HomeMy WebLinkAboutCannonTerry Affidavit Disclosure 2022 yPN S 1 �C
CITY OF LANSING
AFFIDAVIT OF DISCLOSURE
cHIGP r
TO: CITY CLERK DATE: la ! 7 120 2__z
I, J- r q C r Ctti,..,1,v/x" make the following disclosure under oath:
Na a (please print)
PLEASE CHECK THE BOX AND FILL IN THE APPROPRIATE BLANKS FOR EACH OF THE FOLLOWING
ITEMS
Yes No
1. n ❑ I am an ❑ elected or ❑ appointed ❑ officer or io employee of the City of Lansing
holdin`g�e position of for in the G Department.
ntiiILL �t
❑ ❑X I am an immediate family member related to an elected or appointed officer or
employee of the City of Lansing named , holding the position of
in the Department
❑ ❑ 1 am a Business Associate of an elected or appointed officer or
employee of the City of Lansing named
holding the position of in the
Department.
2. Fj❑ n I may derive income or benefit directly or indirectly from the bidding of,
negotiation o` , solicitation of or entry into a contract with the City or from any City action detailed
below. (Charter 5-505.1)
❑ ❑- I may have a conflict between a personal interest and the public
interest, the nature of which is disclosed below. (Charter 5-505.2)
[Chapter 290.04(I) of the Code of Ordinances]
❑ N I may have a financial interest in a matter proposed to be acted upon by the City
of Lansing as described below. [Chapter 290.04(I) of the Code of Ordinances]
❑ ❑ I make this disclosure because of a possible appearance that I may be in
violation of or in conflict with the City of Lansing Ethics Ordinance as provided for in the Code
of Ordinances and in the City Charter.
3. My City of Lansing position is:
Ni Full-time ❑Part-time (less than 25 hours/wk) ❑ Unpaid
4. Name of the activity/business in question: h cvv_S�- P"p-,V vJ�.1
5. Do you have ownership or interest in the activity/business? Yes No
Updated Feb 2022
I 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 this iAday of 20z�
Signa ure of Filer
STATE OF MICHIGAN )
)ss.
COUNTY OF�V�f )
The foregoing instru nt was ackno I ged before me this day of ,
year), by U kc�e I (Notary Signature)
(Print Name)
Notary Public, ` �'1`1 County,
Acting in •r_ i'1 County,
My Commissio Expires:
CHRISTINA RAEDER
Notary Public-State of Michigan
County of Ingham
My Commission Expires Jul 1} 20 7
Acting in the County of `
Updated Feb 2022