Statutory Declaration

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1 Statutory Declaration Organisations must complete and submit this Statutory Declaration to the Australian Government Department of Education (the department), through the HELP IT System (HITS), when there has been any change to their company structure or if there has been an addition or deletion of, or any change to, any persons of influence in the organisation. The declaration is to be used by: organisations that have submitted an application to become a higher education provider (HEP) and/or VET provider and approved HEPs and VET providers. A person of influence is someone who makes, or participates in making, decisions that affect the whole, or a substantial part, of the organisation s affairs. Examples of persons of influence would be members of the governing body (ALL directors, office holders, presidents, council members, the chief executive officer and the chief financial officer). This Statutory Declaration: provides authorisation to the department to obtain any information and make any inquiries that may be relevant for the purposes of the Higher Education Support Act 2003 (the Act) confirms that individuals detailed as a person of influence in HITS have given permission for disclosure of their personal information to the department for the purposes of the Act. Important Note: The Statutory Declaration must not be signed and dated until all relevant changes have been made in HITS, including adding the details of any additional persons of influence. The Statutory Declaration must be signed by an officer of the organisation who is authorised, because of the position they hold within the organisation, to legally bind the organisation, such as an executive director. Contact Tertiary Study Enquiries Phone: SD_2013_V1.1

2 STATUTORY DECLARATION Statutory Declarations Act Insert name, address and occupation of person making the declaration. I 1, Occupation 1 Address 1 make the following declaration under the Statutory Declarations Act 1959: AUTHORITY 2. Insert position/title (eg Director) 3. Insert name of organisation 4. Insert ACN/ABN I am currently a 2 of 3 ACN: 4 ABN: 4 and am authorised to make this declaration on its behalf. AUTHORISATION 1 I authorise the department to: a) undertake the necessary steps to assess the credentials and financial viability of the abovenamed organisation by verifying information contained within the application, or within information provided, relevant to the ongoing administration processes or compliance of the abovenamed organisation as a provider, with, or obtaining additional information from: other Commonwealth agencies (such as the Australian Taxation Office, Australian Securities and Investments Commission) state or territory agencies law enforcement agencies credit reference agencies qualified accountants and auditors courts or tribunals any other appropriate organisation or person reasonably required as part of these checks. b) obtain any information and make any inquiries that relate to the abovenamed organisation and/or any named individual that may be relevant for the purposes of the Higher Education Support Act 2003 (the Act). c) disclose any information provided by the abovenamed organisation, or those organisations listed in point 1(a) of the Authorisation, to authorised officers of the Tertiary Education Quality and Standards Agency (TEQSA), Australia Skills Quality Authority (ASQA), the Department of Employment or other relevant sections of the department in relation to the application or ongoing administration processes or compliance of the abovenamed organisation as a provider under the Act. 2 SD_2013_V1.1

3 2 I warrant that all individuals named in the persons of influence component in the HELP IT System have given permission for disclosure of their personal information to the department for the purposes of the Authorisation in point 1 above. 3 I warrant that all of the named individuals have been made aware that giving false or misleading information is a serious offence under section of the Schedule to the Criminal Code Act NO ILLEGAL ACTIVITIES 4 I confirm that, through its officers, employees and agents, the abovenamed organisation has not attempted and will not attempt to influence improperly an officer of the Commonwealth in connection with the assessment of applications or with ongoing administration processes or compliance of the abovenamed organisation as a provider under the Act. 5 I understand that a person who intentionally makes a false statement in a statutory declaration is guilty of an offence under section 11 of the Statutory Declarations Act 1959, and I believe that the statements in this declaration are true in every particular. 5. Signature of person making the declaration. 6. Signature of person before whom the declaration is made. Declared at On 7. Full name, qualification and address of person before whom the declaration is made (in printed letters) (Refer Note 3) Before me: 7 Qualification: 7 Address: 7 NOTE 1: A person who intentionally makes a false statement in a statutory declaration is guilty of an offence, the punishment for which is imprisonment for a term of up to four years see section 11 of the Statutory Declarations Act NOTE 2: Chapter 2 of the Criminal Code applies to all offences against the Statutory Declarations Act 1959 see section 5A of the Statutory Declarations Act NOTE 3: A Statutory declaration under the Statutory Declarations Act 1959 as amended may be made before a person who, under a law in force in a state or territory, is currently licensed or registered to practise in an occupation listed in Part 1 below, or a person who is enrolled on the roll of the Supreme Court of a state or territory, or the High Court of Australia, as a legal practitioner (however described), or a person listed in Part 2 below. 3 SD_2013_V1.1

4 Part 1 Occupations Chiropractor Dentist Legal practitioner Medical practitioner Nurse Optometrist Patent attorney Pharmacist Physiotherapist Psychologist Trade marks attorney Veterinary surgeon Part 2 Other persons Agent of the Australia Postal Corporation who is in charge of an office supplying postal services to the public Australian Consular Officer, or Australian Diplomatic Officer, (within the meaning of the Consular Fees Act 1955) Bailiff Bank officer with 5 or more continuous years of service Building society officer with 5 or more years of continuous service Chief executive officer of a Commonwealth court Clerk of a court Commissioner for Affidavits Commissioner for Declarations Credit union officer with 5 or more years of continuous service Employee of the Australian Trade Commission who is: a) in a country or place outside Australia; and b) authorised under paragraph 3(d) of the Consular Fees Act 1955; and c) exercising his or her function in that place Employee of the Commonwealth who is: a) in a country or place outside Australia; and b) authorised under paragraph 3(c) of the Consular Fees Act 1955; and c) exercising his or her function in that place Fellow of the National Tax Accountants Association Finance company officer with 5 or more years of continuous service Holder of a statutory office not specified in another item in this Part Judge of a court Justice of the Peace Magistrate Marriage celebrant registered under Subdivision C of Division 1 of Part IV of the Marriage Act 1961 Master of a court Member of Chartered Secretaries Australia Member of Engineers Australia, other than at the grade of student Member of the Association of Taxation and Management Accountant Member of the Australian Defence Force who is: a) an officer, or b) a non-commissioned officer within the meaning of the Defence Force Discipline Act 1982 with 5 or more years of continuous service; or c) a warrant officer within the meaning of that Act Member of the Institute of Chartered Accountants in Australia, the Australian Society of Certified Practising Accountants or the Institute of Public Accountants Member of: a) the Parliament of the Commonwealth; or b) a Parliament of a state; or c) a territory legislature; or d) a local government authority of a state or territory Minister of religion registered under Subdivision A of Division 1 of Part IV of the Marriage Act 1961 Notary public Permanent employee of the Australia Postal Corporation with 5 or more years of continuous service who is employed in an office supplying postal services to the public Permanent employee of: a) the Commonwealth or a Commonwealth authority; or b) a state or territory or a state or territory authority; or c) a local government authority; with 5 or more years of continuous service who is not specified in another item in this Part. Person before whom a statutory declaration may be made under the law of the state or territory in which the declaration is made Police Officer Registrar, or Deputy Registrar, of a court Senior Executive Service employee of: a) the Commonwealth or a Commonwealth authority; or b) a state or territory or a state or territory authority Sheriff Sheriff s officer Teacher employed on a full-time basis at a school or tertiary education institution Member of the Australasian Institute of Mining and Metallu 4 SD_2013_V1.1

5 Privacy and Confidentiality Information Notice All personal information collected by the Australian Government Department of Education (the department) is protected by the Privacy Act The department collects personal information in order to properly and efficiently carry out its functions, and only uses personal information for the purposes for which it was given to the department (unless otherwise required by or authorised under law). The department collects personal information from entities applying for approval, or entities approved to offer, FEE-HELP and/or VET FEE-HELP to eligible students to enable checks to be undertaken to assess whether the entities are, or continue to be, suitable to be approved providers under the Higher Education Support Act 2003 (the Act). The statutory declaration is used to authorise the department to obtain further information about the entity and/or any named individuals of the entity from the department s own records and databases, publicly available records of the Australian Securities and Investment Commission, credit rating agencies, other Commonwealth agencies, state or territory agencies (including regulatory authorities and agencies), law enforcement agencies, qualified accountants and/or other appropriate organisations or persons reasonably required as part of the application or ongoing administration or compliance processes. The declaration also authorises the department to disclose related information to: the Department of Employment Tertiary Education Quality Standards Agency (TEQSA) Australian Skills Quality Agency (ASQA) other relevant sections of the department other agencies or bodies permitted under the Act. in relation to the ongoing administration or compliance of the entity under the Act. Exceptions to confidentiality The department s obligation to keep an entity s information confidential will not be breached if the information: is disclosed by the department to the responsible Minister is disclosed by the department in response to a request by a House or a Committee of the Parliament of the Commonwealth of Australia is authorised or required by law to be disclosed, or is in the public domain. Entities should note that there are provisions for access to records held by the department under the Freedom of Information Act 1982, the Auditor-General Act 1997 and the Ombudsman Act SD_2013_V1.1

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