FDC Payments

to take FDC Payments by Credit Card

Instructions

Please complete the payment form on this page, ensuring you complete all the mandatory fields indicated by an *

Once you press the Process Credit Card Payment button, wait until you receive a confirmation message.

Payment Form

This gift is required to be used for the purposes of incurring Commonwealth electoral expenditure, or creating or communicating Commonwealth electoral matter
Donor Details
Name*
First Name Last Name
Donor Type*
- Individual
- Business
- Trust
- Unincorporated Association
Company Name*
ABN*
Address*
Street or Postal Address Suburb State Post Code Country
Phone*
Hidden
Phone Number (old)
FDC/Branch Segment
Segment*
Campaign / Candidate Name
Payment Details
Payment Amount*
Payment for:*
Number of Tickets*
Receipt
Email Address*
Enter the email address you'd like a receipt emailed to
Hidden
Foreign Donor Declaration
- I am NOT a foreign donor
Donor Declaration*
I am NOT a prohibited donor
This donation is being made for the purpose of incurring electoral expenditure within the meaning of the Commonwealth Electoral Act 1918.
Foreign residents and anonymous donors are prohibited donors.
By ticking this box, you certify to the LNP that you are not a prohibited donor.
Phone
This field is for validation purposes and should be left unchanged.

Credit Card Details

32178

Disclosure Warning: Commonwealth and State legislation require disclosure of gifts to registered political parties. For more information about gift threshold amounts and reporting periods contact the AEC (13 23 26 or www.aec.gov.au) for information about Commonwealth obligations and ECQ (1300 881 665 or www.ecq.qld.gov.au) about State obligations.

FDC Payments

Instructions

Payment Form

Donor Details

FDC/Branch Segment

Payment Details

Receipt

Credit Card Details