Principal Executive Officer declaration form (Charities)

Information status

All documents issued prior to 1 July 2017 were issued by the former Department of Commerce. Documents listed here are the latest versions available. For more information on this document, please contact online@dmirs.wa.gov.au.

This publication is for: 
Not for profit

This form is an integral part of any application for, or renewal of, a Charitable Collections Licence, and may also be used to advise of a change in office bearers or director of a licence holder.

Part of the responsibility of the Charitable Collections Advisory Committee is to ensure all licence holders, and those administering any organisation holding a licence, are fit and proper persons to deal with public collection monies. To assist with the exercise of this responsibility, all those persons who have been identified as a Principal Executive Officer are required to provide an original Police Certificate (no older than six months).

Consumer Protection
Form – notification
Last updated 22 Mar 2017

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