Fillable FORM A12 - T2: Annual summary of nancial (New South Wales)

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FORM A12 - T2: Annual summary of nancial (New South Wales)

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Form A12 – T2 – Annual summary of nancial affairs - Tier 2
FORM A12 - T2
Annual summary of nancial affairs – Tier 2
Associations Incorporation Act 2009 (section 49)
1800 502 042 fairtrading.nsw.gov.au
Please read this information before completing this form.
This form can be completed in Adobe Reader and saved for your records.
Tier 2 associations
The Associations Incorporation Act 2009 establishes a two
tier reporting regime for associations registered in NSW.
An association is a Tier 2 association if:
• the gross receipts/total revenue (income/money
collected) of the association for the association’s
nancial year is less than $250,000, AND
• the current assets (cash/bank accounts/shares) of the
association for the association’s nancial year is less
than $500,000.
The fact sheet titled `Financial reporting requirements’ on
www.fairtrading.nsw.gov.au provides information on the
reporting requirements for Tier 1 and Tier 2 associations.
When should this form be used?
The association’s nancial statements must be presented
to the annual general meeting (AGM) BEFORE this form
can be lodged.
This form must be lodged by the association within one
month after each AGM.
Association details (part 1)
Name - please ensure the correct name and incorporation
number of the association is included in this section.
Principal activity - Tick one box that best describes the
main activity of the association.
Current public ofcer and ofcial address
(part 2)
Insert details of the public ofcer and ofcial address as at
the date of completing this form.
Form A9, Notice of appointment of public ofcer & Notice
of change of association address, must be lodged with this
form if the public ofcer or ofcial address has changed
since your last lodgement.
The ofcial address must be a physical address in NSW
where the public ofcer can generally be found. It must be
premises at which documents can be received by post.
The ofcial address cannot be a post ofce box.
Date of nancial year end (part 3)
The nancial year is an annual period that ends on a
specied date. This date should be set in the association’s
constitution. The association’s nancial statements are
based on its nancial year.
Date of annual general meeting (part 4)
The AGM must be held after the end of the Association’s
nancial year. The form will be returned if the date of the
AGM is earlier than the nancial year end date.
Financial summary (part 5)
Part 5 conrms the association’s Tier 2 reporting. Tick Yes
or No against each question from a. to d.
Members (part 6)
An association must have 5 or more members AND 3 or
more committee members to remain incorporated. Tick
Yes or No for both questions
a. and b.
Declaration (part 7)
The declaration on the reverse of the form MUST be
completed by a person authorised by the committee.
This form may be returned if:
• it is not completed correctly, or
• it is received without payment.
Fees
The following fees apply for the lodgement of an Annual
summary of nancial affairs - Tier 2
(Form A12 - T2):
• $48.00 (If lodged not more than one month after the
annual general meeting)
• $77.00 (If lodged more than one month but less than
two months after the annual general meeting)
• $85.00 (If lodged more than two months after the
annual general meeting)
How to lodge
• By email to
registrylodgements@customerservice.nsw.gov.au
ensuring a copy of the receipt of payment is attached.
• By post to Registry and Accreditation, PO Box 22,
Bathurst NSW 2795, ensuring a copy of the receipt of
payment is included.
• In person at any Service NSW Centre. For the address
of your nearest Service NSW Centre please telephone
13 77 88 or visit www.service.nsw.gov.au/service-centre
PAGE 2 of 2Form A12 – T2 – Annual summary of nancial affairs - Tier 2
How to pay the lodgement fee
Pay by credit card or PayPal using the following link:
www.fairtrading.nsw.gov.au/registrypayments
Step 1
- Click on the link or type the URL into your
web browser.
Step 2
- Follow the instructions online to complete
payment. (select `Registry and Accreditation’ as
the agency)
Step 3
- You will receive a receipt upon payment.
Step 4 - Attach a copy of the receipt to the form.
Not providing this information may result in delays in
processing your form.
Alternatively, if you intend to pay by cheque or money order
this can be done in person at any Service NSW Centre.
Cheques or money orders should be made payable to NSW
Fair Trading.
Contacting Registry and Accreditation
Telephone 1800 502 042
Mail Registry and Accreditation
PO Box 22
Bathurst NSW 2795
Website www.fairtrading.nsw.gov.au/
associations-and-co-operatives/associations
Assistance
Telephone - 13 14 50
Ask for an interpreter in your language.
TTY - 133 677
Telephone service for the hearing impaired.
The above information is intended as a guide only and is included to assist you in completing and lodging this
form. This page is not part of the form. If required, professional advice should be obtained regarding the matters
dealt with in this form.
PAGE 1 of 2Form A12 – T2 – Annual summary of nancial affairs - Tier 2
FORM A12 - T2
Annual summary of nancial affairs – Tier 2
Associations Incorporation Act 2009 (section 49)
Registry use only
Updated July 2021
1800 502 042 fairtrading.nsw.gov.au
Please read the information before completing this form.
This form can be completed in Adobe Reader and saved for your records.
Fee (GST free) - $48.00
Additional late fees may be payable
1. Association details
Name
INCORPORATED
Registration number (not ABN) INC or Y
1. Aged care/respite care/home care
2. Arts/culture/literary/heritage
3.
Business/professional association
4. Child care services
5. Education/employment/training/research
6. Environment/horticulture/animal protection
7. Legal/civic/advocacy services
8. Personal interest/hobby group/social group
9. Religious
10. Social services/community association
11. Sporting
12. Other
Title Given name(s) Family/Surname
Ofcial address
The principal activity of the association is
(tick 1 box only)
2. Current public ofcer and ofcial address
THE FOLLOWING OFFICIAL ADDRESS CANNOT BE A POST OFFICE BOX
Suburb State Postcode
Association email
3. Date of nancial year end
Financial year end (FYE) date:
(DD/MM/YYYY)
4. Date of annual general meeting
Annual general meeting (AGM) date:
(DD/MM/YYYY)
The AGM date MUST BE AFTER the FYE date.
DO NOT attach minutes of meeting.
5. Financial summary (DO NOT attach the nancial report to this form.)
a. Is the association’s income LESS THAN
Yes
No
$250,000 ?
b. Is the association’s current assets* LESS THAN
Yes
No
$500,000 ?
* Current assets include cash, bank accounts and shares
c. Is the value of total assets MORE THAN $5 million?
Yes
No
d. Does the association own real property*?
* Real property is land or buildings
Yes
No
If you tick ‘NO’ to EITHER
question, please complete a
Form A12 - T1 Annual summary
of nancial affairs - Tier 1.
6. Members
(An association must have 5 or more members and 3 or more committee members to remain incorporated.)
a. Does the association have 5 or more members?
Yes
No
b.
Does the association have 3 or more
Yes
No
committee members?
If you tick ‘NO’ to EITHER
question, the association
must take steps immediately
to increase these numbers.
PAGE 2 of 2Form A12 – T2 – Annual summary of nancial affairs - Tier 2
7. Declaration and privacy acknowledgement
I declare:
• I am authorised by the committee to make the following statements,
– the association’s nancial statements for the last nancial year were presented to the members of the
association at the annual general meeting,
– the particulars set out in this document are correct and give a true and fair view of the nancial matters to
which they relate and are not misleading, and
– there are reasonable grounds to believe, at the date of this statement that the association will be able to pay
its debts as and when they fall due.
I acknowledge:
• NSW Fair Trading is collecting and holding information (including personal information) supplied in this form
for the purposes of the Associations Incorporation Act 2009 and in particular, inclusion in a register maintained
under that Act which is open to public inspection,
• NSW Fair Trading may disclose personal information to persons or bodies and to receive information from them
in respect of purpose(s) related to the association’s incorporation and activities, and
• I have a right to seek access to and correction of the personal information supplied/collected from me.
Signature
Date signed (DD/MM/YYYY)
This form is designed to be completed in Adobe Reader. A cross appearing in the digital signature eld above may
indicate a compatibility issue. If a cross appears please sign here
......................................................................................................................................................................................................................................................
Printed name
Position held
Please DO NOT submit other documents such as minutes or nancial records with this form
click to sign
signature
click to edit
Form A12 – T2 – Annual summary of nancial affairs - Tier 2
THIS PAGE DOES NOT CONSTITUTE PART OF THE FORM AND WILL NOT BE PLACED ON THE PUBLIC REGISTER.
Who should NSW Fair Trading contact if there is a query about this form?
Title Given name(s) Family/Surname
Contact number Mobile number
Address
Suburb State Postcode
Email address
How to pay The fee must be paid on lodgement of the form
Pay by credit card or PayPal using the following link: www.fairtrading.nsw.gov.au/registrypayments
Step 1 - Click on the link or type the URL into your web browser.
Step 2 - Follow the instructions online to complete payment (select `Registry and Accreditation’ as the agency).
Step 3 - You will receive a receipt upon payment.
Step 4 - Attach a copy of the receipt to the form.
Not providing this information may result in delays in processing your form.
Alternatively you can pay by cheque or money order made payable to NSW Fair Trading, or in person at any
Service NSW Centre.
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FORM A12 - T2: Annual summary of nancial (New South Wales)

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Completed 12 May 2022

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