Update of Associated Individuals following an Annual General Meeting

Note: If your AGM has not yet taken place, please bookmark this form and complete it after the meeting.

Entity Name: ^*

Licence Number: ^*

1. Date of Annual General Meeting: ^*

2. List of Returning Officers/Committee Members: ^*

Name	Position






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3. List of NEW Officers/Committee Members: ^*

Please note, Associated Individual forms for new associates must be completed and lodged with
the VCGLR as soon as possible

In order to lodge application forms within 30 days, new associates can begin the process by
requesting an ASIC report, Credit report and National Police Certificate immediately.

Name	Position/Status	Date Appointed (dd/mm/yyyy)


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4. List of any associates that have CEASED to be Officers/Committee Members: ^*

Name	Previous Position/Status	Date ceased to be an associate (dd/mm/yyyy)


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5. Attach Minutes of the Meeting: ^*

Please attach a copy of the Minutes of the Meeting regardless of whether there have been any changes to
the committee.

Contact Name:^*

Position:^*

Date:^*

Click the Print button if you wish to keep a copy of your completed form. After clicking the Submit button, this form will disappear from view.