FORM OF WRITTEN RETURN OF INTERESTSSUBMITTED UNDER CLAUSE 4.18
'Disclosures by Councillors and Designated Persons' Return
OFFICE USE ONLY
Date Received:
Received by:
REALPROPERTY A.
Street address of each parcel of realproperty in which Ihad an interest at the retu rn date/at any time since 3o June
36 BirHgan Close
NOBBYS CREEK NSW 2484
Nature of interest
SOURCESOFINCOME B
1.
Sources ofincome Ireasonably expect to receive from an occupation in the period commencing on the first day after the return date and ending on the following 3o June
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Sources ot income Ireceived from an occupation at an time since 3o June Description of Occupation Name and address of employer or
description of office held(if applicable)
Name under which partnership conducted (if applicable)
Director Sustainable Communities and Environment
L The pecuniaryinterests and other matters to be disctosedin this return are prescribed by schedule zof the Model Code of Conductjor LocalCounciis in
NSW
z !f this is thelirst returnyou have been required to lodge with the general manager after becoming a councillor or designated person. do not complete )arts C. D and laf the return. Ali other parts of the return should be completed with appropriate information based on your circumstances at the 'eturn date, that k, the date on which you became a councillor or designated )elson
3- Ifyou have prevfcuslylodged a return with the general manager andyou are :ompleting this returnfor the purposes o#disctosing a new interest that was
lot disclosed in th e imt return you lodged with the gen eraimanager. you must complete alt parts of the return with appropriate informationfor the periodfrom 3a June af the previousfinancialyear or the date on which you )ecame a designated person(whichever is the later date) to the return date which is the date you became aware af the new interest to be disclosed in
our updated return
4. tfyou have prwiouslytadged a return with the genera! manager and are
;ubmit ting Q new return for the newjinancialyew. yo u must complete alt paRS of the return with appropriate in$ormationjor the lz month period :ommencing on 3o June of the previous year ta 3o June this year 5- Thisjorm must be completed using block letters ar typed
3. If there is insu6lcient spacefor all the information you are required to disclose. you must attach an appendix which is to be properly identified and iignedbyyau
!fthere are no pecuniary interests or ether matters o# the kind required to be ]isciosed under Q heading in thisjorm, the word "NfL" is to be placed in an appropriate space under that heading
:MPORTAN'l'INFORMATION
This information is being collected for the purpose of complying with clause 4.i8 of the Code of Conduct
You must not lodge a return that you know or ought reasonably to know is false or misleading in a materialparticular(see clause 4.20 Of the
Code ofConduct)-Complaints about breuhes ofthese requirementsarelcLbe referredlo the Office ofLocal Government and may result in disciplinary action by the council, the Chief Executive of the Office of LocaIGovernment orthe NSW Civiland Administrative Tribunal The information collected on this form willbe kept bathe generalmanagerin a register of returns. The generalmanager is required to table all
returns at a council meeting.Information contained in returns made and lodged underclause 4.z8 is to be made publicly available in accordance with the requirements of
the Government Information (Public Access) Act goog. the Government Information (Public Access) Regulation goog 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.DISCLOSURE OF PECUNIARY INTEREST AND OTHER MATTERS
by.L cey Stinson ...J..*;s;t 3o September 2021
Jul! name ofdesignatedpersen)/ /(return date)
+inrespectof the periadfram I July 20ZOerio(jo June 2021 ./ , ©natedpenon'ssiynature)
1 ,4 1b- '+. a.,\
''-"r(date;
z. Sources of income I reasonably expect to receive from a trust in the period commencing on the first day afterthe return date and ending on the following 3o June;
3. Sources of other income I reasonably expect to receive in the period commencing on the first day afterthe return date and ending on the following 3o June;
Sources of other income Ireceived at any time since 3o June.
whom. or the circumstances in which, that income was
+
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$.
+
Sources of income Ireceived from a trust since 10 June.
Name and address of settler Name and address of trustee
:iHi [q I i F
Description of each gift Ireceived at any time since 3o June Name and address of donor
!X tH.dellliill+lljllellEih(e dill\TlqH g! :l LI H
Name and address of each person who made any financialor other contribution to any travel
undertaken by me at any time since 3o June
Date on which travel was
undertaken Names of States, Territories of the Commonwealth and ove rseas countries in which travel was underta ken
Name and address of each corporation in which I had an interest or held a position at the return date/at any time since 3o June.
Name of interest (if any)
Description of position (ifany)
Description of principal objects (if any} or
corporation(exceptin case of public compa ny)
Blaze Prqects Pty Lld
Palmas Energy Managanont Pty LU I
NIL
NIL
NIL
NIL
WERE YOU A PROPERTY DEVELOPER OR A CLOSE ASSOCIATE OF A PROPERTY F
DEVELOPER ON THE RETURN DATE? (Y/N)
No
G POSITIONS IN TRADE UNIONS AND PROFESSIONAL OR BUSINESS ASSOCIATIONS
Name of each trade union and each professionalor business association in which Description of Position held any position(whether remunerated or not) at the return date/at any time
since 3oJune
H DEBTS
Name and address of each person to whom lwas liable to pgy any debt at the return date/at any time since 3o June
NIL
DISPOSITIONS OFPROPERTY
z. Particulars of each disposition of real property by me(including the street address of the affected property) at any time since 3o June as a result ofwhich Iretained, eitherwholly or in part, the use and benefit of the property orthe
right to re-acquire the property at a latertime
z. 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 3o June. as a result
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NIL
NIL
NIL
DISCRETIONARY DISCLOSURES
NIL
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