Register of interests annual confirmation

nie
                                                                                                vo Queensland
                                                                                                  (aia
                                                                                                (SRT     Government

  Hn Sa                                            i                                                                  |

      Register of interests annual confirmation
      FORM 5 - Councillors and councillor advisors Local Government Act 2009
      Mayors, councillors and councillor advisors whose related persons' registers of interests have not changed can submit the below
      declaration to provide annual confirmation of these register of interests.
      Complete a separate form for EACH of your related persons if their interests have not changed. If one of your related persons
      interests has changed, submit and updated Form 4 - Related person register of interest update before completing this declaration.
      If you fail to correctly submit or update your register of interests as required you may be guilty of misconduct or an integrity offence
      and may face significant penalties. When completing this form, refer to the Registers of interest notes, Local Government Act
      2009/Local Government Regulation 2012 and City of Brisbane Act 2010/City of Brisbane Regulation 2012. If you are unsure of your
      obligations it is strongly recommended that you seek independent legal advice.

      Declaration
      | have reviewed my current register of interests and certify that it is correct and up to date

         Name

         Councillor                                                        Noosa Shire Council
        Position                                                          Council

                                                                       241         71     25
                                        ®                               ¢

          iGnatare                                                      Date

      You must sign this form and submit it to the chief executive officer (CEO) within 30 days of the end of each financial year.
   pr                    i                                                                    tt

 You can print a Register of Interests form by selecting a PDF from the list below:
    e Form 1 - New Register of Interests (/2) 440.6 KB)
    e Form 2 - New Related Person Register of    Interests ([£) 431.0 KB)
    e Form3 - Register of Interests Update ([4 159.5 KB)
    e Form 4 - Related Persons Register of Interests Update ([Z) 152.8 KB)
    e Form 5 - Register of Interests Annual Confirmation ([2j) 114.3 KB)
    e Form6 - Related Person Register of Interests Annual Confirmation ([4 115.6 KB)

Form 5 - OCTOBER 2020 - Jessica Phillips