HomeMy WebLinkAbout2019-10-28 - CouncilKiTcHENER
DECLARATION OF INTEREST
Municipal Conflict of Interest Act
Mayor/Councillor/Committee Member Name: C d
Date of Meeting:
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Item Title:
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Report Number (if applicable): �� 1
(*Please circle the appropriate variable)
1, Mayor irCouncillor fCommittee* member 66 PALq
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declare that I -believe that I have a direct / indirect* pecuniary inter t as
defined in the Municipal Conflict of Interest Act related to the above
topic/item found on the Council/Committee agenda for the following
reason: r--
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Mayor/Councillor/Committee Member Signature:
l e t /� )
Date of Declaration:
FOR OFFICE USE
Date received: -Ab fY((-�
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Received by:
Date entered into registry: Registry updated by: