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4M , 0 <br />DECLARATION OF INTEREST <br />ER Municipal Conflict of Interest ActKiTCfJET,-- <br />Mayor/Councillor/Committee Member Name: <br />Date of Meeting: <br />Item Title: <br />Report Number (if applicable) <br />`� �...� d\ �. ��.`y`l 1. 7-'t..l.. C. �i/ry1. 1�/- Ol �: �`\.. - �, . ?�.6.•� �-- Lt �i v �: <br />(*Please circle the appropriate variable) <br />I, Mayor / Councillor) Committee* member i0/1 C4 <br />declare that I believe that I have a direct / indirect* pecuniary i4rest 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: Y <br />V\ <br />r <br />Mayor/Councillor/Committee Member Signature: <br />Date of Declaration: <br />FOR OFFICE USE <br />Date received: Sr.p . a 4 / ao as . Received by: <br />Date entered into registry: Sep• 3a)aoaa. Registry updated by: <br />