STRENSALL WITH TOWTHORPE PARISH COUNCIL

LEGAL DECLARATION OF QUALIFICATION TO HOLD PUBLIC OFFICE AS A LOCAL COUNCILLOR

Where a local council is undertaking the process of co-option of a councillor to the authority, it is duty bound to ensure that the person(s) appointed are eligible to hold office as a local councillor. The qualifications and disqualifications are contained in the Local Government Act 1972, Sections 79 and 80.

Please complete the following declaration form and return it to the Clerk to the Council

.	by (insert date).

Qualifications

Please indicate which qualifications are applicable to you:

You have the required citizenship (s.79 LGA 1972)	¨

You are 18 years of age or over	¨

and
At the date of application to the parish council you are a local government elector for the parish of Strensall with Towthorpe:	¨
or
At the date of application to the parish council you have, during the whole of the twelve months preceding that day, occupied as owner or tenant of any land or other premises in the parish:	¨
or
At the date of application to the parish council you have, during the whole the twelve months preceding that day, had your principal or only place or work in the parish :	¨
or
At the date of application to the parish council you have, during the whole the twelve months preceding that day, resided in the parish or within three miles of it:
¨

(Please note that you do not have to meet all of these qualifications. To be eligible you must be 18 or over and must also meet one of the other provisions. However, it would be helpful if you could indicate all of those which apply).

Disqualifications

You hold any paid office with the parish council	Yes ¨	No ¨

You are the subject of a Bankruptcy Restrictions Order or Interim Order, or a Debt Relief Restrictions Order or an Interim Debt Relief Restrictions order under Schedule 4ZB of the Insolvency Act 1986.
Yes ¨	No ¨

You have within five years prior to the day of your prospective appointment to the council been convicted in the United kingdom, the Channel Isles or the Isle of Man, of any offence and have had passed on you a sentence of imprisonment (whether suspended or not) for a period of not less than three months without the option of a fine.
Yes ¨	No ¨

You are disqualified from being elected or from being a member of Strensall with Towthorpe Parish Council under Part III of the Representation of the People Act 1983 or under the Audit Commission Act 1998.
Yes ¨	No ¨

You are subject to the notification requirements of Part 2 of the Sexual Offences Act 2003 (this applies to persons subject to relevant notification requirements or an order made on or after 28 June 2022).
Yes ¨	No ¨

(If you are subject to any of these disqualifications you will not be able to hold public office as a parish councillor until the disqualification is no longer effective).

Strensall with Towthorpe Parish Council confirms that it is duty bound to treat this
information as strictly confidential.

Signature of candidate 		......................................................................

Printed name of candidate 	......................................................................

Date 					......................................................................