Information About the Form

Information About the Form

Declaration pursuant to Section 24 of Political Parties (Registration, Conduct, Funding and Disclosures) Decree, 2013

Information about the Form:

  1. The Form is in Microsoft Word version to allow you to add more details if the space provided is not sufficient.
  2. Please do not mark or write any information on this cover page. At the time of publication, only the Form will be published.
  3. Information submitted on the cover page will not be considered.
  4. The information provided on this form will be published by the Registrar of Political Parties and the person submitting the form is required to pay for such costs.
  5. For the purposes of the declaration, ‘children’ means any child, step child or adopted child who is –
  6. under the age of 18 years
  7. over the age of 18 years and is dependent on his or her parents for support.
  8. According to section 24 (5), any person who submits any information that is false, commits an offence and shall be liable upon conviction to a fine not exceeding $50,000 or to a term not exceeding 10 years or both.

DECLARATION OF ASSETS, LIABILITIES AND INCOME AS AT:______/ ______/ 2014

Name of Declarant: Political Party:

Residential Address:

Position held in Political Party: Date of Appointment://

Particulars of Spouse & Dependent Children

Name of Spouse:

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  1. Name of Child:
  2. Name of Child:
  3. Name of Child:
  4. Name of Child:

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Particulars of Income[Salaries, Wages, Fees, Gratuities, Allowances, Dividends, Interest, etc. from Fiji & Abroad]

Type of Income / Name of Person Receiving / Source of Income / Value Declared - $

Particulars of Assets in Fiji or Abroad [Property, Vehicles, Cash, Shares, Bonds, etc.]

Type of Asset / Details or Description of Asset / Holder / Recipient / Value Declared - $

Particulars of Liabilities in Fiji or Abroad [Loans, Creditors, Debts, etc.]

Type of Liability / Particulars of Liability / Holder/ Recipient / Value Declared - $

Other details: [Particulars of any other business connections, directorships, transactions or gifts in Fiji or Abroad]:

Description / Details / Holder/ Recipient / Value Declared - $

Statutory Declaration

I solemnly and sincerely declare that the above particulars are true and complete declarations as required under the Political Parties (Registration, Conduct, Funding and Disclosures) Decree 2013.

Declared at this ____day of ,2014 before me and I certify that the declaration was read over in the language to the declarant who appeared fully to understand the meaning thereof

[Person authorized to take statutory declarations.]

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