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Disclosures of Interest

You have been invited to provide a Disclosure of Interest under Anti-Racketeering and Corrupt Organisations (ARCO) Act, 2025 Section 6(1f). This form collects the information required by the Standards in Public Office Commission. Information may be published unless otherwise ordered by a Court of Ireland.

Section 1 - Identity and Appointment

Please disclose any current Directorships you have within Ireland *

Complete rows where applicable. Leave unused rows blank.

Type of Business options

Sole Tradership - A company which is operated by only one shareholder.

Limited Liability Company - A company in which the owners or shareholders are not held directly liable for issues within the company.

Unlimited Company - A company in which the owners or shareholders may be held directly liable for issues within the company.

General Partnership - A company in which the shares are held by two or more individuals.

Non-Profit Organisation - An organisation which pertains to a public, social or charitable benefit.

Business Name Business Registration ID Type of Business Nature of Business

Please disclose any current Occupations you have within Ireland *

Complete rows where applicable. Leave unused rows blank.

Nature of Employment (Job Title, Nature of Profession etc.) Name of Business where profession/trade is carried out and Name of Employer Business/Employer ID Type of Business Other Information (Optional)

Please disclose any current Shares you possess within Ireland *

Complete rows where applicable. Leave unused rows blank.

Business Name Business Registration ID Type of Business Nature of Business Percentage of Business Owned

Please disclose any current Political Positions you hold outside of Ireland *

Complete rows where applicable. Leave unused rows blank.

Country Name Link to Group Position held Nature of Position Date of Appointment to position

Declaration

You declare that under Anti-Racketeering and Corrupt Organisations Act, 2025 Section 6(1f) you are declaring to the Standards in Public Office Commission your interests domestically and in foreign nations, and that all disclosed information is true and current. You understand this disclosure will be made public after processing. You acknowledge that failure to provide truthful information may result in prosecution and a formal investigation.