SECTION 2: For Third Party to Complete Third Party details Registered name Trading name Third Parties’ main activity Third Party address Address Line 1 Address Line 2 City/Suburb State, Postcode Country Postal address As above? Contact Person FAMILY NAME, Given name Position Office telephone number Email address Third Party applicant leadership endorsement Project Title: With reference to the application to the CSIRO-CAS Fund, for the project (above) I… (Authorised representative for the third party, SURNAME, first name, and title) Authorised representative for the Third Party (Third Party Organisation Name) 1. I declare that to the best of my knowledge and belief the information contained in this application is true and correct, and acknowledge that if any information provided by the Third Party in this application is false or misleading in any respect, then in addition to other remedies available at law, CAS or CSIRO may withdraw, suspend, terminate or seek repayment of funding for the project. 2. The Third Party agrees that CAS or CSIRO may ask you to provide clarification, further information or documentation in order to verify or supplement the information supplied in this application.
SECTION 2: For Third Party to Complete Third Party details Registered name Trading name Third Parties’ main activity Third Party address Address Line 1 Address Line 2 City/Suburb State, Postcode Country Postal address As above? Contact Person FAMILY NAME, Given name Position Office telephone number Email address Third Party applicant leadership endorsement Project Title: With reference to the application to the CSIRO-CAS Fund, for the project (above) I… (Authorised representative for the third party, SURNAME, first name, and title) Authorised representative for the Third Party (Third Party Organisation Name) 1. I declare that to the best of my knowledge and belief the information contained in this application is true and correct, and acknowledge that if any information provided by the Third Party in this application is false or misleading in any respect, then in addition to other remedies available at law, CAS or CSIRO may withdraw, suspend, terminate or seek repayment of funding for the project. 2. The Third Party agrees that CAS or CSIRO may ask you to provide clarification, further information or documentation in order to verify or supplement the information supplied in this application.
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