Localism Act 2011 Sections 29 and 30

These are the interest you are obliged to disclose with by law, or under the Parish Council's Standing Orders. You must complete this form and return it to the Parish Clerk, who will forward it to the Local Authority's Monitoring Officer. You must also let the Parish Clerk Know immediately in writing if there is a change to any of the information on this form. A copy of this form is by law required to be published on Fair Oak and Horton Heath Parish Council's website as well that of the Local Authority..

3. Sponsorship

Has any person or body (other than Fair Oak & Horton Heath Parish Council) made any payments to you towards your expenses in carrying out your duties as a councillor, or towards your election expenses, within the last 12 months, such as a political party?.

4. Shares/Securities

Please give the name of the any person or body which to your knowledge has a place of business or land in the Fair Oak & Horton Heath Parish Council's area where you have either:

i) A beneficial interest in securities (for example shares, debentures, bonds etc.) in the person or body with a nominal value of more than £25 000, or

ii) A beneficial area in securities in the person or body amounting to one hundredth of their total issued capital

5. Contracts with Fair Oak and Horton Heath Parish Council

Please describe any contract for goods, services or works between Fair Oak and any of the following:

• You, individually
• Any firm in which you are a partner
• Any company with which you are a director
• Any person or body declared under paragraph 4 above

6. Land in the Fair Oak & Horton Heath Parish Council Area

Please describe with enough detail to identify its location, any land within the Fair Oak & Horton Heath Parish Council area in which you have a beneficial interest (i.e. own, rent, lease or have a licence to occupy for a month or longer), whether alone or with others. (please provide plan if appropriate)

7. Tenancies

Please describe with enough detail to identfity its location, any land where the landlord is Fair Oak & Horton Heath Parish Council and;

• You, or
• Any firm in which your are a partner, or
• Any company in which your are a director, or
• Any person or body declared under paragraph 4 above is the tenant. (Please provide plan if appropriate)

8. Non-Pecuniary Interests

Please list any bodies of which you are a member, or are in a position of general control managment, and:

9. Do you have a spouse/partner

Are you married, or do you have a civil partner, or are you living with someone as if you were married or civil partners?

11. Spouse/Partner Employment

Please state any employment, office, trade, profession or vocation that your spouse/partner carries on for profit or gain.

12. Spouse/Partner's Shares/Securities

Please give the name of any person or body which to your knowledge has a lace of business or land in the Fair Oak & Horton Heath Parish Council area where your spouse/partner has either:

i) A beneficial interest in securities (for example shares, debentures, bonds etc.) in the person or body with a nominal value of more than £25,000 or

ii) A beneficial area in securities in the person or body amounting one hundredth of their total issued capital

13. Spouse/partner's contracts with Fair Oak & Horton Heath Parish Council

Please describe any contract for goods, services or works between Fair Oak & Horton Heath Parish Council and any of the following;

• Your spouse/partner as an individual, or
• Any firm in which your spouse or partner, is a partner or
• Any company in which your spouse or partner is a director, or
• Any person or body declared under Paragraph 12 above

14. Spouse/Partner's land in the Fair Oak & Horton Heath Parish Council Area

Please describe with enough detail to identfity its location, any land within the Fair Oak and Horton Heath parish Council area in which your spouse/partner has a beneficial interest (i.e. own, rent, lease or have a licene to occupy for a month or longer), wither alone or with others. (please provide plan if appropriate)

15. Spouse/Partner Tenancies

Please describe with enough detail to identfity its location, any land where the landlord is Fair Oak & Horton Heath Parish Council and;

• Your Spouse/Partner, or
• Any firm in which your Spouse/Partner is a partner, or
• Any company in which your Spouse/Partner is a director, or
• Any person or body declared under paragraph 12 above is the tenant. (Please provide plan if appropriate)

Declaration

As a member of the Fair Oak & Horton Heath Parish Council, I declare that the information set out above is a true and complete record of the Interests that I must declare under the Relevant Authority's (Disposal Pecuniary Interests) Regulations and the Council's Standing Orders.  I understand that it is a criminal offence if I provide false or misleading information about my, or my spouse/partner's disclosable pecuniary intererts when I know that the information is misleading or I am reckless as to whether it is true and not misleadng.