Fill - Free fillable APPLICATION FOR A DISPENSATION (Stockton-on-Tees Borough Council) PDF form

director/standards committee/application for dispensation – November 2012

Thisdocumentwasclassifiedas:OFFICIAL

APPLICATION FOR A DISPENSATION

1. Name/Names of the Members and/or Co-opted members to whom the dispensation

would apply.

2. The reasons why (each) Member and/or Co-opted member considers a dispensation

is required.

(NB The above section should indicate why the Member or Members are considered to be prohibited

from participating in the particular business of the Council and the interest or interests which give

rise to the prohibition.)

director/standards committee/application for dispensation – November 2012

Thisdocumentwasclassifiedas:OFFICIAL

3. The business or matter and meeting or meetings (including dates) to which any

dispensation would apply if granted.

4. The period of time required for dispensation.

(NB. The maximum time a dispensation can be granted for is 4 years)

5. Extent of dispensation required (please tick the appropriate box)

To be able to participate in any discussion of the matter at a meeting or

To be able to participate in any vote taken on the matter at the meeting or

To be able to participate in any discussion of and in any vote taken in the matter at a

meeting

director/standards committee/application for dispensation – November 2012

Thisdocumentwasclassifiedas:OFFICIAL

6. Signatures of Members and/or Co-opted members requesting the dispensation.

Signed: ……………………………………….. Signed: ………………………………………..