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Disclosure of Pecuniary Interest Form


Procedures for Disclosure

If a matter comes before Council, or a Board or Committee, that a Member believes they have a pecuniary interest in, the Member must:

  1. Orally declare the pecuniary interest at the beginning of the meeting during Disclosures of Pecuniary Interest and General Nature Thereof portion of the Agenda.
  2. When the matter of pecuniary interest comes forward for consideration, the Member must leave the meeting room until discussion and voting on the matter are concluded.
  3.  Refrain from attempting in any way, whether before, during or after the meeting, to influence the voting on any such matter.
  4.  Complete and submit the Disclosure of a Pecuniary Interest Form below before the meeting where the matter will be discussed.

Note: The above procedures are to be followed for all meeting types.

The Integrity Commissioner is available to provide advice on a Member's obligations under the Municipal Conflict of Interest Act.

The Integrity Commissioner for the Town of LaSalle is:

 Davies Howe LLP                                                                                                                                                                                                               Attention: Robert G. Miller
 The Tenth Floor
 425 Adelaide St. W.
 Toronto, ON
 M5V 3C1
 Telephone: 416-263-4508
 Fax: 416-977-8931                                                                                                      

I am declaring a pecuniary interest as it relates to the below Agenda Item:

I confirm that I will not vote on the matter, I will not take part in discussion on any question in respect of the matter, and I will not attempt in any way whether before, during or after the meeting to influence the voting on any such question.


Privacy Statement: In accordance with Section 5.1 of the Municipal Conflict of Interest Act, R.S.O. 1990, c. M.50, a member who knows that they will be declaring a conflict of interest at an upcoming meeting should notify the Clerk and complete this form prior to the meeting. Section 5(1) of the Act authorizes the Clerk of the municipality or the secretary of the committee or local board to collect a written statement of the interest and its general nature. Please note that as per section 6(1) of the Act, the Clerk will make the disclosure(s) public and record the declaration in the minutes of the meeting.