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DECLARATION OF INTEREST <br />�I'T+HENER Municipal Conflict of Interest Act <br />Mayor/Councillor/Committee Member Name <br />Date of Meeting: <br />Item Title: <br />1 <br />Report Number (if applicable): Z� r. /q O 1 <br />(*Please circle the appropriate variable) <br />I, Mayor(Co;uncillor Committee* memberdeclare thaa leve 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: <br />Mayor/Councillor/Committee Member Signature: -` <br />q/ <br />Date of Declaration:0jq= <br />FOR OFFICE USE <br />Date received: HO) -Ch 41P c901q_ _ Received by: <br />Date entered into registry: MctR.ch S� aolq Registry updated by: SLS <br />