Certified Statement of Box Office Takings

Organisation Name *

Address *

Show Name *

Venue Name *

Venue Capacity *

Performances *

Currency *

Ticket Prices (excluding GST)

Adult *

Concession

Other

Performance Dates

Opening Performance Date *

Day

Month

Year

Opening Performance Date *

Closing Performance Date *

Day

Month

Year

Closing Performance Date *

Takings (excluding GST)

Total receipts *

Ticket/Treasurer's Report & Declaration

Treasurer/Business Manager's Name *

Phone Number

Email Address

Ticket Agent's Name (if used)

Please ATTACH the ticket report(s) from your venue or ticketing agency to support these details. If your tickets were sold in-house, please provide a report from your accounting system (MYOB or other).

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Files must be less than 5 MB.
Allowed file types: pdf.

Please DO NOT send payment at this stage. We will issue a final tax invoice once we have received these details and your hire materials. Thank you.

I declare that the information provided is a true and accurate account of ticket sales *

True

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