Victorian Numbered Regulations Victorian Numbered Regulations" SCHEDULE
Local Government (General) Regulations 2004, Regulation 6
Primary Return
Notes—Please Read:
(1) Interests which you are required to register are prescribed in section 81(6) of the Local Government Act 1989 .
(2) If there is not sufficient space on this form for all of the information you are required to register, you may attach additional papers for that purpose. Each paper is to be signed, dated and witnessed in the same manner as this return.
(3) Answer all questions and ensure your answers are clear and legible.
Family name: Given names:
Name of Council:
Name of Ward (if applicable):
Position held:
Insert details of the Registrable Interests you have held as at the date of this return:
1. The name of any company or other body in which you hold any office whether as director or otherwise.
2. The name or description of any company or body in which you hold a beneficial interest unless the total value of the interest does not exceed $10 000 and the total value of issued shares of the company or body exceeds $10 million.
3. The address or description of any land in the municipal district of the Council or in a municipal district which adjoins that municipal district in which you have 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 a member of your family* holds a beneficial interest.
5. Any other substantial interest (whether of a pecuniary nature or not) held by you or a member of your family of which you are aware and which you consider might appear to raise a material conflict between your private interest and your public duty as a Councillor, member of a special committee or nominated officer.
Signature of person making return: Date:
Signature of witness: Name of witness:
*A reference to family has the same meaning as "family member" has in section 78 of the Act.
__________________
Local Government (General) Regulations 2004, Regulation 7
Ordinary Return
Notes—Please Read:
(1) Interests which you are required to register are prescribed in section 81(7) of the Local Government Act 1989 .
(2) If there is not sufficient space on this form for all of the information you are required to register, you may attach additional papers for that purpose. Each paper is to be signed, dated and witnessed in the same manner as this return.
(3) Answer all questions and ensure your answers are clear and legible.
Family name: Given names:
Name of Council:
Name of Ward (if applicable):
Position held:
Insert details of the Registrable Interests held during the return period*:
1. The name of any company or other body corporate or unincorporate in which you held an office as a director or otherwise.
2. The name or description of any company or body in which you hold or have held a beneficial interest unless the total value of the interest does or did not exceed $10 000 and the total value of issued shares of the company or body exceeds $10 million.
3. The address or description of any land in the municipal district of the Council or in a municipal district which adjoins that municipal district in which you had any beneficial interest other than by way of security for any debt.
4. A concise description of any trust in which you held a beneficial interest or of which you are a trustee and in which a member of your family** held a beneficial interest.
5. Particulars of any gift of or above the amount or value of $500 received by you, either directly or indirectly from a person, but does not include a gift received from a relative*** of yours or received at an event or function you attended in an official capacity as a Mayor, a member of Council staff or a member of a special committee.
6. Any other substantial interest (whether of a pecuniary nature or not) held by you or a member of your family of which you are aware and which you consider might appear to raise a material conflict between your private interest and your public duty as a councillor, member of a special committee or nominated officer.
Signature of person making return: Date:
Signature of witness: Name of witness:
*A reference to "return period" has the same meaning as "return period" has in section 81 of the Act.
**A reference to family has the same meaning as "family member" has in section 78 of the Act.
*** A reference to "relative" has the same meaning as relative has in section 78 of the Act.
__________________
APPLICATION TO INSPECT REGISTER OF INTERESTS
Local Government (General) Regulations 2004, Regulation 8
r. 9
Family name: Given names:
Address: Postcode:
Telephone Number (For Contact):
I, the undersigned, apply under section 81(10) of the Local Government Act 1989 to the
(Name of Council)
to inspect the register of interests maintained under section 81 of the Act relating to:
(Name(s) of person(s) whose return(s) is/are to be inspected)
Signature of applicant: Date: ".