REGISTER OF DISCLOSABLE PECUNIARY INTERESTS
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1 REGISTER OF DISCLOSABLE PECUNIARY INTERESTS Derbyshire ['Istria Council Councillor's Name NEW, SiOviti6k Name of Authority Ot'1524 ;'J-1 3-rtbcr This form must be completed by an elected member or co-opted member within 28 days of adoption of the Members' Code of Conduct or within 28 days of becoming a member or coopted member of the authority. A Disdosable Peaziiary Interest is an interest of yourself or your partner (which means spouse or civil partner, a person with whom you are living as husband or wife, or a person with whom you are living as if you are ChM partners). Further Guidance Notes on Disdosable Pecuniary Interests can be found on page 6. Please insert 'None' in the appropriate box where there are no interests and 'Joint where such interest affects you and your partner equally. I GIVE NOTICE below, under the appropriate headings, of my interests and those of my partner of which I am aware, that are Disclosable Pectziary Interests as defined in The Relevant Authorities (Disdosable Pecuniary Interests) Regulations , Employment,Office,Trade, Profession or Vocation Any employment, office, trade, profession or vocation carried on for profit or gain. Counallor S Y
2 Any payment or provision of any other financial benefit (other than from the relevant authority) made or provided within the relevant period in respect of any expenses Incurred by me in carrying out *Mos as a member, or towards my election expenses. This Includes any payment or financial benefit from a trade union within the meaning of the Trade Union and Labour Relations (Consolidation) Act Coundlbr IVOA) 3. Contracts My contract which is made between the relevant person (or a body in which the relevant person has a beneficial interest) and the relevant authority (a) under which goods or services are to be provided or works we to be executed; (b) and which has not been fully ckscharged. Cotincillor NONE NON( 4. Land Any beneficial interest in land which is within the area of the reward authority. CAc,-,figr t-- N-0-1V C 22 Ai Os //or Page 2
3 5. Licences Any licence (alone or jointly with others) to occupy land in the area of the relevant authority for a month or longer_ Councillor NONE 6. Corporate Tenancies Any tenancy where to my knowledge - (a) the landlord is the relevant authority, and (b) the tenant is a body in which the relevant person has a beneficial interest. Councillor 7. Sscurtbes Any beneficial interest in securities of a body where - (a) that body (to my knowledge) has a place of business or land in the area of the relevant authority, and (b) either - (i) the total nominal value of the securities exceeds 25,000 or one hundredth of the total issued share capital of that body; or (ii) if the share capital of that body is of more than one class, the total nominal value of the shares of any one class in which the relevant person has a beneficial interest exceeds one hundredth of the total issued share capital of that class. Councillor NONI No Alk:
4 REGISTER OF OTHER INTERESTS I GIVE NOTICE below, under the appropriate headings, of my other interests required to be registered by the Members' Code of Conduct. B. Bodies of which s am a member or in &position of amoral or manauerrient and to which I apt anvois ted or ncedmild by the coami as its isiorrtefive - mmmmmmmmmmmm mmmmmmmmmm +P.... +P.= " -... a... r T.! =...RI mm amma on... b.** mi... a # Ii!Mt exercising functions of a public nature; directed to charitable purposes; or one of whose principal purposes include, the policy (including any political party or trade union) influence of public *pig= or of which I ern a member or in a position of general control or monogiolook (WA/.a La a a aa.a.a.a. # a... TR.. ma a...a...a dii 4.* drib... maw... mw 11"11.1. inlom I Au.. - a.* 'm di lb F.E....
5 10. Any easement servitude, interest or fiord in or over laid which dose not carps with it a rig imam Algol or jointly with another) to ooctuaripp lend or to receive Income mmmmmmmmmmmmmm mmmmm mi-am mai.1.mie a. NOIV C% m mmm a mi. =Am mm T m mmmmmm mmmmmmmmm MT R...1m T FE. mmmmmmm -... mmmmmm - deb. a.. del mm m-l mira I understand that I must, within 28 days of becoming aware of any new or change in the Discknahle Pecuniary Interests or other interests specified above, including any change in relation to a sensitive interest, provide written notification to the Monitoring Officer of that change. Original signed n-r a... mm mmm 514 S7tru iu 7 mmmmmm ii.i. lb de mmmmm mm Y..1 T T4111. iiiiiima m...6 Received by idonildriig Officer Deb Wink mm mmmmmmmmmmm - eked On VainbSitO.1. tr> is -.
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617 Request for Unforeseeable Emergency Withdrawal MTA 457 Plan Instructions Please print using blue or black ink. Send completed form to the following address or fax it to 1-866-439-8602. If faxing, please
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