Employment, Office, Trade, Profession or Vocation *
Please give details of (i) every employment, job, trade, business or vocation you have, for which you receive any benefit or gain (i.e. profit, salary or benefit in kind) including description of the activity e.g. ‘Accountant’ or ‘Farmer’ and (ii) the name of any employer or body, firm or company which you own or in which you have any beneficial interest.
Please give details of any person or body (other than the Town/Parish Council) who has made any payment to you in respect of your election or any expenses you have incurred in carrying out your duties as a Town/Parish Councillor.
Securities: Interests in Companies *
Please give details of a body which has a place of business or owns land in the Town/Parish Council’s area and in which you have a beneficial interest (a shareholding) of more than £25,000 (nominal value) or more than 1/100 of the total shares issue of that body (whichever is the lower) or if there is more than one class of share, the total nominal value of shares in any class of that body of more than 1/100,h of the total shares of that class.
Note: It is not necessary to declare the nature or size of the holding, simply the name of the company or other body.
Contracts: for Goods, Works or Services with the Council *
Please give details of any current, existing contracts for goods, works or services between the Town/Parish Council and you and a body, firm or company by which you are employed or which you own or in which you have a beneficial, interest, as referred to at 'Securities: Interests in Companies' above.
Landholdings and Licences in the Area *
Please give the address or other description (sufficient to identify the location) of any land or property in the Town/Parish Council’s area in which you have a beneficial interest. Indicate whether you are the owner, lessee or tenant, including land in which you may have a licence - alone or with others - to occupy for a period of one month or longer.
You must include the land and house you live in and, for example, an allotment you own or use.
Corporate Tenancies: Land leased from your Town/Parish Council *
Please give the address or other description (sufficient to identify the location) of any land leased or licensed from the Town/Parish Council by you or a body firm or company by which you are employed or which you own or in which you have a beneficial interest (specified at 'Securities: Interests in Companies' above).
Your Personal Interests *
Please give details of your membership of, or any position of general control or management, of any bodies in the categories listed below, your interests in land in the area of the Town/Parish Council (other than those set out in 'Landholdings and Licences in the Area' & 'Corporate Tenancies: Land leased from your Town/Parish Council') and of any gifts and hospitality received worth over £25.
Eligibility Declaration *
By clicking on the submit response button and submitting this form you hereby declare that the information provided is true and correct and that you are:
(a) British or a citizen of the Commonwealth or European Union;
(b) at least 18 years old; and,
(c) registered to vote in the area or have lived, worked or owned property there for at least 12 months before the election.