HomeMy WebLinkAboutBealEllen Affidavit Disclosure 1997 CITY OF LANSING
AFFIDAVIT OF DISCLOSURE
TO: CITY CLERK
CITY ATTORNEY
BOARD OF ETHICS
(Name), being duly sworn, says under
oath:
1. I am an elected or appointed officer or employee of the City of
Lansing, holding the position of )z LJ 4L(Title) in the
GI �L l'Zl/1
Department. This position is: .
Full Time: Part Time
(Less than 25 hrs. per week)
Unpaid:
2. 1 may derive income or benefit, directly or indirectly, from a contract
with the City or from any City action detailed as follows (Charter 5-505.1):
ter.
/ /
(Paragraph 2. CONTINUED)
3. 1 have a conflict between a personal interest and the public
interest, the nature of which is disclosed below: (Charter 5-505.2; Lansing
Code 290.04 (1)):
4. 1 have a financial interest in a matter proposed to be acted upon
by the City of Lansing as described below (Lansing Code 290.04(l):
(Paragraph 4. CONTINUED)
5. 1 have/have not attached page(s) of additional detail
concerning this disclosure.
6. 1 hereby certify that this disclosure is complete and accurate to
the best of my knowledge, information and belief.
The foregoing Affidavit of Disclosure was executed on the,�)l day of
C 19.q
I
(Name)
STATE OF MICHIGAN)
) SS.
COUNTY OF —�
`rGti ,
Subscribed and sworn to before me this -g day of -
19-q:� in County, Michigan.
Notary Pub ic/
Deputy Clerk
11AAf�il:'�t�N 81.-.¢r�at , J Count Michigan
Notary Public, Inotia n CpurlEy, IVIi y, c
My Comm. Expirn� Mpr, IP, 199c- Mjbommission Expires: - �