Associates Template #2

Associates template #2

To be completed for the purposes of Part 4 of the application form: ‘Details of the applicant’s associates—where the applicant is an individual’.

Notes on completion

This template must be used by an applicant that is an individual to provide the information listed in Table 2 in Part 4 of the application form.

The applicant must complete the template by inserting, either electronically or in handwriting, the relevant information where prompted. Where there is insufficient space to provide information about all associates in a particular category, the applicant should copy and paste additional tables into the relevant part of the template, as necessary.

Applicants are reminded that Part 6 of the application form requires them to declare that they:

> understand that a person who knowingly or recklessly makes a false statement in, or in connection with, an application for a licence is guilty of an offence under section 136.1 of the Criminal Code (Cth);

> believe that the statements made in the application form and its attachments are true in every particular.

Name of applicant

Insert applicant’s name as it appears in Part 1 of the application form

Part A: Applicant’s spouse or de facto partner

Insert the relevant information in the right-hand column of the table. The term ‘de facto partner’ has the meaning given by section 2D of the Acts Interpretation Act 1901.

Details of the spouse or de facto partner

Name
Address

Part B: Bodies corporate in which the applicant controls at least 15 per cent of the voting power or holds at least 15 per cent of the issued shares

Insert the relevant information in the right-hand column of each table.

Details of body corporate #1

Name
ACN/ARBN
Registered office address or principal office address

Details of body corporate #2

Name
ACN/ARBN
Registered office address or principal office address

Details of body corporate #3

Name
ACN/ARBN
Registered office address or principal office address

Details of body corporate #4

Name
ACN/ARBN
Registered office address or principal office address

Applicants should copy and paste additional tables here as necessary to provide details of all associates that fall within this category.

Part C: Bodies corporate of which the applicant is a director or secretary

Insert the relevant information in the right-hand column of each table.

Details of body corporate #1

Name
ACN/ARBN
Registered office address or principal office address

Details of body corporate #2

Name
ACN/ARBN
Registered office address or principal office address

Details of body corporate #3

Name
ACN/ARBN
Registered office address or principal office address

Details of body corporate #4

Name
ACN/ARBN
Registered office address or principal office address

Applicants should copy and paste additional tables here as necessary to provide details of all associates that fall within this category.

Part D: Related bodies corporate in relation to a body corporate of which the applicant is a director or secretary

Insert the relevant information in the right-hand column of each table. The term ‘related body corporate’ is defined in sections 9 and 50 of the Corporations Act 2001.

Details of related body corporate #1

Name
ACN/ARBN
Registered office address or principal office address
Why the associate meets the definition of a ‘related body corporate’

Details of related body corporate #2

Name
ACN/ARBN
Registered office address or principal office address
Why the associate meets the definition of a ‘related body corporate’

Applicants should copy and paste additional tables here as necessary to provide details of all associates that fall within this category.

Part E: Other persons (other than the Commonwealth represented by the ACMA) who have a relevant agreement with the applicant that is of a type described in subparagraph 2.2(1)(c)(i) or 2.2(1)(c)(ii) of the Radiocommunications (Spectrum Licence Allocation—1800 MHz Band) Determination 2015 (the Allocation Determination)

Insert the relevant information in the right-hand column of each table. The term ‘relevant agreement’ is defined in subsection 2.2(2) of the Allocation Determination.

Details of person #1

Name
ACN/ARBN (if applicable)
Address (if the person is a body corporate, enter the person’s registered office or principal office address)
Why the agreement meets the definition of ‘relevant agreement’

Details of person #2

Details of person #3

Applicants should copy and paste additional tables here as necessary to provide details of all associates that fall within this category.

ACMA 1800 MHz auction | Associates template #2—individual(s)1 of 9