Docstoc

A - Guide - CMAA

Document Sample
A - Guide - CMAA Powered By Docstoc
					3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                               A - Guide



                             GUIDELINES TO DIRECTOR'S REPORTING REQUIREMENT

        The legislation provides for the Director of Liquor and Gaming to
        approve the form in which information is gathered and reported.

        To comply with C.41G requires registers to maintained by secretary for Division 2 returns
        In particular:
          Returns of S.41C                                 directors                      General interests              Worksheet 3
          Returns of S.41D                                 directors     top executives   Interests in hotels            Worksheet 3
          Returns of S.41E                                 directors     top executives   Gifts from affiliated bodies   Worksheet 2
          Returns of S.41F                                 directors     top executives   Gifts from contractors         Worksheet 1

        To comply with S.41H (1) requires information be sent to members.
          (a) Include worksheet 4 as an addendum to the club's annual report; and
          (b) to (l) Include worksheet 6 as an addendum to the club's annual report.


          HOW TO USE THIS SPREADSHEET
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                      B - DLG Approved Forms



                                           FORMS APPROVED BY THE DIRECTOR

                                                        Effective 16 June 2004


        Section 41E (2)(a) Gifts from Affiliated Bodies [Sheet 3 - Disclose within 14 days ]
             The details required include:
             1     A club reference number for each declaration.
             2     Date the person made the declaration to the club.
             3     Name of person making the declaration.
             4     Whether the person is a member of the governing body.
             5     Whether the person is a top executive.
             6     Description of gift.
             7     Date the person received the gift.
             8     Name of entity providing the gift.
             9     Value of gift.
             10    Signature of the person making the declaration if a hard copy kept.


        Clause 47F (1)(c) Gifts from Contractors [Sheet 4 - Annual Return ]
             The details required include:
             1     A club reference number for each declaration.
             2     Date the person made the declaration to the club.
             3     Name of person making the declaration.
             4     Whether the person is a member of the governing body.
             5     Whether the person is an employee of the club.
             6     Description of gift.
             7     Date the person received the gift.
             8     Name of entity providing the gift.
             9     Value of Gift.
             10    Signature of the person making the declaration if a hard copy kept.


        Clause 47G (2)(d) Register kept by secretary [Sheet 5 - Available for inspection ]
             In respect to Section 41C, the details required include:
             1.1    A club reference number.
             1.2    Date the declaration was made.
             1.3    Name of person making the declaration.
             1.4    Date the person became aware of the interest.
             1.5    Contractor name.
             1.6    Contract description or nature.
             1.7    Nature of interest.
             1.8    Signature of the person making the declaration if a hard copy kept.

             In respect to Section 41D, the details required include:
             2.1    A club reference number.
             2.2    Date the declaration was made.
             2.3    Whether the person is a director or top executive.
             2.4    Date of appointment of director or date employee became a top executive.
             2.5    Date the person became aware of interest.
             2.6    The nature of the interest including the name and licence number of hotel or hotels and where appropriate holding
                    company name and ACN number.
             2.7    Signature of the person making the declaration if a hard copy kept.

             3      In respect to Section 41E, the details and form required is the same as approved by the Director pursuant to Section
                    41E(2)(a).

             4      In respect to Section 41F the details and form required is the same as approved by the Director pursuant to Clause 47
                    (1)(c).




        Clause 47H (f) Annual report information (a) to (l) [Sent to Members ]

                                                                                                                                            Page 2 of 86
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                        B - DLG Approved Forms



                                           FORMS APPROVED BY THE DIRECTOR

                                                           Effective 16 June 2004

             The details required include:
             1     The material is to be printed on white paper in black print in a font size not less than 10 point.
             2     The material is to be on separate pages without any other material.
             3     The information must have a suitable message to the effect that the information:
             3.1   Is important information for club members.
             3.2   Is in a form approved by the Director of Liquor and Gaming.
             3.3   Must be sent to members of the club.
             4     A message advising that the original declarations, disclosures and returns made pursuant to sections 41C, 41D, 41E and
                   41F are held in the secretary registers may be inspected by members on written application to the secretary.

             5      Name of the club, serial number and the date of the reporting period.
             6      In respect to the details of the information:
             6.1    Refer to ss (a). Number of declarations, disclosures and returns received pursuant to S.41C to S.41F and the total value
                    of all gifts reported pursuant to s.41E to s.41F.
             6.2    Refer to ss (b). As per sub-section.
             6.3    Refer to ss (c). Name of person travelling, Whether a director or employee, Destination, Nature or Purpose of Travel,
                    Date approved by Board, Costs paid for directors/employees, and other persons paid by the club.
             6.4    Refer to ss (d). Date approved by Board; Date Loan Drawn, Whether loan made to director or employee; Loan Amount;
                    Interest rate; Term of Loan.
             6.5    Refer to ss (e). Number of controlled contracts approved pursuant to each section.
             6.6    Refer to ss (f). As per sub-section.
             6.7    Refer to ss (g). Date contract approved by Board, Name of consultant, Nature of consultancy, and costs paid to each
                    consultant.
             6.8    Refer to ss (h). As per sub-section.
             6.9    Refer to ss (i). Number of settlements with a.) directors, and b.) employees, Total value of all settlements, Legal fees
                    paid by the club for the director or employee.
             6.10   Refer to ss (j). Number of instances when the club paid legal fees with a.) directors, and b.) employees, that did not
                    include ss (j), Total value of legal fees paid by the Club for the director or employee.
             6.11   Refer to ss (k). As per sub-section.
             6.12   Refer to ss (l). As per sub-section.




                                                                                                                                               Page 3 of 86
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                                             1 - S.41C Interests Contracts
                                                                DISCLOSURES OF INTERESTS IN CONTRACTS




 Club       Date   Name of Person                  Date          Contractor                            Contract Description                   Nature of interest        Signature
 Ref:     Declared    Making                    Became
           to Club   Declaration                Aware of
                                                 Interest
    (A)      (B)               (C)                  (D)              (E)                                      (F)                                     (G)                    (H)
1         1-May-04      Citizen, John          25-Apr-04 Citizen Meats                            Supply of meat                        Brother is proprietor of
                                                                                                                                        Citizen Meats
2         3-May-04      Doe, Mary              29-Apr-04       Zippy Cleaning P/L                 Supply of cleaning products           Sister is director of
                                                                                                                                        company.
3         15-May-04 Doe, John                  2-May-04        Snappy Peanuts P/L                 Supply of peanuts                     Director of Snappy Peanuts
                                                                                                                                        Pty Ltd.

          Total number of declarations made by DIRECTORS in reporting period……………………………………..…
                                                                                        0




1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20




This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                               Page 4 of 86
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                                 1 - S.41C Interests Contracts
                                                                DISCLOSURES OF INTERESTS IN CONTRACTS




21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56




This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                   Page 5 of 86
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                                 1 - S.41C Interests Contracts
                                                                DISCLOSURES OF INTERESTS IN CONTRACTS




57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92




This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                   Page 6 of 86
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                                 1 - S.41C Interests Contracts
                                                                DISCLOSURES OF INTERESTS IN CONTRACTS




93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128




This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                   Page 7 of 86
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                                 1 - S.41C Interests Contracts
                                                                DISCLOSURES OF INTERESTS IN CONTRACTS




129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164




This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                   Page 8 of 86
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                                 1 - S.41C Interests Contracts
                                                                DISCLOSURES OF INTERESTS IN CONTRACTS




165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190




This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                   Page 9 of 86
      3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                                              2 - S.41D Interests Hotels
                                                                                        DISCLOSURES OF HOTEL INTERESTS




                                                      Director
Club         Date          Name of Person                                      Date           Date     What is the nature of your interest in the hotel? Include name of            Signature




                                                                 Executive
Ref:       Declared           Making                                         Appointed     Became each hotel/s, licence number and where appropriate the company,
            to Club          Declaration                                                   Aware of                   address and serial or ACN number.




                                                                 Top
                                                                                            Interest
    (A)       (B)                 (C)              (D)               (E)         (F)           (G)                                     (H)                                                (I)
1         1-May-04       Citizen, John            1                          1-Jun-02     25-Apr-04 Director and shareholder of Hotelex Corp P/L ACN : 007 123 456,
                                                                                                     which owns Railway Hotel, serial 21123, 1 Victoria St, Sydney,
2         3-May-04       Citizen, Mary                           1           29-Apr-04    29-Apr-04 1/2 share Partner with John Smith as owner of Royal Hotel, serial
                                                                                                     21456, 50 Royal St., Sydney
3         15-May-04      Doe, John                1                          1-Jun-03     2-May-04 25% share holder of 'Hotels R Us P/L ACN: 008 456 123, which has
                                                                                                     just acquired the Outback Hotel, Serial 22345, 11 Jones St., Sydney.


          Total declarations made by DIRECTORS………………………..….…
                                                       0
          Total declarations made by TOP EXECUTIVES……………..……….
                                                       0


1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19




      This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                           Page 10 of 86
     3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                                 2 - S.41D Interests Hotels
                                                                           DISCLOSURES OF HOTEL INTERESTS




20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55




     This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.              Page 11 of 86
     3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                                 2 - S.41D Interests Hotels
                                                                           DISCLOSURES OF HOTEL INTERESTS




56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91




     This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.              Page 12 of 86
      3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                                 2 - S.41D Interests Hotels
                                                                            DISCLOSURES OF HOTEL INTERESTS




92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127




      This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.              Page 13 of 86
      3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                                 2 - S.41D Interests Hotels
                                                                            DISCLOSURES OF HOTEL INTERESTS




128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163




      This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.              Page 14 of 86
      3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                                 2 - S.41D Interests Hotels
                                                                            DISCLOSURES OF HOTEL INTERESTS




164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190




      This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.              Page 15 of 86
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                          REGISTER OF GIFTS FROM AFFILIATED BODIES                                                             3 - S.41E Gifts (Affiliates)




                                                                                                                   Received
                                             Director

                                                        Top Exec




                                                                                                                   Date Gift
Club   Date   Name of Person                                       Description / Nature of Gift                                Affiliated Body Providing Gift    Gift        Signature
Ref: Reported    Making                                                                                                                                         Value
      to Club   Declaration                                                                                                                                       $

 (A)    (B)                 (C)             (D) (E)                        (F)                                    (G)                   (H)                       (I)             (J)
1    1-May-04        Citizen, John          1       Doulton Cultery                                            25-Apr-04 City Football Club P/L                 $650
2    3-May-04        Citizen, Mary              1   Promotional Clothing                                       29-Apr-04 Kids In Need P/L                       $540
3    5-May-04        Doe, John              1       Various clothing and office equipment                      30-Jun-04 Bay Rowing P/L                         $880
                                                    individually value at under $500 and
                                                    received between 15 Apr 04 and 30 Jun 04


                     Total number of gifts (valued at more than $500) received by DIRECTORS ………………...………………..…....……0
                     Total number of gifts (valued at more than $500) received by TOP EXECUTIVES...……………………………….…. 0
                     Total value of gifts (valued at more than $500) received by abovementioned persons…………………………………………
                                                                                                                    $0


1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20




 This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                               Page 16 of 2
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                          REGISTER OF GIFTS FROM AFFILIATED BODIES                                                             3 - S.41E Gifts (Affiliates)




                                                                                                                   Received
                                             Director

                                                        Top Exec




                                                                                                                   Date Gift
Club   Date   Name of Person                                       Description / Nature of Gift                                Affiliated Body Providing Gift    Gift        Signature
Ref: Reported    Making                                                                                                                                         Value
      to Club   Declaration                                                                                                                                       $

 (A)       (B)                (C)           (D) (E)                              (F)                                (G)                        (H)               (I)              (J)
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52




 This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                               Page 17 of 2
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                          REGISTER OF GIFTS FROM AFFILIATED BODIES                                                             3 - S.41E Gifts (Affiliates)




                                                                                                                   Received
                                             Director

                                                        Top Exec




                                                                                                                   Date Gift
Club   Date   Name of Person                                       Description / Nature of Gift                                Affiliated Body Providing Gift    Gift        Signature
Ref: Reported    Making                                                                                                                                         Value
      to Club   Declaration                                                                                                                                       $

 (A)       (B)                (C)           (D) (E)                              (F)                                (G)                        (H)               (I)              (J)
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84




 This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                               Page 18 of 2
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                          REGISTER OF GIFTS FROM AFFILIATED BODIES                                                             3 - S.41E Gifts (Affiliates)




                                                                                                                   Received
                                             Director

                                                        Top Exec




                                                                                                                   Date Gift
Club   Date   Name of Person                                       Description / Nature of Gift                                Affiliated Body Providing Gift    Gift        Signature
Ref: Reported    Making                                                                                                                                         Value
      to Club   Declaration                                                                                                                                       $

 (A)       (B)                (C)           (D) (E)                              (F)                                (G)                        (H)               (I)              (J)
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116




 This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                               Page 19 of 2
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                          REGISTER OF GIFTS FROM AFFILIATED BODIES                                                             3 - S.41E Gifts (Affiliates)




                                                                                                                   Received
                                             Director

                                                        Top Exec




                                                                                                                   Date Gift
Club   Date   Name of Person                                       Description / Nature of Gift                                Affiliated Body Providing Gift    Gift        Signature
Ref: Reported    Making                                                                                                                                         Value
      to Club   Declaration                                                                                                                                       $

 (A)       (B)                (C)           (D) (E)                              (F)                                (G)                        (H)               (I)              (J)
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148




 This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                               Page 20 of 2
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                          REGISTER OF GIFTS FROM AFFILIATED BODIES                                                             3 - S.41E Gifts (Affiliates)




                                                                                                                   Received
                                             Director

                                                        Top Exec




                                                                                                                   Date Gift
Club   Date   Name of Person                                       Description / Nature of Gift                                Affiliated Body Providing Gift    Gift        Signature
Ref: Reported    Making                                                                                                                                         Value
      to Club   Declaration                                                                                                                                       $

 (A)       (B)                (C)           (D) (E)                              (F)                                (G)                        (H)               (I)              (J)
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180




 This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                               Page 21 of 2
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                          REGISTER OF GIFTS FROM AFFILIATED BODIES                                                             3 - S.41E Gifts (Affiliates)




                                                                                                                   Received
                                             Director

                                                        Top Exec




                                                                                                                   Date Gift
Club   Date   Name of Person                                       Description / Nature of Gift                                Affiliated Body Providing Gift    Gift        Signature
Ref: Reported    Making                                                                                                                                         Value
      to Club   Declaration                                                                                                                                       $

 (A)       (B)                (C)           (D) (E)                              (F)                                (G)                        (H)               (I)              (J)
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204




 This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                               Page 22 of 2
    3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                              REGISTER OF GIFTS FROM CONTRACTORS                                                                 4 - S.41F Gifts (Contractors)




                                                       Director

                                                                  Staff
Club         Date          Name of Person                                   Description / Nature of Gift                 Date Gift      Contractor Providing Gift     Gift            Signature
Ref:       Reported       Making Declaration                                                                             Received                                    Value
            to Club                                                                                                                                                    $

    (A)      (B)                    (C)               (D) (E)                       (F)                      (G)               (H)                                     (I)                 (J)
1         1-May-04        Citizen, John               1       Doulton Cultery                            25-Apr-04 Gaming Enterprises P/L                           $650
2         3-May-04        Citizen, Mary                   1   Promotional Clothing                       29-Apr-04 Boutique Brewers P/L                             $540
3         5-May-04        Doe, John                   1       4 Gifts: various clothing and office       30-Jun-04 Fantastic Gaming P/L                             $880
                                                              equipment individually value at under $500
                                                              and received between 15 Apr 04 and 30
                                                              Jun 04

          Total number of gifts received by DIRECTORS ………………………………………………………...……
                                                                          0
          Total number of gifts received by STAFF………………………………………...…………...0
          Total value of all gifts received…………………………..………………………..………………………
                                                                          $0


1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20




    This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                                   Page 23 of 2
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                              REGISTER OF GIFTS FROM CONTRACTORS                                                               4 - S.41F Gifts (Contractors)




                                                    Director

                                                               Staff
Club      Date          Name of Person                                   Description / Nature of Gift                 Date Gift      Contractor Providing Gift    Gift           Signature
Ref:    Reported       Making Declaration                                                                             Received                                   Value
         to Club                                                                                                                                                   $

 (A)         (B)                  (C)              (D) (E)                              (F)                               (G)                       (H)           (I)                 (J)
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52




 This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                                 Page 24 of 2
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                              REGISTER OF GIFTS FROM CONTRACTORS                                                               4 - S.41F Gifts (Contractors)




                                                    Director

                                                               Staff
Club      Date          Name of Person                                   Description / Nature of Gift                 Date Gift      Contractor Providing Gift    Gift           Signature
Ref:    Reported       Making Declaration                                                                             Received                                   Value
         to Club                                                                                                                                                   $

 (A)         (B)                  (C)              (D) (E)                              (F)                               (G)                       (H)           (I)                 (J)
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84




 This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                                 Page 25 of 2
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                              REGISTER OF GIFTS FROM CONTRACTORS                                                               4 - S.41F Gifts (Contractors)




                                                    Director

                                                               Staff
Club      Date          Name of Person                                   Description / Nature of Gift                 Date Gift      Contractor Providing Gift    Gift           Signature
Ref:    Reported       Making Declaration                                                                             Received                                   Value
         to Club                                                                                                                                                   $

 (A)         (B)                  (C)              (D) (E)                              (F)                               (G)                       (H)           (I)                 (J)
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116




 This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                                 Page 26 of 2
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                              REGISTER OF GIFTS FROM CONTRACTORS                                                               4 - S.41F Gifts (Contractors)




                                                    Director

                                                               Staff
Club      Date          Name of Person                                   Description / Nature of Gift                 Date Gift      Contractor Providing Gift    Gift           Signature
Ref:    Reported       Making Declaration                                                                             Received                                   Value
         to Club                                                                                                                                                   $

 (A)         (B)                  (C)              (D) (E)                              (F)                               (G)                       (H)           (I)                 (J)
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148




 This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                                 Page 27 of 2
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                              REGISTER OF GIFTS FROM CONTRACTORS                                                               4 - S.41F Gifts (Contractors)




                                                    Director

                                                               Staff
Club      Date          Name of Person                                   Description / Nature of Gift                 Date Gift      Contractor Providing Gift    Gift           Signature
Ref:    Reported       Making Declaration                                                                             Received                                   Value
         to Club                                                                                                                                                   $

 (A)         (B)                  (C)              (D) (E)                              (F)                               (G)                       (H)           (I)                 (J)
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180




 This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                                 Page 28 of 2
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                              REGISTER OF GIFTS FROM CONTRACTORS                                                               4 - S.41F Gifts (Contractors)




                                                    Director

                                                               Staff
Club      Date          Name of Person                                   Description / Nature of Gift                 Date Gift      Contractor Providing Gift    Gift           Signature
Ref:    Reported       Making Declaration                                                                             Received                                   Value
         to Club                                                                                                                                                   $

 (A)         (B)                  (C)              (D) (E)                              (F)                               (G)                       (H)           (I)                 (J)
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205




 This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                                 Page 29 of 2
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                          REGISTER OF GIFTS FROM CONTRACTORS                                                     4 - S.41F Gifts (Contractors)




This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                   Page 30 of 2
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                          REGISTER OF GIFTS FROM CONTRACTORS                                                     4 - S.41F Gifts (Contractors)




This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                   Page 31 of 2
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                          REGISTER OF GIFTS FROM CONTRACTORS                                                     4 - S.41F Gifts (Contractors)




This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                   Page 32 of 2
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                          REGISTER OF GIFTS FROM CONTRACTORS                                                     4 - S.41F Gifts (Contractors)




This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                   Page 33 of 2
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                          REGISTER OF GIFTS FROM CONTRACTORS                                                     4 - S.41F Gifts (Contractors)




This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                   Page 34 of 2
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                          REGISTER OF GIFTS FROM CONTRACTORS                                                     4 - S.41F Gifts (Contractors)




This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                   Page 35 of 2
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                          REGISTER OF GIFTS FROM CONTRACTORS                                                     4 - S.41F Gifts (Contractors)




This document is in the approved form of the Director of Liquor and Gaming and may be inspected by club members upon written request to the Secretary.                   Page 36 of 2
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                           5 - S.41H (1)(a) - (l)
                                                              IMPORTANT INFORMATION FOR CLUB MEMBERS




        THE REPORTING PERIOD FOR THE [club name] is DD/MM/200Y

1       IMPORTANT NOTES
1.1     The Registered Club Act defines a Top Executive as being one of the five highest paid employees of the Club.

2       DISCLOSURE OF INTERESTS OF DIRECTORS AND EMPLOYEES IN CONTRACTS WITH THE CLUB - SECTION 41C
2.1     Club members may inspect the original of these disclosures and declarations by making a written application to the Secretary.
2.2     The Registered Club Act requires DIRECTORS who have a material personal interest in matters that relates to the affairs of the club to declare
        the interest at a board meeting AND display the declaration on the Club's notice board.
2.3     A contract is any commercial arrangement whether written or not.
2.4     In the reporting period there were 0 occasions when DIRECTORS reported a material personal interest in a matter that related to the affairs of the club.

3       INTERESTS IN HOTELS - SECTION 41D
3.1     Club members may inspect the original of these disclosures and declarations by making a written application to the Secretary.
3.2     In the reporting period there were 0 occasions when DIRECTORS reported an interest in a hotel in NSW.
3.3     In the reporting period there were 0 occasions when TOP EXECUTIVES reported an interest in a hotel in NSW.

4       GIFTS TO DIRECTORS AND STAFF - SECTION 41E AND SECTION 41F
4.1     Club members may inspect the original of these disclosures and declarations by making a written application to the Secretary.
4.2     An affiliated body of the club includes subsidiary clubs, and any body which the club made a grant to within the previous 12 months.
4.3     A gift includes money, hospitality, or discounts.
4.4     A gift valued at more than $500 must be disclosed; gifts from CONTRACTORS must disclosed if they total more than $500 from an
        individual contractor in the reporting period.
4.5     Directors
4.5.1   In the reporting period there were 0 occasions when DIRECTORS of the club reported receiving gifts from AFFILIATED BODIES.
4.5.2   In the reporting period there were 0 occasions when DIRECTORS of the club reported receiving gifts from CONTRACTORS.
4.6     Employees
4.6.1   In the reporting period there were 0 occasions when TOP EXECUTIVES of the club reported receiving gifts from AFFILIATED BODIES.
4.6.2   In the reporting period there were 0 occasions when EMPLOYEES of the club reported receiving gifts from CONTRACTORS.
4.7     Value of Gifts
4.7.1   The total value of all gifts that DIRECTORS and TOP EXECUTIVES received from AFFILIATED BODIES in the reporting period is      $0
4.7.2   The total value of all gifts that DIRECTORS and EMPLOYEES received from CONTRACTORS in the reporting period is                 $0

5       TOP EXECUTIVES - S.41H (1)(b)
5.1     In the reporting period the following TOP EXECUTIVES received total remuneration above $100,000.
        Band                        Band                  Band                               Band                      Band




 This document is in the approved form of the Director of Liquor and Gaming and MUST be sent to members of the club.                                      Page 37 of 86
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                                 5 - S.41H (1)(a) - (l)
                                                                IMPORTANT INFORMATION FOR CLUB MEMBERS




6       OVERSEAS TRAVEL - S.41H (1)(c)
6.1     In the reporting period the club incurred the following costs for the overseas travel of DIRECTORS and EMPLOYEES:
        Name                        Position                Destination                           Travel Purpose               Costs paid by club


7       LOANS TO STAFF - S.41H (1)(d)
7.1     The Registered Clubs Act restricts the club to providing loans to EMPLOYEES to less than $10,000.
7.2     In the reporting period, the Club made the following loans to EMPLOYEES:
        Loan Amount                 Date of loan            Interest Rate P.A.                                  Term of Loan


8       CONTRACTS APPROVED BY BOARD - S.41H (1)(e)
8.1     The Registered Club Act defines a Controlled Contracts as being a club contract:
8.1.1             > in which a DIRECTOR of TOP EXECUTIVE has a pecuniary interest.
8.1.2             > of employment of a TOP EXECUTIVE of the club.
8.1.3             > for provision of professional advice relating signficant change of management structure or governance of the club;
                    significant changes to the financial management of the club, disposal of land, and the amalgamation of the club.
8.2     During the reporting period            0    controlled contracts, were approved by the Board and forwarded to the Director of Liquor and Gaming
        of which:
8.3.1       0       such contracts related to contracts in which a DIRECTOR or TOP EXECUTIVE has a pecuniary interest.
8.3.2       0       such contracts related to contracts of employment of the club's TOP EXECUTIVES.
8.3.3       0       such contracts related to the provision of professional advice. These contracts fall into the following advice categories:
8.3.4                    0       Significant change of management structure or governance of the club.
8.3.5                    0       Significant changes to the financial management of the club.
8.3.6                    0       Disposal of club land.
8.3.7                    0       Amalgamation of the club.

9       EMPLOYEES RELATED TO DIRECTORS AND TOP EXECUTIVES - S.41H (1)(f)
9.1     A CLOSE RELATIVE is defined is Section 41B of the Registered Clubs Act and includes the immediate family.
9.2     In the reporting period, the club employed the following persons who were a close relative of a DIRECTOR or TOP EXECUTIVE of the Club.
        Name of Close Relative                     Related to                    Total remuneration paid to Close Relative


10      PAYMENTS TO CONSULTANTS - S.41H(1)(g) and (h)
10.1    During the reporting period there were           0       instances where the Club engaged a consultant.
10.2    The total costs paid by the Club to consultants in the reporting period was          $0
10.3    Which included the following instances when consultants were paid more than $30,000
        Consultant                  Nature of Consultancy                        ($) Amount


11      DETAILS OF SETTLEMENTS PAID BY THE CLUB - S.41H (1)(i)




 This document is in the approved form of the Director of Liquor and Gaming and MUST be sent to members of the club.                                            Page 38 of 86
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                                  5 - S.41H (1)(a) - (l)
                                                              IMPORTANT INFORMATION FOR CLUB MEMBERS




11.1    In the reporting period there were               0      instances where the Club made a legal settlement with either a director or staff member.
11.2    The total legal costs paid by the Club for such settlements was           0      which included:

12     LEGAL FEES PAID BY THE CLUB - S41H (1)(j)
12.1   In the reporting period, there were              0  instances when the club paid legal fees for DIRECTORS and EMPLOYEES This included:
12.1.1                  0      instances for DIRECTORS and
12.1.2                  0      instances for EMPLOYEES
12.2   In the reporting period the club paid a total of          0      being for legal fees paid for DIRECTORS and EMPLOYEES.

13      GAMING MACHINE PROFIT - S.41H (1)(k)
13.1    Gaming machine profit is defined in the Gaming Machines Tax Act.
13.2    The reporting period is the financial year ending 30 November
13.3    The Club recorded a gaming machine profit of                                         in the reporting period.

14      AMOUNT PAID TO COMMUNITY DEVELOPMENT - S.41H (1)(l)
14.1    Clubs earning in excess of $1,000,000 p.a. in gaming machine profit are required to make donations to community development and support.
14.2    In the reporting period the Club donated              pursuant to such requirement.




 This document is in the approved form of the Director of Liquor and Gaming and MUST be sent to members of the club.                                             Page 39 of 86
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                                          6 - S41H (1)(c) Travel
                                                                                     OVERSEAS TRAVEL




                                 Staff



                                         Persons
Club           Name                                   Destination                       Nature/ Purpose of Travel           Date      Cost for      Costs for Total Costs




                                         Director
                                          Other
Ref.                                                                                                                      approved     other        directors   paid by
                                                                                                                          by Board    person         & staff     Club
 (A)        (B)                 (C) (D) (E)          (F)                                         (G)                         (H)         (I)           (J)             (K)
1    John Citizen                 1         Las Vegas                        Study gaming venues                          23-Mar-04                                    $15,000
2    Mary Citizen                     1     New Jersey                       Study catering systems                        1-Apr-04                                     12,500
3    John Doe                             1 Shanghai                         Study catering and gaming systems            10-May-04      $2,500       $15,000          $17,500


       Overseas trips made by STAFF on behalf of Club…………………….…………………….………………       0
       Overseas trips made by DIRECTORS on behalf of Club………………………………………….………………..  0
       Overseas trips made by OTHER PERSON on behalf of Club……………………………………..…………….. 0
       Occasions when other person expenses were paid by Club…………………………………….……… $1
       Total costs paid by the Club for the abovementioned travel ……………………………………………...….
                                                                                    $3


1
2                                                                                                                                              $1            $2               $3
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19




This document is in the form approved by the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                                   Page 40 of 86
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                  6 - S41H (1)(c) Travel
                                                                                     OVERSEAS TRAVEL




20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55




This document is in the form approved by the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.           Page 41 of 86
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                  6 - S41H (1)(c) Travel
                                                                                     OVERSEAS TRAVEL




56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91




This document is in the form approved by the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.           Page 42 of 86
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                  6 - S41H (1)(c) Travel
                                                                                     OVERSEAS TRAVEL




92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127




This document is in the form approved by the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.           Page 43 of 86
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                  6 - S41H (1)(c) Travel
                                                                                     OVERSEAS TRAVEL




128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163




This document is in the form approved by the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.           Page 44 of 86
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                  6 - S41H (1)(c) Travel
                                                                                     OVERSEAS TRAVEL




164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189




This document is in the form approved by the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.           Page 45 of 86
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                                           7 - S.47H (1)(d) Staff loans
                                                                                  LOANS TO EMPLOYEES




Club      Date Loan    Date Loan                    Employee the subject            Amount of            Interest          Term of             Purpose / Nature of Loan
Ref:     Approved by     Drawn                          of the loan                     loan               Rate             Loan
            Board                                                                         $
(A)           (B)          (C)                               (D)                         (E)              (F)             (G)                             (H)
1       15-Apr-04    1-May-04                     John Citizen                     $3,500             4.50%            12 months To pay professional educations expenses.
2       15-Apr-04    1-May-04                     Mary Citizen                     $1,500             4.50%            6 months To pay urgent medical expenses of relative.
3       15-Apr-04    1-May-04                     John Doe                         $6,500             4.50%            9 months To pay urgent domestic expenses.

        Total number of loans approved by the Board  0
        Total value amount of loans………………………..………... $0


1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23




This document is in the form approved by the Director of Liquor and Gaming pursuant to the Registered Clubs Regulations.                                                        Page 46 of 86
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                   7 - S.47H (1)(d) Staff loans
                                                                                  LOANS TO EMPLOYEES




24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59




This document is in the form approved by the Director of Liquor and Gaming pursuant to the Registered Clubs Regulations.                Page 47 of 86
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                   7 - S.47H (1)(d) Staff loans
                                                                                  LOANS TO EMPLOYEES




60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95




This document is in the form approved by the Director of Liquor and Gaming pursuant to the Registered Clubs Regulations.                Page 48 of 86
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                   7 - S.47H (1)(d) Staff loans
                                                                                  LOANS TO EMPLOYEES




96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131




This document is in the form approved by the Director of Liquor and Gaming pursuant to the Registered Clubs Regulations.                Page 49 of 86
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                   7 - S.47H (1)(d) Staff loans
                                                                                  LOANS TO EMPLOYEES




132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167




This document is in the form approved by the Director of Liquor and Gaming pursuant to the Registered Clubs Regulations.                Page 50 of 86
3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                   7 - S.47H (1)(d) Staff loans
                                                                                  LOANS TO EMPLOYEES




168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192




This document is in the form approved by the Director of Liquor and Gaming pursuant to the Registered Clubs Regulations.                Page 51 of 86
    3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                         CONTROLLED CONTRACTS                                                                                                                             8 - S.47O - Control Contract




             Date Approved by Board




                                                                                                                                                                                                                                                           Financial Management


                                                                                                                                                                                                                                                                                  Disposal of Club Land
                                                                                                                                                      Estimated Contract Value




                                                                                                                                                                                                                                                                                                             Amalgamation of the
                                                                                                                                                                                                                     of Top Executives


                                                                                                                                                                                                                                         Management
                                                                                                                                                                                            Director Interests




                                                                                                                                                                                                                                         Governance
                                                                                          Director




                                                                                                                                                                                                                     Employment
                                                      Date
Club                                    Date of     Contract      Name of Person




                                                                                                         Staff




                                                                                                                                                                                                                                                                                                             Club
Ref:                                    Contract   Sent to DLG   Linked to Contract                                     Name of Contractor

                                                                                                                                                                                                                                           (a)             (b)                    (c)                           (d)


                                                                                                                                                                                                                                                      C.47K (1)
(A)          (B)                          (C)          (D)              (E)           (F)            (G)                       (H)              ($)                              (I)       S.41K                     S.41M                       Professional Advice
1       3-May-04 17-May-04 20-May-04 Mary Citizen                                                    1           Citizen Meats                $5,000                                   1
2       5-May-04 19-May-04 24-May-04 William Jones                                    1                          Jones Financial Management   $3,000                                                                                                   1
3       1-Jun-04 15-Jun-04 20-Jun-04 John Smith                                                      1           Club                         $85,000                                                            1

                                      During per the Board approved ………...… 0         controlled contracts. These were made up of:
                                      0           contracts where DIRECTORS declared a pecuniary interest.
                                      0           contracts of employment with TOP Executives.
                                                  Additionally there were a further
                                      0           controlled contracts were for professional advice in respect to the specific categories:
                                      0           contracts relating to Management and Corporate Governance issues of the Club.
                                      0           contracts relating to Financial Management of the Club.
                                      0           contracts relating to the Disposal of Club Land
                                      0           contracts relating the Amalgamation of the Club with another club.


1
2
3
4
5
6
7
8
9
10




    This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                                                                                                                                                               Page 52 of 2
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                        CONTROLLED CONTRACTS                      8 - S.47O - Control Contract




11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                  Page 53 of 2
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                        CONTROLLED CONTRACTS                      8 - S.47O - Control Contract




48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                  Page 54 of 2
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                        CONTROLLED CONTRACTS                      8 - S.47O - Control Contract




85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                  Page 55 of 2
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                        CONTROLLED CONTRACTS                      8 - S.47O - Control Contract




122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                  Page 56 of 2
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                        CONTROLLED CONTRACTS                      8 - S.47O - Control Contract




159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                  Page 57 of 2
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                        CONTROLLED CONTRACTS                      8 - S.47O - Control Contract




196
197
198




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                  Page 58 of 2
     3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                              CLOSE RELATIVES                                                          9 - S.41L Close relative




Club        Top Executive                 Director               Employee who is a                Relationship to Director/Top   Position/Role of Close Relative         Total
Ref:                                                               close relative                          executive                                                remuneration
                                                                                                                                                                      paid in last
                Name                        Name                       Name                                                                                         financial year
    (A)           (B)                        (C)                         (D)                                  (G)                              (E)                        (F)
1         Joe Citizen                                         John Citizen                   Son of Top Executive                Bar staff                         $49,000
2                                 Louis Thompson              Mary Smith                     Wife of Director                    PA to CEO                         $34,400
3         Jane Murphy                                         John Murphy                    Son of Top Executive                Gaming Manager                    $50,000

                                  Number of instances where a TOP EXECUTIVE has a close relative employed by the Club.
                                  Number of instances where a DIRECTOR has a close relative employed by the Club.

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24




    This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                                    Page 59 of 1
  3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                              CLOSE RELATIVES                                                         9 - S.41L Close relative




Club     Top Executive                 Director               Employee who is a                Relationship to Director/Top   Position/Role of Close Relative        Total
Ref:                                                            close relative                          executive                                               remuneration
                                                                                                                                                                  paid in last
              Name                       Name                         Name                                                                                      financial year
 (A)           (B)                        (C)                          (D)                                      (G)                         (E)                         (F)
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                                   Page 60 of 1
  3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                              CLOSE RELATIVES                                                         9 - S.41L Close relative




Club     Top Executive                 Director               Employee who is a                Relationship to Director/Top   Position/Role of Close Relative        Total
Ref:                                                            close relative                          executive                                               remuneration
                                                                                                                                                                  paid in last
              Name                       Name                         Name                                                                                      financial year
 (A)           (B)                        (C)                          (D)                                      (G)                         (E)                         (F)
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                                   Page 61 of 1
  3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                              CLOSE RELATIVES                                                         9 - S.41L Close relative




Club     Top Executive                 Director               Employee who is a                Relationship to Director/Top   Position/Role of Close Relative        Total
Ref:                                                            close relative                          executive                                               remuneration
                                                                                                                                                                  paid in last
              Name                       Name                         Name                                                                                      financial year
 (A)           (B)                        (C)                          (D)                                      (G)                         (E)                         (F)
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                                   Page 62 of 1
  3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                              CLOSE RELATIVES                                                         9 - S.41L Close relative




Club     Top Executive                 Director               Employee who is a                Relationship to Director/Top   Position/Role of Close Relative        Total
Ref:                                                            close relative                          executive                                               remuneration
                                                                                                                                                                  paid in last
              Name                       Name                         Name                                                                                      financial year
 (A)           (B)                        (C)                          (D)                                      (G)                         (E)                         (F)
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                                   Page 63 of 1
  3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                              CLOSE RELATIVES                                                         9 - S.41L Close relative




Club     Top Executive                 Director               Employee who is a                Relationship to Director/Top   Position/Role of Close Relative        Total
Ref:                                                            close relative                          executive                                               remuneration
                                                                                                                                                                  paid in last
              Name                       Name                         Name                                                                                      financial year
 (A)           (B)                        (C)                          (D)                                      (G)                         (E)                         (F)
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                                   Page 64 of 1
  3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                              CLOSE RELATIVES                                                         9 - S.41L Close relative




Club     Top Executive                 Director               Employee who is a                Relationship to Director/Top   Position/Role of Close Relative        Total
Ref:                                                            close relative                          executive                                               remuneration
                                                                                                                                                                  paid in last
              Name                       Name                         Name                                                                                      financial year
 (A)           (B)                        (C)                          (D)                                      (G)                         (E)                         (F)
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                                   Page 65 of 1
    3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                              10 - S.41H (1)(g)(h) Consultant
                                                                                              CONSULTANTS



Club        Date Contract             Name of consultant                                               Details of consultancy     Costs paid to consultant in
Ref:          approved                                                                                                          the reporting period          $

    (A)         (B)                           (C)                                                                   (D)                         (E)
1         1-May-04                John Citizen                        Land development                                          $35,000
2         3-May-04                Mary Citzen                         IT                                                        $2,500
3         15-May-04               John Doe                            Amalgamation proposals                                    $8,000

          Total amount paid to consultants……………………………………………………………………………………………………….. $0
          Total number of occasions consultants were engaged by the Club…………………………………………………………….. 0

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25




    This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                 Page 66 of 1
  3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                            10 - S.41H (1)(g)(h) Consultant
                                                                                           CONSULTANTS



Club     Date Contract             Name of consultant                                               Details of consultancy     Costs paid to consultant in
Ref:       approved                                                                                                          the reporting period          $

 (A)             (B)                          (C)                                                                (D)                        (E)
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                Page 67 of 1
  3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                            10 - S.41H (1)(g)(h) Consultant
                                                                                           CONSULTANTS



Club     Date Contract             Name of consultant                                               Details of consultancy     Costs paid to consultant in
Ref:       approved                                                                                                          the reporting period          $

 (A)             (B)                          (C)                                                                (D)                        (E)
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                Page 68 of 1
  3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                            10 - S.41H (1)(g)(h) Consultant
                                                                                           CONSULTANTS



Club     Date Contract             Name of consultant                                               Details of consultancy     Costs paid to consultant in
Ref:       approved                                                                                                          the reporting period          $

 (A)             (B)                          (C)                                                                (D)                        (E)
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                Page 69 of 1
  3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                            10 - S.41H (1)(g)(h) Consultant
                                                                                           CONSULTANTS



Club     Date Contract             Name of consultant                                               Details of consultancy     Costs paid to consultant in
Ref:       approved                                                                                                          the reporting period          $

 (A)             (B)                          (C)                                                                (D)                        (E)
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                Page 70 of 1
  3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                            10 - S.41H (1)(g)(h) Consultant
                                                                                           CONSULTANTS



Club     Date Contract             Name of consultant                                               Details of consultancy     Costs paid to consultant in
Ref:       approved                                                                                                          the reporting period          $

 (A)             (B)                          (C)                                                                (D)                        (E)
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                Page 71 of 1
  3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                            10 - S.41H (1)(g)(h) Consultant
                                                                                           CONSULTANTS



Club     Date Contract             Name of consultant                                               Details of consultancy     Costs paid to consultant in
Ref:       approved                                                                                                          the reporting period          $

 (A)             (B)                          (C)                                                                (D)                        (E)
186
187
188
189
190
191
192
193
194
195
196
197
198




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                Page 72 of 1
    3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                        11 - S.41H (1)(i) Settlements
                                                                                                    SETTLEMENTS




                                                                 Director

                                                                                Staff
Club  Date of                  Name of settlement                                                       Description of settlement       Value of      Value of legal
Ref: settlement                    recipient                                                                                           settlement     fees paid by
                                                                                                                                            $       Club             $

    (A)       (B)                      (C)                    (D)           (E)                                    (F)                     (G)             (H)
1         1-May-04         John Citizen                      1                          Unfair Dismissal                            $18,000         $4,000
2         3-May-04         Mary Citizen                                     1           Sexual Harassment                           $8,000          $2,200
3         5-May-04         William Citizen                   1                          Public Liability                            $65,000         $13,000

          Total number of settlements………………………………          0
          Total number settlements with STAFF…………….…………..  0
          Total number of settlements with DIRECTORS………………...…
                                                           0
          Total value of all settlements…………………………………..    $0
          Legal fees paid by the Club for such settlements………
                                                           $0

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22




    This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                         Page 73 of 1
  3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                               11 - S.41H (1)(i) Settlements
                                                                                           SETTLEMENTS




                                                            Director

                                                                       Staff
Club  Date of               Name of settlement                                                  Description of settlement    Value of      Value of legal
Ref: settlement                 recipient                                                                                   settlement     fees paid by
                                                                                                                                 $       Club             $

 (A)         (B)                      (C)                   (D)        (E)                                     (F)             (G)                 (H)
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                 Page 74 of 1
  3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                               11 - S.41H (1)(i) Settlements
                                                                                           SETTLEMENTS




                                                            Director

                                                                       Staff
Club  Date of               Name of settlement                                                  Description of settlement    Value of      Value of legal
Ref: settlement                 recipient                                                                                   settlement     fees paid by
                                                                                                                                 $       Club             $

 (A)         (B)                      (C)                   (D)        (E)                                     (F)             (G)                 (H)
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                 Page 75 of 1
  3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                               11 - S.41H (1)(i) Settlements
                                                                                           SETTLEMENTS




                                                            Director

                                                                       Staff
Club  Date of               Name of settlement                                                  Description of settlement    Value of      Value of legal
Ref: settlement                 recipient                                                                                   settlement     fees paid by
                                                                                                                                 $       Club             $

 (A)         (B)                      (C)                   (D)        (E)                                     (F)             (G)                 (H)
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                 Page 76 of 1
  3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                               11 - S.41H (1)(i) Settlements
                                                                                           SETTLEMENTS




                                                            Director

                                                                       Staff
Club  Date of               Name of settlement                                                  Description of settlement    Value of      Value of legal
Ref: settlement                 recipient                                                                                   settlement     fees paid by
                                                                                                                                 $       Club             $

 (A)         (B)                      (C)                   (D)        (E)                                     (F)             (G)                 (H)
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                 Page 77 of 1
  3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                               11 - S.41H (1)(i) Settlements
                                                                                           SETTLEMENTS




                                                            Director

                                                                       Staff
Club  Date of               Name of settlement                                                  Description of settlement    Value of      Value of legal
Ref: settlement                 recipient                                                                                   settlement     fees paid by
                                                                                                                                 $       Club             $

 (A)         (B)                      (C)                   (D)        (E)                                     (F)             (G)                 (H)
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                 Page 78 of 1
  3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                               11 - S.41H (1)(i) Settlements
                                                                                           SETTLEMENTS




                                                            Director

                                                                       Staff
Club  Date of               Name of settlement                                                  Description of settlement    Value of      Value of legal
Ref: settlement                 recipient                                                                                   settlement     fees paid by
                                                                                                                                 $       Club             $

 (A)         (B)                      (C)                   (D)        (E)                                     (F)             (G)                 (H)
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                 Page 79 of 1
    3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                  12 - S.41H (1)(j) Legal fees
                                                                                                LEGAL FEES




                                              Director

                                                         Staff
Club Name of Director or Staff                                                         Nature or Reason For Legal Fees          Value of legal     Date fees paid
Ref: member incurring legal                                                                                                   fees to be paid by
              fees                                                                                                                 the Club
                                                                                                                                       $
    (A)               (B)                     (C) (D)                                                      (E)                        (F)               (G)
1         John Citizen                       1                                                                                $1,000               25-Apr-04
2         Mary Citizen                            1                                                                           $300                 29-Apr-04
3         William Citizen                    1                                                                                $4,500               30-Jun-04

                                                                 Total number instances when legal fees paid by the Club…………………………………………………
                                                                                                                                  0
                              Including:                 0       Instances when club paid legal fees of DIRECTORS, and
                                                         0       Total number of instances when club paid legal fees of STAFF.
                                                                 Total value legal fees paid by the Club…………………………………………………………………………
                                                                                                                                  $0


1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21




    This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                  Page 80 of 1
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                 12 - S.41H (1)(j) Legal fees
                                                                                             LEGAL FEES




                                           Director

                                                      Staff
Club Name of Director or Staff                                                      Nature or Reason For Legal Fees          Value of legal   Date fees paid
Ref: member incurring legal                                                                                                fees to be paid by
              fees                                                                                                              the Club
                                                                                                                                    $
 (A)                  (B)                  (C) (D)                                                      (E)                        (F)              (G)
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                 Page 81 of 1
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                 12 - S.41H (1)(j) Legal fees
                                                                                             LEGAL FEES




                                           Director

                                                      Staff
Club Name of Director or Staff                                                      Nature or Reason For Legal Fees          Value of legal   Date fees paid
Ref: member incurring legal                                                                                                fees to be paid by
              fees                                                                                                              the Club
                                                                                                                                    $
 (A)                  (B)                  (C) (D)                                                      (E)                        (F)              (G)
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                 Page 82 of 1
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                 12 - S.41H (1)(j) Legal fees
                                                                                             LEGAL FEES




                                           Director

                                                      Staff
Club Name of Director or Staff                                                      Nature or Reason For Legal Fees          Value of legal   Date fees paid
Ref: member incurring legal                                                                                                fees to be paid by
              fees                                                                                                              the Club
                                                                                                                                    $
 (A)                  (B)                  (C) (D)                                                      (E)                        (F)              (G)
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                 Page 83 of 1
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                 12 - S.41H (1)(j) Legal fees
                                                                                             LEGAL FEES




                                           Director

                                                      Staff
Club Name of Director or Staff                                                      Nature or Reason For Legal Fees          Value of legal   Date fees paid
Ref: member incurring legal                                                                                                fees to be paid by
              fees                                                                                                              the Club
                                                                                                                                    $
 (A)                  (B)                  (C) (D)                                                      (E)                        (F)              (G)
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                 Page 84 of 1
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                 12 - S.41H (1)(j) Legal fees
                                                                                             LEGAL FEES




                                           Director

                                                      Staff
Club Name of Director or Staff                                                      Nature or Reason For Legal Fees          Value of legal   Date fees paid
Ref: member incurring legal                                                                                                fees to be paid by
              fees                                                                                                              the Club
                                                                                                                                    $
 (A)                  (B)                  (C) (D)                                                      (E)                        (F)              (G)
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                 Page 85 of 1
 3d10dba1-4fd5-4d6c-bef0-37d2af8945fe.xls                                                                                                 12 - S.41H (1)(j) Legal fees
                                                                                             LEGAL FEES




                                           Director

                                                      Staff
Club Name of Director or Staff                                                      Nature or Reason For Legal Fees          Value of legal   Date fees paid
Ref: member incurring legal                                                                                                fees to be paid by
              fees                                                                                                              the Club
                                                                                                                                    $
 (A)                  (B)                  (C) (D)                                                      (E)                        (F)              (G)
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198




 This document is in the approved form of the Director of Liquor and Gaming pursuant to the Registered Clubs Regulation.                                 Page 86 of 1

				
DOCUMENT INFO