Disclosure of Interests Return

Disclosure of Interests Return

A Disclosure of Interest Return (Return) is required to be submitted by Designated Persons in accordance with City of Newcastle (CN) Codes of Conduct that are available on our website.

Important Information
  • This information is being collected for the purpose of complying with clause 4.21 of the Model Code of Conduct.
  • You must not lodge a return that you know or ought reasonably to know is false or misleading in a material particular (see clause 4.23 of the Model Code of Conduct). Complaints about breaches of these requirements are to be referred to the Office of Local Government and may result in disciplinary action by the council, the Chief Executive of the Office of Local Government or the NSW Civil and Administrative Tribunal.
  • The information collected on this form will be kept by the general manager in a register of returns. The general manager is required to table all returns at a council meeting.
  • Information contained in returns made and lodged under clause 4.21 is to be made publicly available in accordance with the requirements of the Government Information (Public Access) Act 2009, the Government Information (Public Access) Regulation 2009 and any guidelines issued by the Information Commissioner.
  • You have an obligation to keep the information contained in this return up to date. If you become aware of a new interest that must be disclosed in this return, or an interest that you have previously failed to disclose, you must submit an updated return within three months of becoming aware of the previously undisclosed interest.
  • For helpful tips on completing your Return, refer to the Office of Local Government Guide to completing Returns of interest.
YOUR DETAILS
NOTE:

For those who are lodging their first return:
- the ‘return date’ is the date you became a councillor or designated person, and
- leave the return ‘period’ at the top of the form blank

For those who are lodging their annual return:
- the ‘return date’ is 30 June of the calendar year in which the return is made, and
- the return ‘period’ is from 30 June of the previous year to 30 June of the current year.

For those who are disclosing new interests:
- the ‘return date’ is the date you became aware of the interest(s), and
- the return ‘period’ is from 30 June of the previous financial year, or the date on which you became a councillor or designated person (whichever is later) to the date you became aware of the interest(s).
A. REAL PROPERTY
Street address of each parcel of real property in which I had an interest at the return date/at any time since 30 June - nature of interest:
B. SOURCES OF INCOME
1. Sources of income I:
- Reasonably expect to receive from an occupation in the period commencing on the first day after the return date and ending on the following 30 June, and
- Received from an occupation at any time since 30 June:
Description of occupation - Name and address of employer or description of office held (if applicable) - Name under which partnership conducted (if applicable)
2. Sources of income I:
- Reasonably expect to receive from a trust in the period commencing on the first day after the return date and ending on the following 30 June, and
- Received from a trust at any time since 30 June:
Name and address of settlor - Name and address of trustee
3. Sources of income I:
- Reasonbly expect to receive from other income in the period commencing on the first day after the return date and ending on the following 30 June, and
- Received at any time since 30 June:
Sources of other income
Include description sufficient to identify the person from whom, or the circumstances in which, that income was received.
C. GIFTS
Description of each gift I received at any time since 30 June - Name and address of donor:
D. CONTRIBUTIONS TO TRAVEL
Name and address of each person who made any financial or other contribution to any travel undertaken by me at any time since 30 June - Dates on which travel was undertaken - Names of States, Territories of the Commonwealth and overseas countries in which travel was undertaken:
E. INTERESTS AND POSITIONS IN CORPORATIONS
Name and address of each corporation in which I had an interest or held a position at the return date/at any time since 30 June - Nature of interest (if any) - Description of position (if any) - Description of principal objects (if any) of corporation (except in case of listed company):
F. PROPERTY DEVELOPMENT
G. POSITIONS IN TRADE UNIONS AND PROFESSIONAL OR BUSINESS ASSOCIATIONS
Name of each trade union and each professional or business association in which I held any position (whether remunerated or not) at the return date/at any time since 30 June - Description of position:
H. DEBTS
Name and address of each person to whom I was liable to pay any debts at the return date/at any time since 30 June:
I. DISPOSITIONS OF PROPERTY
1. Particulars of each disposition of real property by me (including the street address of the affected property) at any time since 30 June as a result of which I retained, either wholly or in part, the use and benefit of the property or the right to re-acquire the property at a later time:
2. Particulars of each disposition of property to a person by any other person under arrangements made by me (including the street address of the affected property), being dispositions made at any time since 30 June, as a result of which I obtained, either wholly or in part, the use and benefit of the property:
J. DISCRETIONARY DISCLOSURES
ACKNOWLEDGEMENT
In submitting this Return:
If you would like further information redacted from your Return (other than your residential address), please upload your ‘Request for Omission of information’ and ‘Statutory Declaration’ in PDF format