HomeMy WebLinkAboutCouncillor Jones 2019-04-29C11rington
Council / Committee Member
Declaration of Interest Form
If this information is required in an alternate format, please contact the Accessibility
Coordinator at 905-623-3379 ext. 2131.
This form shall be completed by the Member for each matter for which the Member is
declaring an interest in accordance with the Municipal Conflict of Interest Act. The
completed form shall be provided to the Municipal Clerk, or designate, at the conclusion
of the meeting. Note, the details of the declaration shall be recorded in the Declaration
of Interest Registry and a copy of the completed form shall be posted on the Municipal
Website in addition to the Registry.
I, Councillor Jones
(❑ deemed / ❑direct / indirect2) pecuniary interest on
Agenda:
Details:
❑ General Government Committee
❑ Planning and Development Committee
Council
, declare a potential
Agenda Item / Subject matter: Item 11 of the GGC Report
or+ �„r. FND-011-19
epo num er.
Date of meeting: April 29, 2019
for the following reason:
Employee of Lakeridge Health
Councillor Si ature Date
CA/Ia� April 29, 2019
b�fe Receiv��� by the Clerk (or
Desianate)
Notes: 'For a "deemed" direct or indirect pecuniary interest see Section 3 of the
Municipal Conflict of Interest Act.
2For an "indirect pecuniary interest" see Section 2 of the Municipal Conflict of
Interest Act.