Staff Register of Interests

  1. Information
  2. Section 1
  3. Section 2
  4. Section 3
  5. Section 4
  6. Section 5

Information

Guidance notes

The Staff Register of Interests Form is a corporate register containing details of any financial or non financial interests that staff have that could conflict with the Council’s interests, or invite claims that they could conflict.

Please complete this form by providing all relevant personal interests that you have influence over (or could be influenced by), which may conflict with or affect the interests of Rugby Borough Council. This includes financial, business and any other personal interests that you or any close member of your family may have. You must also include details of memberships of any external organisation where the organisation may have connections with the Council.

If you have any queries regarding this form, please contact the Monitoring Officer, Aftab Razzaq on 01788 533521.

All forms should be submitted, including “nil” returns. If you need to add/amend the form during the year, you can find it on the DASH forms

Please ensure you click the 'Add record' button where the form fields require you to add additional details

Guidance notes

The Staff Register of Interests Form is a corporate register containing details of any financial or non financial interests that staff have that could conflict with the Council’s interests, or invite claims that they could conflict.

Please complete this form by providing all relevant personal interests that you have influence over (or could be influenced by), which may conflict with or affect the interests of Rugby Borough Council. This includes financial, business and any other personal interests that you or any close member of your family may have. You must also include details of memberships of any external organisation where the organisation may have connections with the Council.

If you have any queries regarding this form, please contact the Monitoring Officer, Aftab Razzaq on 01788 533521.

All forms should be submitted, including “nil” returns. If you need to add/amend the form during the year, you can find it on the DASH forms

Please ensure you click the 'Add record' button where the form fields require you to add additional details

Staff Name null
Email address null
Phone No.
Job Title null
Service / Team null

 


 

Are you a Councillor ?
Are you a Councillor ? null
Please give details null
Do you hold a politically restricted post?
Do you hold a politically restricted post? null
Are you involved in letting contracts on behalf of the Council
Are you involved in letting contracts on behalf of the Council null
Please give details null

For the following questions, for each interest listed, please provide details of the nature of the interest, when your interest arose, details of any position you hold (where appropriate) and any other relevant details. If your interest is time limited please specify the end date. If you are a member of any external organisation please also state the full name of the organisation and whether you are a member in a personal capacity or as a representative of the Council. Where you do not have an interest please select 'NO' under the relevant heading.

 Other Employment, Office, Trade, Profession or Vocation (e.g. where you have a second employment or hold an unpaid position)

 Please provide details of those interests and click the '+' button for each entry

For the following questions, for each interest listed, please provide details of the nature of the interest, when your interest arose, details of any position you hold (where appropriate) and any other relevant details. If your interest is time limited please specify the end date. If you are a member of any external organisation please also state the full name of the organisation and whether you are a member in a personal capacity or as a representative of the Council. Where you do not have an interest please select 'NO' under the relevant heading.

 Other Employment, Office, Trade, Profession or Vocation (e.g. where you have a second employment or hold an unpaid position)

 Please provide details of those interests and click the '+' button for each entry

Other employment Interest held ?
Other employment Interest held ? null
Name of Organisation null
Position Held
Number of hours typically worked each week or month null

 


 

Sponsorship or Grants (e.g. where an organisation, such as a charity of village hall committee, in which you are incolved applies to the Council for grants)

Sponsorship or Grants (e.g. where an organisation, such as a charity of village hall committee, in which you are incolved applies to the Council for grants)

Sponsorship / Grant Interest held ?
Sponsorship / Grant Interest held ?
Name of Company / Organisation null
Grant applied for null

 


 

Contracts (e.g. where you, a close family member or any business which you are involved with, have or may tender for a contract being let by the Council and you are involved in or can influence the contract purpose)

Contracts (e.g. where you, a close family member or any business which you are involved with, have or may tender for a contract being let by the Council and you are involved in or can influence the contract purpose)

Contracts Interest held ?
Contracts Interest held ?
Name of company null
Contracts tendered for
I have a business interest to declare. This includes organisations / contractors etc that I or close family, are involved with and in what capacity
I have a business interest to declare. This includes organisations / contractors etc that I or close family, are involved with and in what capacity null
Please give details null
To the best of your knowledge do you or your family socialise with any of the Council's approved contractors or suppliers ?
To the best of your knowledge do you or your family socialise with any of the Council's approved contractors or suppliers ? null
Please give details
Which ones and what circumstances ? null

 


 

Do you or any family members have a close personal relationship with any Rugby councillors or employees ?
Do you or any family members have a close personal relationship with any Rugby councillors or employees ? null
Please give details of relationships null

 


 

Do you or any close member have an indirect pecuniary interest (e.g. spouse in business who may undertake work on behalf of the Council) ?
Do you or any close member have an indirect pecuniary interest (e.g. spouse in business who may undertake work on behalf of the Council) ? null
Name of Company null
Relationship to you null

Land and Property in which the Council has an interest (e.g. where you lease, rent or have a license to occupy land or property owned by the Council)

Land and Property in which the Council has an interest (e.g. where you lease, rent or have a license to occupy land or property owned by the Council)

Property Interest held ?
Property Interest held ? null
Address of property null

 


 

Interests in Companies and Securities (e.g. where you have a significant shareholding in a company which might do business with the Council or you are a director of such a company)

Interests in Companies and Securities (e.g. where you have a significant shareholding in a company which might do business with the Council or you are a director of such a company)

Shares Interest held ?
Shares Interest held ? null
Name of Company null
Position held null
Shares held (Please provide the amount or quantity and if known the percentage of total shareholding) null

 


 

Memberships of External Organisations (e.g. such as governing bodies, Parish Councils or voluntary organisation that could have dealings with the Council)

Memberships of External Organisations (e.g. such as governing bodies, Parish Councils or voluntary organisation that could have dealings with the Council)

External Organisation Interest held ?
External Organisation Interest held ? null
Name of Organisation null
Position held null

 


 

Do you have any other relevant personal or financial interests?
Do you have any other relevant personal or financial interests? null
Please provide details null

I declare that the information I have provided is accurate to the best of my knowledge and belief, that I have provided all information that ought to have been provided and that none of the details set out are materially false or misleading. I recognise that a failure to declare an interest or the provision of false or misleading information may result in disciplinary action.

By completing this survey I understand that this information is required in connection with the Council's obligations to ensure that its actions are open and accountable and stand up to scrutiny and I consent to it being held for those purposes

I understand that if my circumstances change then I need to inform my manager immediately.

I declare that the information I have provided is accurate to the best of my knowledge and belief, that I have provided all information that ought to have been provided and that none of the details set out are materially false or misleading. I recognise that a failure to declare an interest or the provision of false or misleading information may result in disciplinary action.

By completing this survey I understand that this information is required in connection with the Council's obligations to ensure that its actions are open and accountable and stand up to scrutiny and I consent to it being held for those purposes

I understand that if my circumstances change then I need to inform my manager immediately.

Single Selection
Single Selection null