Additions Or Retirements

Directors/Trustees/Elders and ‘other contacts’ update form

Additions or retirements

Use this form to notify ENTRUST of any changes in the board of management of the Environmental Body. You should do this within 7 days of any change taking place. Please complete in black ink, using block CAPITALS, and keep a copy for your records.

For further information, or if you have any questions on this form, please see our website or contact us:

Telephone:01926 488 300

Website:

Please return your completed form:

By post:ENTRUST

60 Holly Walk

Royal Leamington Spa

Warwickshire

CV32 4JE

By fax:01926 488 388

By email:

Environmental Body details

Name of your Environmental Body (EB)
Your EB enrolment number
Details of the Director/Trustee/Elders and ‘other contacts’
1. / Title (Mr, Mrs, Miss etc.)
2. / Forename
3. / Surname
4. / Email address
5. / Will this person log on to EOL / Yes / No
6. / Are you a director/board member or trustee of this Environmental Body? If yes please complete the details below. / Yes / No
7. / Date of birth
(dd/mm/yyyy e.g 04/04/2004)
8. / Telephone number
9.Home address
10. / Address line one
11. / Address line two
12. / Address line three
13. / Town
14. / County
15. / Post code
16. / Role in the organisation
17. / Are you an excluded individual? / “An excluded person is someone who: (a) controlled or was concerned in the management of an Environmental Body that was involuntarily revoked; (b) has been convicted of an indictable offence; (c) id disqualified for being a charity trustee or a trustee for a charity; (d) is connected with any of the persons or bodies mentioned above; or (e) is incapable by reason of mental disorder.”
Yes / No
18. / Occupation
19. / Employer’s name
20. / Serve as a Cllr with a Local Authority / Yes / No
21. / Employed by a Landfill Operator / Yes / No
22. / Does this person have a right to vote in a committee meeting? / Yes / No
23. / Please state if this is an Addition or Retirement

ENTRUST is the regulator of the Landfill Communities Fund (LCF) and we are required to collect and process personal data of individuals who have roles within Environmental Bodies. We will only use the personal information provided to us within this form to direct queries and information to the correct person within the Environmental Body. In addition, Paragraph 33(1)(g) of the Landfill Tax Regulations 1996 precludes anyone being involved in the management of the Environmental Body who has controlled or been involved in the management of a previously compulsory revoked Environmental Body. By supplying the personal information below, ENTRUST are able to determine if the organisations and the individual fulfil this requirement. By completing this form, you confirm that all individuals have given their consent to you providing their personal information to ENTRUST for use in accordance with the privacy policy and as otherwise required under the LCF Regulations. We will not share any personal information from this form with any third parties, other than those that have a statutory right of access to information held by ENTRUST pursuant to the LCF, nor will we sell any personal data to any third party organisation. For further information on how we use and secure the personal data provided and your rights of access to the data held, please contact the Data Protection Officer, ENTRUST, 60 Holly Walk, Leamington Spa, Warwickshire, CV32 4JE.

Please confirm you have read the Privacy Policy above.

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