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XXX TOWN/PARISI{ COUNCIL

REGISTER OF MEMBERS' INTERESTS

GENERAL NOTICE OF REGISTRABLE INTERESTS

l, 1fu{ namel {please pint)

a Member of {authanty)

Any employment, offrce, trade, profession or vocationcarried on for profit or gain.State the name of your employerlcompany and jobtitle

Member

Re"rtRED

r< E , T-t-{ ChrhreLeS Bor^rr__er<

Lrte€y C-Reer.l

r. Employmenf office, trade, profession or vocation

lQg'rr RE b

2. Sponsorshi

Any payment or provision ofany other financial benefit(other than from the Council) made or provided withinthe last 12 months in respect ofany expenses incurred incan'ying out your duties as a member or towards yourelection expensesState the name the body making the paymentNote: This includes ary payment or fininiial benefitfiom a Trade Union

dracts

lcontr.act (which has not been fully discharged) forcprovisions ofgoods, services or the execution of

rorks made between the Council and you or a firm inwhich you are a partner, a company of which you are aremunerated director or a company in whose securitiesyou have a benet-icial interest.Give a description of the contract

Any land in the Council's area in which you have ateneficial iaterest.This will include your place of residence if you own orrent it and it is within the Council,s area.It also includes any property from which you receiverent, or of which you are the mortgagee.

Give tte addrcss/desetiption dihe tafrd

Spouselpartner

NON €

Spous€lparfrer\nlr r.ro/ctD6-G

Mn,.v RoAD

l-rnc€/ GT116:EN

PRrnteeS Rr s Be ReUG+l

8,.-l Ct< S

l..'{.rJLI oq,6-

4. Land

\^,I NoTRI DGE

Mr+rr.r Roao

L-rccE 7 GrraecX

Pl-<t ntcss R ts BoR<*r-lc.+{

BuexsHP2-? oq(i

Any land in the Cauncil's area for which you have aIicence (alone or jointly with others) to oicupy for amonth or longer.This will include any allotments that you use.

Give the address/description of the land

Tena

,1

1ff't"nun"y where to your knowledge the

/ ltAWd is the Council and the tenant is a body in

,/whtchyou are a partner, a company of wlrich you are a

remunerated director or a company in whose securities

you have a beneficial interest.

Give a description of the tenancY

N (lN€

/

? Ear:rrifiac

Spouse/partner

N or.rE

A body who to your knowledge has a place of business

or land in the Council's area, and in whom you have a

beneficial interest in a class ofsecurities that exceeds the

nominal value off,25,000 or one hundredth ofthe total

issued share capital of that body or if the strare capital ofthat My is of more tlran olre class, tho total norninal

value of the shares of any one class in which you have a

beneficial interest exceeds one hundredth ofthe totalissred share capital of th:t class.

lfrtfc ppcr of ttry ?rlrIqdct, inftftfiJ*Ud-prcrftleut ror.tiec or otht' bodier corporate rt'at {toyour knowledge) are active in the Council's area-

You do not need to state the extent ofyour interesl

Member

NoF.r€

Spouselpartoer

n$o rJ6

8. Membership of other bodies

2 - Other Personallnterests

nare only required to disclose your own personal,lease state "aone" where appropriate

interests under the headings listed below.

8. 1 Any body of which you are a mernber or in aposition of general control or management and to whichyou are appointed or nominated by the Council.Ncte. These will be need to be added after AnnualCouncil

Give the names of the My/ies

8,2 Any body exercising functions of a public nature ofwhich you are a member or in a position of general

control or management.This will include other local authorities of which you are

a member. It also includes government agencies, publicheaith botiies, councii-owned companies and schooigovernorships

Give the names of the bodv/ies

S.3 Any body directed to charitable purposes of whichyou aro a member or in a position of general control ormanagemert.This will inclurle mem-herchin of anv reeisterer{ chanties

zuch as Rctery ar Licns. M€{ribe{ship of,mascnicorganisations which are registered charities with theCharities Commission will also fall within this category.

Give the names of the body/ies

NoN€

Th-tE RoyAr- BR-r'rtSH r_Eel()N

Lt ^rC:oLNt 51-t t |?g's r-Ar-tC:6r'l-Er" FIS1;C-

'T. H'E l\ aT i oNl r) r- '-f R LrsT

rHE c}.|rurer?rrl soct€T7

r*.1w tr

eHlNNoR e Pr+lrvees RrsaoRouGxt?-nr L-h, A

8.4 Any body one of whose principal purposes includesthe influence of public opinion orpolicy (including any political party or trade union),of which you are a member or in a position of general

control or management.This will include any lobby group, local pressure groupor resident's association


l-l Or..l g

of Gifts and H

person from whom you have received a gift or hospitality worth more than an estimated value of f50 which you

received by virtue of your offrce - including brief details of the giMrospitality received.

Date of receipt of Gift/Hosnitalifv

Name of Donor Reason and Nature ofGiftlHosoilalitv

NCNE

Dated: ?er^ f"ln/ L<:?-l

l, 1tutl name) (Please print)

a Member of (authon$)

X)O( TOWN/PARISH COI]NCIL


GEI{ERAL NOTICE OT' REGISTRABLE INTERESTS

K" e*e G,€*unu c/ema t

GftlAr /*(,stt &uhtctt- TownlParish Council

PART 1 - Disclosable Pecuniar:v Interests

r. Em t, officeo trade, profession or vocation

Any employment, office, trade, profession or vocation

carried on for profit or gain.

State the name of your employer/company and jobtitle

)

Any payment or provision of any other financial benefit(other than from the Council) made or provided withinthe last 12 months in respect of any expenses incurred incarrying out your duties as amember or towards yourelection expenses

State the name the body making the paymentNote: This includes any payment or financial benefit

from a Trade Union

Any contract (which has not been fully discharged) forthe provisions ofgoods, services or the execution ofworks made between the Council and you or a firm inwhich you are aparbler, a company of which you are a

remunerated director or a company in whose securitiesyou have a beneficial intereslGive a description of the contract

N/A

Member

Spouse/partner

4. Land

Any land in the Council's area in which you have a

beneficial interest.This will include your place of residence if you own orrent it and it is within the Council's area.

It also includes any property from which you receiverent, or of which you are the mortgagee.


lht*t alf*G€l+tuaL1gn ,A@

f/€1r//l,acdt /rsAo&vfu+

&ucxr. t/a7 ottl

Member

,(r**. G*vuw d&4

Spouselpartn-e1

/144"4f ,&te C.#r'

5. Licences

Any land in the Council's area for which you have a

licence (alone or jointly with others) to occupy for amonth or longer.This will include any allotments that you use.

Give the address/description of the Iand

*/e

Member

Spouse/partner

orporate Tena

Any tenancy where to your knowledge thelandlord is the Council and the tenant is a body inwhich you are a partner, a company of which you are a


you have a beneficial interesl

Give a description of the tenancY

N/'t

7, Securities

A body who to your knowledge has a place of business

or land in the Council's area, and in whom you have a

beneficial interest in a class of securities that exceeds the

nominal value of f,25,000 or one hundredth of the totalissued share capital ofthat body or ifthe share capital ofthat body is of more than one class, the total nominal

value of the shares of any one class in which you have a

beneficial interest exceeds one hundredth ofthe totalissued share capitalofthat class-

List the names of any companies, industrial and

provident societies or other bodies corporate that (toyour knowledge) are active in the Council's area.

You do not need to state the extent ofyour interest.

ART 2 - Other Personallnterests

You are only required to disclose your own personal interests under the headings listed below.

Please state'hone" where appropriate


8.1 Any body of which you are a member or in aposition of general control ormanagement and to whichyou are appointed or nominated by the Council.Note: These will be need to be added after AnnualCouncil


nfr

8.2 Any body exercising functions of a public nature ofwhich you are a member or in a position of general


a member. It also includes govemment agencies, publichealth bodies, council-owned companies and schoolgovernorships


il/r+

8.3 Any body directed to charitable purposes of whichyou are a member or in a position of general control ormanagement.This will include membership of anyregistered charities

such as Rotary or Lions. Membership ofmasonicorganisations which are registered charities with the

Charities Commission will also fall within this category.


lla8.4 Any body one of whose principal purposes includesthe influence of public opinion orpolicy (including any political parly or trade union),of which you are a member or in a position of general

control or management.This will include any lobby Broup, local pressure goupor resident's association,


A/f*,

, Disclosure of Gifts and

Any person from whom you have received a gift or hospitality worth more thm m esfimated value of f,50 which you

have received by virtue of your office - including brief details of the gift/hospitality received.

foo ma/ &0f,.t

Date of receipt of Gift/Hosnitalitv

Name of Donor Reason and Nature ofGift/Hospitalitv

,.t /,*

l, ltutl namel (Ptease print)

a Member of (authority)

X)O( TOWNIPARISH COT]NCIL



CATHRYN DAVIES

LACEY GREEN X)Offh/Parish Council

panf t - n;sctosanrc

t. Emplovment, office, trade, profession or vocation

Any employment, office, trade, profession or vocationcarried on for profit or gain.

State the name of your employer/company and jobtitle

MemberFinance Director of Widmer Feeds LimitedDirector of Widmer Equestrian Centre LtdDirector of Widmer Farm LimitedSole Pi'oprietor Widmer Farm

Spouse/parfterDirector of Widmer Feeds LimitedDirector of Widmer Equestrian Centre LtdDirector of Widmer Farm Limited

2. Sponsorshin

Any payment or provision of any other financial benefit(other than from the Council) made or provided withinthe last 12 months in respect of any expenses incurred incarrying out your duties as a member or towards yourelection expenses

State the name the body making the paymentNote: This includes any payment or financial benefitfrom a Trade Union

MemberNone

Spouse/partnerNone

Contracts

Any contract (which has not been fully discharged) forthe provisions of goods, services or the execution ofworks made between the Council and you or a frm inwhich you are a partner, a company of which you are a

remunerated director or a company in whose securitiesyou have a beneficial interest.Give a description of the contract

MemberNone

Spouse/partnerNine

4. Land

Any land in the Council's area in which you have abeneficial interest.This will include your place of residence if you own orrent it and it is within the Council's area.

It also includes any property from which you receiverent, or of which you are the mortgagee.


Member

Widmer FarmPink RoadLacey GreenHP27 OPG

Spouse/parkter

Widmer FarmPink RoadLacey GreenHP27 OPG

5. Licences

Any land in the Council's area for which you have a

licence (alone or jointly with others) to occupy for a

month or longer.This will include any allotments that you use.


MemberNone

Spouse/partnerNone

'6. Corporate Tenancies


remunerated director or a company in whose securitiesyou have a beneficial interest.

Give a description of the tenancy

MemberNone

Spouse/partnerNone

7. Securities

A body who to your knowlrdge has a place of businessor land in the Council's area, and in whom you have abeneficial interest in a class ofsecurities that exceeds thenominal value of f25,000 or one hundredth of the totalissued share capital ofthat body or ifthe share capital ofthat body is of more than one class, the total nominalvalue of the shares of any one class in which you have abeneficial interest exceeds one hundredth ofthe totalissued share capital ofthat class.

List the n&mst of rny comprnies, industrial and

MemberNone

provident societies or other bodies corporate that (toyour knowledge) are active in the Councilos area.


Spouse/parherNone

'PART 2 - Other Personallnterests

you are only required to disclose your own personal interests under the headings listed below.

Please state o'$sn€" whetr€ appropriate

8. MembershiP of other bodies

8.I Any body of which you are a member or in a'pCIsitiofi of g€fieral esntrsi sr managefiI€fit and to whi'ch

you are appointed or nominated by the CouncilNote: These will be need to be added after Annual

Council

Give the rarnes of the body/ies

rlone

8.2 Any body exercising functions of a public nature ofwhich you are a fiiembcr or in a position of general


a member. It also includes govemment agencies, public

health bodies, council-owned companies and school

gov.emorships


None

8,3 Ary body directed ts charitable prposes of whichyou are a member or in a position of general control ormanagement.This wilt include membership of any registered charities

such as Rotary or Lions. Membership of masonic

organisations which,are registered cbaritiss with rhe

Charities Commission will also fall within this category'

Give the names of the bodyiies

Nsne

8.4 Any body one of whose princtpal purposes includes

the influence of public opinion orpolicy (including any political party or trade union),

of which you are a momber or in a position of general

control or management.This will include any lobby group, local pressure group

or resident's association,


9. Disclosure of Gifts and

Any person from whom you have received a gift or hospitality worth more than an estimated value of f50 which you

have received by virtue of your office -including brief details of the gift&ospitality received.

Date of receipt of GifUHosoitalitv

Name of Donor Reason and Nature ofGift/Hospitalitv

None None None

Dated: rb- 5 -2oz\ Signed:

l, (fult name) (Please print)

a Member af {authority)

XXX TOWN/PARISH COTINCIL



[4uer6a *uavt€S

LA- LgV r-..Q€lLN P*&<rt (o o Nrtu Ter*alParish Councit

PART 1- Disclosable Pecuniar.v Interestq

Any employment, office, trade, profession or vocationcarried on for profit or gain.State the name of your employer/compnny and jobtitle

Any pavment or pror"rsion of any other financial berefit(other than &om the Courcil) made or provided withinthe last 12 months in respect of any expenses incurred incarrying out your duties as a member or towards yourelection expensesState the name the body making the paymentNote: This includes any payment or financial benefitfrom a Trade Union

Oo nq_

r. Employment, office, trade, profession or vocation

Spouselparfrer

ftqn e

7 sorsh

Spouse/partner

ft\nq

cts

Any cortract (which has not been ful1y discharged) for

the provisionsof goods, services orthe execution of

woiks made betwien the Council and you or a firm in

which you are a partner, a company of wfrich you are a


you have a beneficial intereslGive a descriPtion of the contract

Spouse/partner

fltng

/f. Lild

Any tand in the Council's area in which you have a

beneficial interest.

This will include your place of residence if you own or

rent it and it is within the Council's area.

It also includes any propefty from which you receive

rent, or of which you are the mortgagee.


Mernber

oroc,€JDnY f-cFqeo ?PAP t c-t<-tt/€r-N d Av6*! N\s&ro N\

f e-r xc-rs R,<SoRsuq tt

gPS'I q,sL-

SFrseprter

prsc-teoAu e-qg q,g

O{ PeLtqK Nl€,rl t^Av

SAn tl1\ORfo N

f e, "r.A s €,rs 8lAo uqt

gPsy qNL

Member

r.-( on s6Any land in the Council's area for which you have a

licence (alone or jointly with others) to occupy for a

month or longer.This will include any allotments that you use'


t.c enancies




A body who to your knowledge has a place cf businessor land in the Council's area, and in whom you have abeneficial interest in a class ofsecurities that exceeds thenominal value of f25,000 or one hundredth of the totalissued share capital ofthat body or ifthe share capital ofthat body is of more than one class, the total nominalvalue ofthe shares ofany one class in which you have a

beneficial interest exceeds one hundredth ofthe totalis-s.led share $cital of,thet glass

I,irt &c rrncr dary oreui* Latr*rid erdprovident sodeties or other bodies cor?orrte that (toyour knowledge) are active in the Council's area.


Spouseipartner

^$c rue

Member

NA l\t(-

Member

Ps xr 6-

7-

.'ART 2 - Other Personallnterests

You are only required to disclose your cwn personal interests under the headings listed below.

Please state "none" where appropriate

8.1 Any body of which you are a member or in aposition of general control or management and to whichyou are appointed or nominated by the Council.Note: These will be need to be added after Annual

Council


8.2 Any body exercising functicns of a public nature ofwhich you are a member or in a position of general


a member. It also includes government agencies, publichealth bodies, council-owned companies and schoolgovernorships

Gir e the nams of the bodv/ies

8.3 Any body directed to charitable purposes of whichyou are a member or in a position of general control ormanagement.This will include membership of any registersd charitiessuch as Rotary or Lions. Membership of masonicorganisations which are registered charities with the

Charities Commission will also fall within this category.

Give the rames of the bodyfies

No n-t 6

hss ru6

8. Membershin of other bodies

{(uSres. o€ l[n"e- &s8oesuce

e-+(+turc6= .

8.4 Any body one of whose principal purposes includesthe influence of public opinion orpolicy (including any political party or trade union),of which you are a member or in a position of general

control or management.This will include any lobhy group, local pressure groupor resident' s association,

Give the names of the bodylies

F

i Disclosure of Gifts and

Any person from whom you have received a gift or hospitaliry worth more than an estimated value of f,50 which you

have received by virture ofyour oflice - including briefdetails ofthe giff/hospitality received.

Dated:.bw $o\rsign

..:

Date of receipt of Gift/Hosnitalitv

Name of Donor Reason and Nature ofGilt/Hospitatitv

NIL- r-.\,q F.(6-

F{l L^ l.h tu&

Fi-- Nq r.Je

t_Town/Parish Council

)Oil( TOWNIB&RISH COT]NCII,REGISTER OT MEMBERS' INTERESTS

GENER.{L NOfi CE OF REGISTRABLE INTERESTS

PART I - Disdosable Pecunhry Intcrests

t. Empbymt office, trade, prcfessien ervocetiou

Aay e,mplolmerf, offrce, trade, professin r rocdincarried on for profit or gain.

Stete tlc seme of yotr erybycrlc;rry J i.ftid€

4htose ,"/e

Mernbr

lEEe s7 tt*tlPna.,P.tz rlrU rLE-tf

brtt,rt'rr+.r7l( .

Spouse/pa+trG

2. Soonsodin

Any paymd crpirovisioa of ayolkfuoiel beae&(olherlhaa &omee Corrcil) es& aprovided witbiathe lxt 12 mmths in respect of any eryases iacurred incarrying ort your drties as a rnember u'towads youelection expenses'hetct* nmette body roldnt&e F.YdNot: This includes any payrnent or finacial b€oefitfmm aTizdeUnion

llernter

l,/h&

Spu*lpartnet

{au€

3. Gontracts

Any contract (which hm not beea ftrlly discharged) fortlre provisiors of po&" services or the exect(ion ofworks made betweas the Council ed you m a firm inwhich you are a p6tner, a compary ofwhich you are a

remuneraled director or a ccmpany in whose socuritis

Member

youhave a kreficial interestGiverdm!*imoftuffilrd N, Mvt

-

l, $,,s,on)(r'.*e*a 7. -,-y f,"e$/ f/r+C6^^tq*?

a Membet af ra*l,w*yt

4. Land

Any land inlhe Couacil's area il whichyor have abeneficial interestThis will include yorr place of residence ifyou own orrent it and it is wilhin the Cornoil's areaIt also includes any prop€tty from which you reseivqren! o,r of which you ae fre mortgagee.

Give tlrc addrrddesctiption of thlead

Membr

6he9* b((,#,8/oos L&a tht,t-Acoart {1 8";tflz+ o/o'(*oe^G)

Spouselpartner

5. Licences

Any lad in the Comcil's rea for which yur have alice,nce (alme m jointly with others) to occrpy fc amonth or longer.

This will inclu& any allotments that you use.

Give the addrcsddscription 61'1trg tand /fi

Member

Spouserpadner

@

Abodywhotoycur*"-r*ffiorland b the Cormil's ereA aad ifl whom you have a Ibeneficial interest in a class of secu'ities that exceeds tk I

nominal value of €25,00O or one htmMth ofthe total Iissued share capital of that body or if rhe shce capital of Ithat body is of more than ooe class, the total nominal Ivalue of lhe shaes of ay one class in which you have a ]beoeficial interest exceeds one hundredth ofthe total I

issued share capital ofthatclass. I

l,isf the namcs of aw comDrmfol* i#rial ad I

Member I

4nlI7

ac{ive in the Council's ar:ea.

^d to state Ore ert€nt of your int€rest-

4o

B{RT 2 - O&erPers*nal Interssts

You are only required to disclose your ow:r personal interests under the headings listed below.Please state *none" w-here appropriate

8.1 Any b@' of shieh Jrc ee a member or in apmitioof gsoet-al sodEo'l of,ffi'g<rg* dtoshi&you ar-e 4rynrl@l or xrl*c{ }y th Ctmefl-Note: These will be ae€d to be aded after AmualComcil

Give the nem ef lbe bodr/ies

8.2 Any b@ exercising fimctiom of a public natrre ofwhich you are a msmber or irr a posilion of general

contml ormaagsmenlThis will inch& otler local ar&oritHs of which you aea member. It also inchrds govermea agencies' publichealth bodi:s, cotxcilorned cqaks d schoolgovernuships

Give tte aarc of fu bo*Yrieu

Mq€ ^{/

+

8.3 Any body directed to chait*le purposes of xhichyou are a member or in a positior ofgeneral coatol orman€ement-This rrill include membership of ay registered charhiessuch as Rotary r lions- Memb{ship ofmaoaicorg-anisations which are registered che'ities with the&aritie" Commissior will also tall within this calegory.

Give the names of ite hadyiie:Aree

8.4 Any body one ofwhose principal purpos€s includesthe influence of p.rblic opinion orpolicy (iacluding any political patty or trade mion),of which you are a member or: in a positioar of genaalcontrol ormoagemenLThis will iaclude any lobtry grorry, local pressure gror.ry

or resident's association

Give the narm of the bodyiies .LIfiA-'4L a@4/r' 1 ,

L.

Any person from whom you have received a gift or hospitality worth more than m estimated value of f,50 which youhave received by virtue ofyour office - including trrief details ofthe gift&ospitality received.

Date of rec'eiptof Gffi/llospitalitv

Name of I)onor Reason and Nature ofGift/Hospitality

r/rAt* Ar/ b

--

r{"5/@, ,Dated: Signed: 7

-1I 9- Disclosurt' nf Giftr *nrl Hosnifrlifv

Glossary of Words and Ilefinitions

"beneficial interesf is one where the owner of t}le interest is entitled to benefrt from the assetconcemed. Such an irferest can arise drectly through the legal oruership of an asset or indireeflyw-here you are the benefrciary of a trust. It excludes those who hold assets under a trust but are notbeneficiaries of that tmst.

"body in which the relevant person has a beneficial interest" means a firm in which the relevaotperson is a partner or a body corporate of which the relevant person is a director, or in the securitiesof which the relevant person has a beneficial interest;

"director" ineludes a member of the committee of management of an industrial and pror.identsociety;

'Disclosable Pecuniary Interest'as a pecuniary interest ofa description rnhich is specified inregulations made by the Secretary' of State and which is either an interest of the Member's or aninterest of Member's spouse or civil partner, a person with whom the Member is living as husbandand wife or a person with whom the Member is living as if they w'ere civil partners, and theMember is aware that the other person has the interest.

"land" excludes atr easement, servitude, interest or right in or over land waich does not carqi with ita right tbr the relevant person (alone orjoint$ with another) to occupy the land or to receiverncome;

"member" includes a co-opted member:

"securities" means shares, debentures, debenture stock, loan stock, bonds, units ofa collectiveinvestment scheme within the meaning of the Financial Services and Markets Act 2000 and othersecurities of any description, other than money deposited with a building societlr.

the "nominal rralue" of shares is usually the face value on the share certifrcate when issued (incontrast to the "market value" which can often be considerably more but may be less)

l, 1ft"# aa*e1 (Ptease print)

a fVlember of (authority)

x)fi TO}YN/PARISII COT}NCIL


GENERAL NOTICE OF' REGISTRABLE INTERESTS

Lnc€y Qzee-^' TexiflcrParish Council

PART ! - Disclnsahle Peeuniars Iaterestq

,Jga"l

t. Employment office, tradg profession or vocation

Any employmenq office, trade, profession or vocationcarried on for profit or gainState the name of your employer/company and jobtitle

Member

hroNe - R€ttz-€D

Spourelparfler

rto Ne _ R€Tt e_€_D

2. Snonsorshio

Any payment or provision ofany otler fi::ancial benefit(other than from the Council) made or provided withinthe last 12 months in respect of any expenses incurred incarrying out your duties as a member or towards yourelection expensesStatc the name the bodymakingthe paymentNote: This includes any paymeat or financial benefitfrom aTrade Union

Member

/Y'o N E

Spouse/partner

No rve

Any contract (which has not been fir1ly discharged) forthe provisions ofgoods, services or t}te execution ofworks made between the Cowrcil and you or a firm inwhich you are a partnsr, a company of which you ar,e a

remrmerated director or a company in wtrose securitiesyou have a beneficial iofierestGivo a dcscription of&e contract

Member

f:fo N€

Spousefparher

No nl€

4, Land

Any laad ia the Cormcil's area ia which you have abeneficial intere$-This will include yow place ofresideoce ifyou orvn orrent it and it is within fu Couocil's alea-It also hcludes aoy prryerty from wLich yor receiveren! or of wtrich you ae the mmtgagee.

GiE ec rddrcss/dc*rnd.r.ffu lrd

Msnber

Dee^l Por.tD (ozra<elCt uN t.-a r'' €LacEy Q?eA-''Eo ctcS

t+? d1 c?T

DA) 7or D C-cTT+zr€

fJ uJ LA /,r €L.acev QZee^'

fi"q o?r

Member

I{o r'J €

Any land in the Cotmcil's aea for which you have alicence (alone orjohtly with others) to occupy fcr a

month or loager.Thiswill include my allotaeatsthat you use.

Givc the addressfdescription sfthe land

Any tenffiy wb€re to yotn knowledge the

faoAora is i* Couacil and the tenant is a body in

which you are a parfier, a company of which you are a

r€mm€raied director or a company in whose securities

you bave a beneficial interest-

Give e kriPtion of thc tenancY

A body who to your knowldge has a place of bus. iness

* nft io tn* iouncil's area, and in whom you have a

beaeficial interest in a class of securities that exceeds the

"o*iruf "4"" of f25,000 or one hrmdredth of the total

i"*"4 -f** capital of that body or if the share capital of

that body is of more thaa one class, the total nominal

valrre ofthe shares ofany one class in which you have a

beneficial ilterest exceeds one hundredth ofthe total

issred share capital ofthat class-

Iirt&c mrcs of tnycorrpanieq industrialarprovidcnt socioties or other bodies corporate that (to

your howledge) are active in the Council's area'

You do not ned to stat€ the extent of your interest

You are only required to disclose your own personal interests under the headinp listed below.Please statc ohone" where appropriate

,F .-j-r*as:'

8. Membershin of other bodies

8.1 Any body of rvhich you are a member or in apositioa of general control or management and to whichyou are appointed or nominated by the CouncilNote: These will be need to be added after AnnualCourrcil


tVo rJe,

8.2 Any bod5r exercising furctioas of a public mture ofwhich you ae a member or in a positioa of genaalcontol or managetneolThis will inclu& der local arthorities of rryhich y<xr area member. ,r r"o;ostrylcs governmerf agruies' pblicklth bodies, comcil-wned cmpmies d sfulgovern€r$ips

Give the Rarns ofthe bodyfies

A/,O N€

8.3 Any body dfueded to chaitable prnpm of c&ichyou are a member q in a positicn of gerreral cmtol qma0agemenlThis will iach& membership of ry registered chflitieswch as Rotay s Lims. Membership of masmicorganisations which are regisered chrities with theCharities Commission will also &ll within this category.


r!o ^./'e

8.4 Any body one ofwhose principal pulposes includesthe influence ofpubhc opinion orpoliry fincluding any political party or trade tmion),of which you are a member or in a positim of general

control or management.This will include any lobby group, local pressure grorpor resident's association,


6Jo rv€

9. Disclsure of Gifts and

Aay person from whom you have received a gift or horyitality worth more than aa estimated value of f,50 which you

have received by virtue ofyour office - includiag briefdetails ofthe gift/hospitality received-

Date of reeeipt of Gift/Hmnitalitu

Name of Donor Reason and Nature ofGift/Hosnitalitv

No Ne

Dated: r-<.frY 2oLt Sign

a

XXX TOWN/PARISH COT]NCIL



PH t'-tp Trmraqr\rw we Su fer(

[xte7 C-*.,e$J Pne''* 4swnlParish Council

PART I - Disclosable Pecuniary Interests

l, lfultnamel (Ptease print)

a Member of @uthofty)

t. Employment, office, trade, profession or vocation

Any employment, office, trade, profession or vocationcaried on for profit or gain.State the name of your employer/company and jobtitle

Member Grnag/ Hlr^utz L:[D

HReclqr

Spouse/partrter

lsH+t\s'?

2. Sponsorship

Any payment or provision of any other financial benefit(other than from the Council) made or provided withinthe last 12 months in respect of any expenses incurred incarrying outyour duties as amember or towards yourelection expensesState the name the body making the paymentNote: This includes any pqment or financial benefitfrom a Trade Union

Member

Nosrf,

Spouse/partner

l'{Osrf

.Contracts

Any contract (which has not been fully discharged) forthe provisions ofgoods, services orthe execution ofworks made between the Council and you or a finn inwhich you are a parhler, a company of which you axe a

remunerated director or a company in whose securitiesyou have a beneficial interest.Give a description of the contract

Any iand in the Council's area in which you have abenefrcial interest.This will include your place of residence if you own orrcnt it and it is within the Council's area.It also includes any property from which you receiverent, or of which you axe the mortgagee.


Member

K.gp.gag'ClrrrAgru \\ ut-SfieeisfiR,l LG K\s$l'6t\{c$*Buces hPz-; osfHor-rs

Spot.*ee*fer

l\:' \-lemese

4. Land

5. Licences

Any land in the Council's area for which you have alicence (alone or jointly with others) to occupy for a

month or longer.This will include any allotnents that you use.


)orporate Tenancies

Any tenancy where to your knowledge thelandlord is the Council and the tenant is a bofu inwhich you are a parEler, a company of which you are a



Member

)-\oNg-

Spouse/partner

N[rNJr

7. Securities

A body who to your knowledge has a place ofbusinessor land in the Council's arez, and in whom you have a

beneficial interest in a class of securities that exceeds thenominal value of f,25,000 or one hundredth of the totalissued share capital of that body or if the share capital ofthat body is of more than one class, the total nominalvalue of the shares of any one class in which you have abeneficial interest exceeds one hurdredth of the totalissued share carital ofthal class.

Member

NoNX6r

lssued Snare capfial of tnal cl;tss.

IiEtfu nrtsof ar5r corrslirlr"irdxffiirt edprcvideut societie or other &CIdies corporate that (tnyour knowledge) are active in the Council's area.



8.1 Any body of which you are a member or in aposition of general conkol or management and to whichyou are appointed or nominated by the Council.Note: These will be need to be added after AnnualCouncil


t.toSfl

8.2 Any body exercising functions of a public nature ofwhich you are a member or in a position of generalcontrol or mutagement.This will include other local authorities of which you are

a member. It also includes govemment agencies, publichealth bodies, council-owned companies and schoolgovernorships

Gh-e the narnes of the bodv/ies

NONIF

8.3 Any body directed to charitable purposes of whichyou are a member or in a position of general control ormanagement.This will include membership of any registered charitiessuch as Rotary or Lions. Membership of masonicorganisations which are registered charities with theCharities Commission will also fall within this category.


N0r{6

8.4 Any body one of whose principal purposes includesthe influence of public opinion orpolicy (including any political party or trade union),of which you axe a member or in a position of generalcontrol 0r management.This will include any lobby $oup, local pressure groupor resident's association,


Norur-

You are only required to disclose your own personal interests under the headings listed below.Please state "norte" where appropriate

I

Disclosure of Gifts and Hos

Any person from whom you have received a gift or hospitality worth more than an esfimaled value of f,50 which youhave received by virtue of your off,tce - including brief details of the gift/hospitalrty received.

Dated: -[tA,\

N{o^{ z0z( ,,nn"o,

)

Date of receipt of Gift/Hospitalitv

Name of Donor Reason and Nafure ofGift/Ilosoitalitv