HomeMy WebLinkAboutCunninghamNancy Affidavit Disclosure 2004 CITY OF LANSING
AFFIDAVIT OF DISCLOSURE
DATE: J t:,-ri-6,
TO:..GITY CLERK,'
CITY ATTORNEY, or
BOARD OF ETHICS��
A-►')C! M, CLC 1-1 Y1 + Lj I1Xi� make the following disclosure under oath:
(Name
PLEASE CHECK THE APPROPRIATE., BOX OR FILL IN THE BLANKS FOR EACH OF THE
FOLLOWING ITEMS
Yes No
1. o I am an ❑ elected orXappointed ❑ officer or Elemployee of the City of
Lansing holding the position of Ri _-50-��( c�ctorin the
P—eir-sc,ai n.e_t department .ma c ►v ��/��
❑ ❑ 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.
❑ ❑ I 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. ❑ ❑ 1 may derive income or benefit directly from a contract with the City or
from any City action detailed below. (Charter 5-505.1)
❑ ❑ 1 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]
❑ ❑ 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]
❑ ❑ 1 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 or Ordinances and in the City Charter
3. This position is: la Full time ❑ Part time (less than 25 hours/wk) ❑ Unpaid
4:: My Address is: 3`F��7 61, c -- s>-,c( �3 /fir f r. �L�, N1
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