Fillable Township of Oro-Medonte Gift, Benefit and Hospitality ["Gift"] (Township of Oro Medonte)

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Township of Oro-Medonte Gift, Benefit and Hospitality ["Gift"] (Township of Oro Medonte)

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This is Form 1 of ____
Township of Oro-Medonte
Gift, Benefit and Hospitality ["Gift"] Declaration Form
Council Code of Conduct Rule No. 2
I, ____________________, a Member of the Council of the Township of Oro-Medonte, hereby
declare as follows:
1. Subject to any particulars that are set out below, I have not received any Gift not expressly
permitted by Rule No. 2, Gifts, Benefits and Hospitality, of the Township of Oro-Medonte
Council Code of Conduct.
Initial here if there are no additional particulars on this form.
__________
2. In the attached list, every reference to a gift, hospitality or benefit ["Gift"] received by me
includes every Gift received with my knowledge by me or by any person on my behalf which I
am obliged by the Township of Oro-Medonte Council Code of Conduct to disclose.
Date Gift Received: ___________________
Provider: ___________________
Type of Gift: Token of Appreciation Nature of Gift: ____________________
Course of Business Nature of Gift: ____________________
Description of Gift: _________________________
Estimated Value of Gift: _________________________
Accumulated value of all Gifts received from this same source in a calendar year: __________
Date Gift Received: ___________________
Provider: ___________________
Type of Gift: Token of Appreciation Nature of Gift: __________________
Course of Business Nature of Gift: __________________
Description of Gift: _________________________
Estimated Value of Gift: _________________________
Accumulated value of all Gifts received from this same source in a calendar year: __________
[Use additional forms as necessary] ____________
3. I confirm that the information I have provided is true and correct.
Name: ____________________
Signature: ___________________________ Date: ______________________
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pleted form to PostOffice@principlesintegrity.org
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Township of Oro-Medonte Gift, Benefit and Hospitality Gift (Township of Oro Medonte)

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Completed 6 April 2021

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