CONSTITUTION
VICTORIA ASSOCIATIONS INCORPORATION ACT 1981
RULES OF DAVEYS BAY YACHT CLUB INCORPORATED
Rules adopted 19 October 2008
RULES OF DAVEYS BAY YACHT CLUB INCORPORATED
Rules adopted 19 October 2008
1. Name
The name of the incorporated association is Daveys Bay Yacht Club Incorporated (in these Rules called "the Club").2. Definitions
(1) In these Rules, unless the contrary intention appears 3. Alteration of the Rules
"Act" means the Associations Incorporation Act 1981;
"Committee" means the committee of management of the Club;
"financial year" means the year ending on 30 June;
"general meeting" means a general meeting of members convened in accordance with Rule 13;
"member" means a member of the Club;
"ordinary member of the Committee" means a member of the Committee who is not an officer of the Club under Rule 22;
"Regulations" means regulations under the Act; and
"relevant documents" has the same meaning as in the Act.
(2) In these Rules, a reference to the Secretary of the Club is a reference
(a) if a person holds office under these Rules as Secretary of the Club to that person; and
(b) in any other case, to the public officer of the Club.
These Rules and the Statement of Purposes of the Club must not be altered except in accordance with the Act.4. Membership, entry fees and subscription
(1) Subject to the following provisions relating to the categories of members, a member shall be a yachtsman or yachtswoman or a person interested in yachting.5. Register of members
(2) Whilst the Club is a yacht club affiliated with Yachting Victoria and the International Sailing Federation through Yachting Victoria and Yachting Australia, members are subject to and bound by the Racing Rules of Sailing in force from time to time.
(3) There shall be the following categories of members
(a) Family members, being a husband and wife or two persons living at the same address, who in either case are persons who have applied for Family membership and been duly elected, shall each be entitled to full membership rights as Family members; provided that only Family members who are issued with a Yachting Australia silver membership card or its equivalent through their membership of the Club shall be entitled to vote.
(b) Senior members, being persons who have applied for Senior membership and been duly elected, shall be entitled to full membership rights as Senior members.
(c) Junior members, being persons under the age of eighteen years who have applied for Junior membership and been duly elected, shall be entitled to all membership rights except the right to vote and the right to be a member of the Committee, as Junior members. A person who is the child of a Family member or a Senior member shall be entitled to the same rights as a Junior member whilst under the age of eighteen years.
(d) Social members, being members who no longer make active use of the Club facilities, who have applied in writing to the Committee for transfer to the category of Social membership and the Committee has in its absolute discretion approved such application. A Social member shall not be liable for any levies or calls other than subscriptions. If in the opinion of the Committee a Social member resumes making active use of the Club's facilities the Committee may in its absolute discretion transfer a Social member to the appropriate membership category. Social membership is conferred only by transfer from another category of membership and no person shall be admitted to membership as a Social member.
(e) Honorary Life Members, being persons granted Honorary Life membership by the Club in general meeting following a recommendation by the Committee, being members who have rendered distinguished service to the Club, or have had a long association with the Club, shall be entitled to full membership rights as Honorary Life members, but shall not be liable to pay any subscriptions or calls.
(f) Temporary members, being persons granted Temporary membership by the Committee for a period not exceeding six months, shall be entitled to all membership rights except the right to vote and the right to be a member of the Committee, as Temporary members.
(g) Absentee members, being members who intend to be absent from Victoria for at least twelve months, and have notified the Secretary of such intention, shall be placed on the list of Absentee members, and shall not be liable for subscriptions or calls during such absence.
(4) A person who applies and is approved for membership as provided in these Rules is eligible to be a member of the Club on payment of the entrance fee and annual subscription payable under these Rules.
(5) A person who is not a member of the Club at the time of the incorporation of the Club (or who was a member at that time but has ceased to be a member) must not be admitted to membership unless
(a) he or she applies for membership in accordance with sub-rule (6); and
(b) the admission as a member is approved by the Committee.
(6) An application of a person for membership of the Club must
(a) be made in writing in the form determined by the Committee from time to time; and
(b) be lodged with the Secretary of the Club.
(7) As soon as practicable after the receipt of an application, the Secretary must refer the application to the Committee.
(8) The Committee must determine whether to approve or reject the application.
(9) If the Committee approves an application for membership, the Secretary must, as soon as practicable
(a) notify the applicant in writing of the approval for membership; and
(b) request payment within 28 days after receipt of the notification of the sum payable under these Rules as the entrance fee and the first year's annual subscription.
(10) The Secretary must, within 28 days after receipt of the amounts referred to in sub-rule (9), enter the applicant's name in the register of members.
(11) An applicant for membership becomes a member and is entitled to exercise the rights of membership when his or her name is entered in the register of members.
(12) If the Committee rejects an application, the Committee must, as soon as practicable, notify the applicant in writing that the application has been rejected.
(13) A right, privilege, or obligation of a person by reason of membership of the Club
(a) is not capable of being transferred or transmitted to another person; and
(b) terminates upon the cessation of membership whether by death or resignation or otherwise.
(14) The entrance fee for Family members and Senior members respectively is an amount equal to the corresponding annual subscription. There is no entrance fee for Junior members.
(15) The annual subscriptions for Family members, Senior members and Junior members shall be set by the Club in general meeting from time to time, and are payable in advance on or before 1 October in each year.
(1) The Secretary must keep and maintain a register of members containing 6. Ceasing membership
(a) the name and address of each member; and
(b) the date on which each member's name was entered in the register.
(2) The register is available for inspection free of charge by any member upon request.
(3) A member may make a copy of entries in the register.
(1) A member of the Club who has paid all moneys due and payable by a member to the Club may resign from the Club by giving one month's notice in writing to the Secretary of his or her intention to resign.
(2) After the expiry of the period referred to in sub-rule (1) 7. Discipline, suspension and expulsion of members(a) the member ceases to be a member; and
(b) the Secretary must record in the register of members the date on which the member ceased to be a member.
(1) Subject to these Rules, if the Committee is of the opinion that a member has refused or neglected to comply with these Rules, or has been guilty of conduct unbecoming a member or prejudicial to the interests of the Club, the Committee may by resolution 9. Annual general meetings
(a) fine that member an amount not exceeding $500; or
(b) suspend that member from membership of the Club for a specified period; or
(c) expel that member from the Club.
(2) A resolution of the Committee under sub-rule (1) does not take effect unless
(a) at a meeting held in accordance with sub-rule (3), the Committee confirms the resolution; and
(b) if the member exercises a right of appeal to the Club under this rule, the Club confirms the resolution in accordance with this rule.
(3) A meeting of the Committee to confirm or revoke a resolution passed under sub-rule (1) must be held not earlier than fourteen days, and not later than 28 days, after notice has been given to the member in accordance with sub-rule (4).
(4) For the purposes of giving notice in accordance with sub-rule (3), the Secretary must, as soon as practicable, cause to be given to the member a written notice
(a) setting out the resolution of the Committee and the grounds on which it is based; and
(b) stating that the member, or his or her representative, may address the Committee at a meeting to be held not earlier than fourteen days and not later than 28 days after the notice has been given to that member; and
(c) stating the date, place and time of that meeting; and
(d) informing the member that he or she may do one or both of the following
(i) attend that meeting;
(ii) give to the Committee before the date of that meeting a written statement seeking the revocation of the resolution; and
(e) informing the member that, if at that meeting, the Committee confirms the resolution, he or she may, not later than 48 hours after that meeting, give the Secretary a notice to the effect that he or she wishes to appeal to the Club in general meeting against the resolution.
(5) At a meeting of the Committee to confirm or revoke a resolution passed under sub-rule (1), the Committee must
(a) give the member, or his or her representative, an opportunity to be heard; and
(b) give due consideration to any written statement submitted by the member; and
(c) determine by resolution whether to confirm or to revoke the resolution.
(6) If at the meeting of the Committee, the Committee confirms the resolution, the member may, not later than 48 hours after that meeting, give the Secretary a notice to the effect that he or she wishes to appeal to the Club in general meeting against the resolution.
(7) If the Secretary receives a notice under sub-rule (6), he or she must notify the Committee and the Committee must convene a general meeting of the Club to be held within 21 days after the date on which the Secretary received the notice.
(8) At a general meeting of the Club convened under sub-rule (7)
(a) no business other than the question of the appeal may be conducted; and
(b) the Committee may place before the meeting details of the grounds for the resolution and the reasons for the passing of the resolution; and
(c) the member, or his or her representative, must be given an opportunity to be heard; and
(d) the members present must vote by secret ballot on the question whether the resolution should be confirmed or revoked.
(9) A resolution is confirmed if, at the general meeting, not less than two-thirds of the members vote in person, or by proxy, in favour of the resolution. In any other case, the resolution is revoked.
8. Disputes and mediation
(1) The grievance procedure set out in this rule applies to disputes under these Rules between
(a) a member and another member; or
(b) a member and the Club.
(2) The parties to the dispute must meet and discuss the matter in dispute, and, if possible, resolve the dispute within fourteen days after the dispute comes to the attention of all of the parties.
(3) If the parties are unable to resolve the dispute at the meeting, or if a party fails to attend that meeting, then the parties must, within ten days, hold a meeting in the presence of a mediator.
(4) The mediator must be
(a) a person chosen by agreement between the parties; or
(b) in the absence of agreement
(i) in the case of a dispute between a member and another member, a person appointed by the Committee of the Club; or
(ii) in the case of a dispute between a member and the Club, a person who is a mediator appointed or employed by the Dispute Settlement Centre of Victoria (Department of Justice).
(5) A member of the Club can be a mediator.
(6) The mediator cannot be a member who is a party to the dispute.
(7) The parties to the dispute must, in good faith, attempt to settle the dispute by mediation.
(8) The mediator, in conducting the mediation, must
(a) give the parties to the mediation process every opportunity to be heard; and
(b) allow due consideration by all parties of any written statement submitted by any party; and
(c) ensure that natural justice is accorded to the parties to the dispute throughout the mediation process.
(9) The mediator must not determine the dispute.
(10) If the mediation process does not result in the dispute being resolved, the parties may seek to resolve the dispute in accordance with the Act or otherwise at law.
(1) The Committee may determine the date, time and place of the annual general meeting of the Club.10. Prize-giving and elections general meetings
(2) The notice convening the annual general meeting must specify that the meeting is an annual general meeting.
(3) The ordinary business of the annual general meeting shall be
(a) to confirm the minutes of the previous annual general meeting and of any general meeting held since that meeting; and
(b) to receive from the Committee reports upon the transactions of the Club during the last preceding financial year; and
(c) to receive and consider the statement submitted by the Club in accordance with section 30(3) of the Act.
(4) The annual general meeting may conduct any special business of which notice has been given in accordance with these Rules.
(1) In addition to the annual general meeting, a prize-giving and elections general meeting shall be held in the same year.11. Special general meetings
(2) The Committee may determine the date, time and place of the prize-giving and elections general meeting of the Club, but preferably it shall be held in May, to allow prizes to be awarded and presented soon after the completion of the main sailing program, and to allow the incoming Committee adequate time to prepare the next following budget and sailing programs for the Club.
(3) The notice convening the prize-giving and elections general meeting must specify that the meeting is a prize-giving and elections general meeting.
(4) The ordinary business of the prize-giving and elections general meeting shall be
(a) to confirm the minutes of the previous prize-giving and elections general meeting and of any general meeting held since that meeting; and
(b) to present the Clubs prizes awarded for the main sailing program last completed and any other Club prizes and awards; and
(c) to elect officers of the Club and the ordinary members of the Committee.
(5) The prize-giving and elections general meeting may conduct any special business of which notice has been given in accordance with these Rules.
(1) In addition to the annual general meeting and the prize-giving and elections general meeting, any other general meetings may be held in the same year.12. Special business
(2) All general meetings other than the annual general meeting and the prize- giving and elections general meeting are special general meetings.
(3) The Committee may, whenever it thinks fit, convene a special general meeting of the Club.
(4) If, but for this sub-rule, more than fifteen months would elapse between annual general meetings, the Committee must convene a special general meeting before the expiration of that period.
(5) The Committee must, on the request in writing of members representing not less than five per cent of the total number of members, convene a special general meeting of the Club.
(6) The request for a special general meeting must
(a) state the objects of the meeting; and
(b) be signed by the members requesting the meeting; and
(c) be sent to the address of the Secretary.
(7) If the Committee does not cause a special general meeting to be held within one month after the date on which the request is sent to the address of the Secretary, the members making the request, or any of them, may convene a special general meeting to be held not later than three months after that date.
(8) If a special general meeting is convened by members in accordance with this rule, it must be convened in the same manner so far as possible as a meeting convened by the Committee and all reasonable expenses incurred in convening the special general meeting must be refunded by the Club to the persons incurring the expenses.
All business that is conducted at a special general meeting and all business that is conducted at the annual general meeting and at the prize-giving and elections general meeting, except for business conducted under the Rules as ordinary business of the annual general meeting or the prize-giving and elections general meeting, is deemed to be special business.13. Notice of general meetings
(1) The Secretary of the Club, at least fourteen days, or if a special resolution has been proposed at least 21 days, before the date fixed for holding a general meeting of the Club, must cause to be sent to each member of the Club, a notice stating the place, date and time of the meeting and the nature of the business to be conducted at the meeting.14. Quorum at general meetings
(2) Notice may be sent
(a) by prepaid post to the address appearing in the register of members; or
(b) if the member requests, by facsimile transmission or electronic transmission.
(3) No business other than that set out in the notice convening the meeting may be conducted at the meeting.
(4) A member intending to bring any business before a meeting may notify in writing, or by electronic transmission, the Secretary of that business, who must include that business in the notice calling the next general meeting.
(1) No item of business may be conducted at a general meeting unless a quorum of members entitled under these Rules to vote is present at the time when the meeting is considering that item.15. Presiding at general meetings
(2) Five members personally present (being members entitled under these Rules to vote at a general meeting) constitute a quorum for the conduct of the business of a general meeting.
(3) If, within half an hour after the appointed time for the commencement of a general meeting, a quorum is not present
(a) in the case of a meeting convened upon the request of members the meeting must be dissolved; and
(b) in any other case the meeting shall stand adjourned to the same day in the next week at the same time and (unless another place is specified by the person presiding at the time of the adjournment or by written notice to members given before the day to which the meeting is adjourned) at the same place.
(4) If at the adjourned meeting the quorum is not present within half an hour after the time appointed for the commencement of the meeting, the members personally present (being not less than three) shall be a quorum.
(1) The Commodore, or in the Commodore's absence, the Vice-Commodore, shall preside at each general meeting of the Club.16. Adjournment of meetings
(2) If the Commodore and the Vice-Commodore are absent from a general meeting, or are unable to preside, the members present must select one of their number to preside.
(1) The person presiding may, with the consent of a majority of members present at the meeting, adjourn the meeting from time to time and place to place.17. Voting at general meetings
(2) No business may be conducted at an adjourned meeting other than the unfinished business from the meeting that was adjourned.
(3) If a meeting is adjourned for fourteen days or more, notice of the adjourned meeting must be given in accordance with Rule 13.
(4) Except as provided in sub-rule (3), it is not necessary to give notice of an adjournment or of the business to be conducted at an adjourned meeting.
(1) Upon any question arising at a general meeting of the Club, a member has one vote only.18. Poll at general meetings
(2) All votes must be given personally or by proxy.
(3) In the case of an equality of voting on a question, the person presiding at the meeting is entitled to exercise a second or casting vote.
(4) A member is not entitled to vote at a general meeting unless all moneys due and payable by the member to the Club have been paid, other than the amount of the annual subscription payable in respect of the current financial year.
(1) If at a meeting a poll on any question is demanded by not less than three members, it must be taken at that meeting in such manner as the person presiding may direct and the resolution of the poll shall be deemed to be a resolution of the meeting on that question.19. Manner of determining whether resolution carried
(2) A poll that is demanded on the election of a person presiding or on a question of an adjournment must be taken immediately and a poll that is demanded on any other question must be taken at such time before the close of the meeting as the person presiding may direct.
If a question arising at a general meeting of the Club is determined on a show of hands 20. Proxies
(a) a declaration by the person presiding that a resolution has been
(i) carried; or
(ii) carried unanimously; or
(iii) carried by a particular majority; or
(iv) lost; and
(b) an entry to that effect in the minute book of the Club
is evidence of the fact, without proof of the number or proportion of the votes recorded in favour of, or against, that resolution.
(1) Each member is entitled to appoint another member as a proxy by notice given to the Secretary no later than 24 hours before the time of the meeting in respect of which the proxy is appointed.21. Committee of management
(2) The notice appointing the proxy must be in the form set out in the Appendix.
(1) The affairs of the Club shall be managed by the Committee of management.22. Office holders
(2) The Committee
(a) shall control and manage the business and affairs of the Club; and
(b) may, subject to these Rules, the Act and the Regulations, exercise all such powers and functions as may be exercised by the Club other than those powers and functions that are required by these Rules to be exercised by general meetings of the members of the Club; and
(c) subject to these Rules, the Act and the Regulations, has power to perform all such acts and things as appear to the Committee to be essential for the proper management of the business and affairs of the Club.
(3) Subject to section 23 of the Act, the Committee shall consist of
(a) the officers of the Club; and
(b) not more than fifteen ordinary members
each of whom shall be elected at the prize-giving and elections general meeting of the Club in each year.
(1) The officers of the Club shall be a Commodore, a Vice-Commodore, a Rear- Commodore, a Club Captain, a Secretary, and a Treasurer.23. Ordinary members of the Committee
(2) The provisions of Rule 24, so far as they are applicable and with the necessary modifications, apply to and in relation to the election of persons to any of the offices referred to in sub-rule (1).
(3) Each officer of the Club shall hold office until the prize-giving and elections general meeting next after the date of his or her election but is eligible for re- election.
(4) In the event of a casual vacancy in any office referred to in sub-rule (1), the Committee may appoint one of its members to the vacant office and the member appointed may continue in office up to and including the conclusion of the prize- giving and elections general meeting next following the date of the appointment.
(1) Subject to these Rules, each ordinary member of the Committee shall hold office until the prize-giving and elections general meeting next after the date of election but is eligible for re-election.24. Election of officers and ordinary Committee members
(2) In the event of a casual vacancy occurring in the office of an ordinary member of the Committee, the Committee may appoint a member of the Club to fill the vacancy and the member appointed shall hold office, subject to these Rules, until the conclusion of the prize-giving and elections general meeting next following the date of the appointment.
(1) Nominations of candidates for election as officers of the Club or as ordinary members of the Committee must be 25. Vacancies
(a) made in writing, signed by two members of the Club and accompanied by the written consent of the candidate (which may be endorsed on the form of nomination); and
(b) delivered to the Secretary of the Club not less than seven days before the date fixed for the holding of the prize-giving and elections general meeting.
(2) A candidate may only be nominated for one office, or as an ordinary member of the Committee, prior to the prize-giving and elections general meeting.
(3) If insufficient nominations are received to fill all vacancies on the Committee, the candidates nominated shall be deemed to be elected and further nominations may be received at the prize-giving and elections general meeting.
(4) If the number of nominations received is equal to the number of vacancies to be filled, the persons nominated shall be deemed to be elected.
(5) If the number of nominations exceeds the number of vacancies to be filled, a ballot must be held.
(6) The ballot for the election of officers and ordinary members of the Committee must be conducted at the prize-giving and elections general meeting in such manner as the Committee may direct.
The office of an officer of the Club, or of an ordinary member of the Committee, becomes vacant if the officer or member 26. Meetings of the Committee
(a) ceases to be a member of the Club; or
(b) becomes an insolvent under administration within the meaning of the Corporations Act 2001; or
(c) resigns from office by notice in writing given to the Secretary.
(1) The Committee must meet at least three times in each year at such place and such times as the Committee may determine.28. Quorum for Committee meetings
(2) Special meetings of the Committee may be convened by the Commodore or by any four members of the Committee.
27. Notice of Committee meetings
(1) Written notice of each Committee meeting must be given to each member of the Committee at least two business days before the date of the meeting.
(2) Written notice must be given to members of the Committee of any special meeting specifying the general nature of the business to be conducted and no other business may be conducted at such a meeting.
(1) Any four members of the Committee constitute a quorum for the conduct of the business of a meeting of the Committee.29. Presiding at Committee meetings
(2) No business may be conducted unless a quorum is present.
(3) If within half an hour of the time appointed for the meeting a quorum is not present
(a) in the case of a special meeting the meeting lapses;
(b) in any other case the meeting shall stand adjourned to the same place and the same time and day in the following week.
(4) The Committee may act notwithstanding any vacancy on the Committee.
At meetings of the Committee 30. Voting at Committee meetings
(a) the Commodore or, in the Commodore's absence, the Vice-Commodore presides; or
(b) if the Commodore and the Vice-Commodore are absent, or are unable to preside, the members present must choose one of their number to preside.
(1) Questions arising at a meeting of the Committee, or at a meeting of any sub- Committee appointed by the Committee, shall be determined on a show of hands or, if a member requests, by a poll taken in such manner as the person presiding at that meeting may determine.31. Removal of Committee member
(2) Each member present at a meeting of the Committee, or at a meeting of any sub-Committee appointed by the Committee (including the person presiding at the meeting), is entitled to one vote and, in the event of an equality of votes on any question, the person presiding may exercise a second or casting vote.
(1) The Club in general meeting may, by resolution, remove any member of the Committee before the expiration of the member's term of office and appoint another member in his or her place to hold office until the expiration of the term of the first-mentioned member.32. Minutes of meetings
(2) A member who is the subject of a proposed resolution referred to in sub-rule (1) may make representations in writing to the Secretary or Commodore of the Club (not exceeding a reasonable length) and may request that the representations be provided to the members of the Club.
(3) The Secretary or the Commodore may give a copy of the representations to each member of the Club or, if they are not so given, the member may require that they be read out at the meeting.
The Secretary of the Club must keep minutes of the resolutions and proceedings of each general meeting, and each Committee meeting, together with a record of the names of persons present at Committee meetings.33. Funds
(1) The Treasurer of the Club must 34. Seal
(a) collect and receive all moneys due to the Club and make all payments authorised by the Club; and
(b) keep correct accounts and books showing the financial affairs of the Club with full details of all receipts and expenditure connected with the activities of the Club.
(2) All cheques, drafts, bills of exchange, promissory notes and other negotiable i nstruments must be signed by two members of the Committee.
(3) The funds of the Club shall be derived from entrance fees, annual subscriptions, donations and such other sources as the Committee determines.
(4) The Club shall exist, operate and incur its expenditure solely and entirely in Australia.
(5) The income and property of the Club shall be applied solely towards the promotion of the objects of the Club set out in the Clubs Statement of Purposes, and no portion thereof shall be paid or transferred directly or indirectly by way of dividend, bonus, or otherwise by way of
(1) The common seal of the Club must be kept in the custody of the Secretary.35. Notice to members
(2) The common seal must not be affixed to any instrument except by the authority of the Committee and the affixing of the common seal must be attested by the signatures either of two members of the Committee or, of one member of the Committee and of the public officer of the Club.
Except for the requirement in Rule 13, any notice that is required to be given to a member, by on behalf of the Club, under these Rules may be given by 36. Winding up
(a) delivering the notice to the member personally; or
(b) sending it by prepaid post addressed to the member at that member's address shown in the register of members; or
(c) facsimile transmission, if the member has requested that the notice be given to him or her in this manner; or
(d) electronic transmission, if the member has requested that the notice be given to him or her in this manner.
In the event of the winding up or the cancellation of the incorporation of the Club, the assets of the Club must be disposed of in accordance with the provisions of the Act to a yacht club or yacht clubs or such other institution or institutions having objects or purposes similar to the objects and purposes of the Club, and whose constitution prohibits or constitutions prohibit the distribution of its or their income and property among its or their members to an extent as great as is imposed on the Club under or by virtue of these Rules, such institution or institutions to be determined by the Club in general meeting at or before the time of dissolution and in default thereof by such judge of the Supreme Court of Victoria as may have or acquire jurisdiction in the matter.37. Custody and inspection of books and records
(1) Except as otherwise provided in these Rules, the Secretary must keep in his or her custody or under his or her control all books, documents and securities of the Club.
(2) All accounts, books, securities and any other relevant documents of the Club must be available for inspection free of charge by any member upon request.
(3) A member may make a copy of any accounts, books, securities and any other relevant documents of the Club.
APPENDIX
FORM OF APPOINTMENT OF PROXY
FORM OF APPOINTMENT OF PROXY
I, . ..
(name)
of ..
(address)
being a member of Daveys Bay Yacht Club Incorporated (the Club)
appoint .
(name of proxy holder)
of . .
(address of proxy holder)
being a member of the Club, as my proxy to vote for me on my behalf at the annual general meeting / prize-giving and elections general meeting / special general meeting* of the Club to be held on
(date of meeting)
and at any adjournment of that meeting.
My proxy is authorised to vote in favour of / against* the following resolution or resolution (insert details):
signed ..
date .
* Delete as applicable

