Victorian Numbered Regulations

CATCHMENT AND LAND PROTECTION (REGISTER OF INTERESTS) REGULATIONS 2006 (SR NO 151 OF 2006) - SCHEDULE 1

SCHEDULE 1

Sch. 1

Regulation 5

PRIMARY RETURN

(Surname)     (Given names)

(Name of Authority)

Details of registrable interests as at the date of this return—

    1.     The name of any company or other body, corporate or unincorporate, in which you hold an office whether as a director or otherwise.

    2.     The name or description of any company, partnership, association or other body in which you hold a beneficial interest exceeding $2000 in value.

    3.     The address or description of any land in the region of the Authority or in a region which adjoins the Authority's region in which you hold any beneficial interest other than by way of security for any debt.

    4.     A concise description of any trust in which you hold a beneficial interest or of which you are a trustee and in which a relative, as defined in section 18L(4) of the Catchment and Land Protection Act 1994 , holds a beneficial interest.

    5.     Any other substantial interest, whether of a pecuniary nature or not, of yours or of a relative, as defined in section 18L(4) of the Catchment and Land Protection Act 1994 , of which you are aware and which you ought reasonably to consider might appear to raise a material conflict between your private interest and your public duty as a member or nominated officer (as the case may be).

Signature of person making return:

Signature of witness:

Date:

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