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The Relevant Authorities (Disclosable Pecuniary lnterests)

Regulations 2012 Register of Members' lnterests
l, print name

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a member/co-opted member (deiete as appropriate)


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Council hereby give notice to the Clerk ofthe Council and the Monitoring Officer for Cheshire
East Council ;f those disclosable pecuniary interests which I am required to declare under The
Relevant Authorities (Disclosable Pecuniary Interests) Regulations 2012 and my Town/Parish
(detete as appropriate) Council's Code of Conduct.
I understand that in so doing I must also declare not only my own interests but also any interest I
am aware of that belongs to my spouse or partner, as defined in my Councal's Code of Conduct.

Where I have no such interests under any heading I have endorsed the form "none".

Additional lnformation
The notes to this form give general guidance,-but.are not necessarily comprehensive. Please
consult the l\,Ionitoring Officer if additional information is required.
under the Localism Act 2011 and the above Regulations you must register your pecuniary
interests. lf you fail to do so, and then participate (speak or vote or both) at a Town or Parish
Council or committee meeting, you may be committing a criminal offence
The information that you give on this form is required to be kept in a Register that must be
available for inspection by the public. lt must also be available for inspection on your
Town/Parish Council's website (if applicable) and on Cheshire East Council's website so it is
important that you keep it up to date. Gifts or hospitality received for a value of fl00.00 or more
should be included on a separate form.
You must, within 28 days of becoming aware of any change of circumstances notify the Clerk to
the Council and/or Cheshire East Council's Monitoring Officer asking that the information be
included in your Register of Members' lnterests
The Act provides that if information relating to your interests is "sensitive", that is to say if you
and the Monitoring Ofllcer agree that disclosure of its details could lead you, or someone
connected with you, to be vulnerable to violence or intimidation, it need not be included in the
Register, even if it is a disclosable pecuniary interest Please consult the Monitoring Officer if
additional information is required on this issue.

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(a) Your Employment, Office, Trade, Profession or Vocation

Pleaae give details ol (i) every employment, job, trade, business orvocation you have, for
which you receivG any benofit o. gain (i-e. profit, salary or beneflt in kind) including a short

doscription ofthe activity e.g. 'Accounlant' or 'Farmer' and (ii) lhe name of any employeror
body, firm or company which you own or in whose securities you have any beneficial
intercsl. This must include any rcmuneEtion as a Director.

Name of Employer

Desc ption of

Description of Employment






1 (b) Your Spouse or Partner's Employment, Office, Trade, Profession or Vocation

Pleaae give detaib of (i) every employment, iob, kade, busineas orvocation your spouae or
partner has, forwhich they aecaive any benefit or gain (i.o. profit, salary or benelit in kind)

including a short description ofthe activity e.g. 'Accou.tant' or 'Farmer' and (ii) the name of
any employer or body, firm o. company which-they own or in whose securities lhey have
any beneficial interesl. This must inelude any rcmuneration a6 a Director.

Name of Employer

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Description of

Description of Employment


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Please give details of any person or body (otherlhan the Town or Parish Council) who has
made any payment to you in respect of your elgction or any expenses you have incurred in
carrying out your dutiea a3 a Town or Padsh Councillor. Please also include any payment
orfinancial benefit received from a Trade Union-

,l(a) Contracts: for Goods, Works o. Services wlth the Council
Plsase give detalls of any curcnt, existing contracts for goods, woaka oraeryices between
lh. Town or Parish Council and you or any body, firm or company by which you are
employed or which you own or in which you have a beneflcial intorogt, .elerred to at 3 above.

,l(b) Contracts: for Goods, Works or Seavices between the Council and your Spouse or
Pleaao giye details ot any cur6nt, exiating coltracts for goods, works or services between
the Town or Parish Councll and yourspouse or partner, orwlth any body, fiIm or company
by which they ale employed orwhlch thoy own o. in whose securlties thoy have a beneticial
lnteEst, rofarred to at 3 above.


5(a) Landholdings and Licenses in the Area
P,ease give the addross or othel doscriplion (sutficiont to ldentify the locatior) ofany land or
propeit, in the Council's area in which you have a beneficial inteiest, indicating whether you
ireihe owner, lessee ortenant. You should include land in which you may havo a licence,
alone or with others, to occupy for a peaiod of one month or longeJ. You must include the
land and houso you live in and for example any allotmenls yolr rent or u9o.

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5(b) Landholdings and Licenses in the Ar-ea belonging to your Spouse or Partner
Pieiso give the address or other description (sufticient to identily the location) of any land or
propert! in the Council's area in which you are awane lhat yourspouse or paftner has a
Le;ficial intorest, indicating whether they a.e the owner, lsssee ortenant. You should
include any land in which they may have a licenco, alone orwith othe,s, to occupy for a
pcriod of one month or longer, such as tor example any allolments they rent or use.


6(a) Corporate Tenancies: Land leased from the Town or Parish Council
Please give the addresa o. other deacription (sufficientto identify the location) ofany land
leaaed or licenaed faom th6 Council by you or any body, tirm or company by which you are
omployod or which you own or in which you have a boneficial interest (epecified at 3 above).

6(b) Corporate Tenancies: Land leased from the Town or Parish Council by your
Spouse or Partner
Please glvc the address or other descdption (Fufficient to iderltlfy the location) of any land
that you are awarc of thal ls leased or licensod from the Council by yourspouse or padner
or any body, tkm or company by whlch lh6y are employed orwhlch lhey own or in whose
secudtles they have a beneflclal lnterest (speclfied at 3 above),

recognlse that if I fail to comply with the Code of Conduct for Membe6 of
councit or l:
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(i) omit any information that Ehould be included in this Notice;

liil dive falso or miBloadlnq information; ol

iiii)io not tllthe cle* oflhs council or cheshire Easl council's Monitoring office' ofany
changes to this Notice or new interests I acquire,
that this may be a crlminal offence andlor the matter may be aefe,aed to Cheshire East
Council's Audit and Governance Sub-Committee for investigation.

Signod :


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