the regulation of charities or carrying out similar functions; and o the information provided in the Objectives Section to any of the charities referred to therein or to any other person, body or association, being a licensee or applicant for a licence under the Act, which the Minister considers may be able to carry out the objects of the applicant more effectively or economically. Authorised Signatory (full name of applicant/authorised person) (office held) Signature Date If you already have a licence or are reapplying for an expired licence, you must attach the following Fundraising Income and Expenditure Statement to your application. Page 7 of 8

8 Fundraising Income and Expenditure Statement Only to be completed by existing licence holders, or applicants for an expired licence Licence number CCP Statement period: Start date End date Under Section 15(2)(b) of the Collections for Charitable Purposes Act 1939 you are required to provided information regarding your income and expenditure at time of re-application of your licence (all columns are to be completed) Money Collected (A) Costs associated (B) Available for charitable purposes (A-B) Section 6 $ $ $ $ Section 7 $ $ $ $ Amount distributed for charitable purposes in the financial year (C) Does the amount available for charitable purposes equal the amount distributed to the charity? YES NO If NO, please give details If payment has been made to a speaker or other performer at any entertainment that exceeds $5,000, this information must be detailed (A) (B) (C) Money collected pursuant to a Section 6 licence includes; direct mail, telemarketing, general unsolicited donations, internet donations, badge/flower/token days, door knock appeals, payroll deduction schemes, any/all grants, donations in memoriam and bequests (only note bequests if monies have been received). If property is collected or received for a charitable purpose (e.g. clothing, second hand goods), the money received from the sale of the property must be included in (A). Money collected pursuant to Section 7 (i.e. entertainment) include: dinners, balls, quiz nights, film nights. Costs associated with the collection or receipt of the money include the relevant proportion of any fixed or overhead costs. (Do not include any other running costs of the charity). Declaration of the amount of the gross proceeds distributed for charitable purposes in the financial year. Declaration I declare that the information contained in this statement is true and correct. I declare that the amount distributed for charitable purposes is true and correct. I acknowledge that the information contained in this statement and associated audited accounts may be published on a website maintained by the Minister. I acknowledge that under item 15C of the Collections for Charitable Purposes Act 1939 it is an offence to make a statement that is false or misleading in any of the information provided under the Act. Authorised Signatory (full name of applicant/authorised person) (office held) Signature Date Page 8 of 8