Laserfiche WebLink
KiTcHENER <br />DECLARATION OF INTEREST <br />Municipal Conflict of Interest Act <br />Mayor/Councillor/Committee Member Name: C d <br />Date of Meeting: <br />/(G, <br />r <br />Item Title: <br />n C� <br />Report Number (if applicable): �� 1 <br />(*Please circle the appropriate variable) <br />1, Mayor irCouncillor fCommittee* member 66 PALq <br />e <br />declare that I -believe that I have a direct / indirect* pecuniary inter t as <br />defined in the Municipal Conflict of Interest Act related to the above <br />topic/item found on the Council/Committee agenda for the following <br />reason: r-- <br />M <br />Mayor/Councillor/Committee Member Signature: <br />l e t /� ) <br />Date of Declaration: <br />FOR OFFICE USE <br />Date received: -Ab fY((-� <br />- <br />5 <br />�5 <br />Received by: <br />Date entered into registry: Registry updated by: <br />