This form must be submitted at least 35 days prior to the co-operative's formation meeting If needed, you can apply for, or a shorter timeframe using the Form 12 - Application for an extension or abridgement (shortening) of time.
What do I need to complete a form
To complete the submission of the form you must:
- Complete all the relevant sections of the form.
- Make sure you have provided all supporting documents.
- Sign the declaration.
- Pay the application fee.
The following supporting documents must also accompany this form:
- Draft rules: A draft of the proposed rules for the co-operative, including active membership provisions. We recommend using one of the sets of the co-operative model rules to draft the proposed rules. Co-operative's that intend to make significant changes to the model rules or write its own rules should consider seeking professional legal assistance.
- Draft Formation Disclosure Statement: A draft formation disclosure statement for the proposed co-operative must be provided for any distributing co-operatives, and any non-distributing co-operatives directed by the Registrar. A template disclosure statement is available on Disclosure Statement Co-op Template.
Lodging forms and paying fees
Once you have all your supporting documents ready, you can lodge the form in one of the three ways:
Online
By post
Download the form and after completing post it to:
Associations and Charities
Department of Energy, Mines, Industry Regulation and Safety
Locked Bag 100
EAST PERTH WA 6892
Pay by credit card or BPAY:
Once we receive your form you will be issued with a Payment Number (PN) so you can make payment using our secure online payment portal.
Pay by cheque or money order:
Attach a cheque or money order made out to "Department of Energy, Mines, Industry Regulation and Safety" to the completed form.
In person
Monday to Friday between 8.30am and 4.30pm
Customer Service
Level 1, Mason Bird Building
303 Sevenoaks Street
CANNINGTON
Need help?
Should you require assistance with completing this form please contact the Association and Charities Branch on 1300 30 40 74 (within Australia) or email.