HomeMy WebLinkAboutHudakJeffrey Affidavit Disclosure 1995 CITY OF LANSING ,��-- r,EIVED
AFFIDAVIT OF DISCLOSURE RECEIVED
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(Name) _=%r4 E,1 !�- � 0DA K being dull
under oath:
1 . I am an elected or appointed officer or employee of the
City of Lansing, holding the pos itio of (Title). Rc i c:.e QFFic6Z
in the City of Lansing (Department) �i-/CC
This position is (X)Fulltime ( )Part time ( less than 25 hrs/wk. )
( ) Unpaid.
2 . I am a member of the Lansing Police Athletic League,
Inc . , a non-profit, tax-exempt organization as defined by 501(C) ( 3 )
of the Internal Revenue Code and I serve on the organization' s
Board of Directors .
3 . The LANSING POLICE ATHLETIC LEAGUE, INC. , (P.A.L. ) is
entering into a Contract with the City of Lansing via the
NEIGHBORHOOD YOUTH AND PARENT PREVENTION PARTNERSHIP PROGRAM,
hereafter referred to as the NEIGHBORHOOD PARTNERSHIP, for which
P.A.L. will receive Three Thousand Three Hundred Twenty-Five
Dollars ( $3, 325 . 00) from the City of Lansing to provide a sports
program for young people in various Lansing neighborhoods . All of
the money will go towards the line items specified in the Contract
- none of which include personnel costs, wages or benefits .
4 . The LANSING POLICE ATHLETIC LEAGUE, INC . , is a private,
non-profit, tax-exempt organization affiliated with the NATIONAL
ASSOCIATION OF POLICE ATHLETIC LEAGUES, INC. The purpose of the
Lansing P.A.L. is to provide recreational, sporting, educational,
and cultural activities for disadvantaged Lansing children.
5 . I or my (Relative) ,
and/or the LANSING POLICE ATHLETIC LEAGUE, INC. , a non-profit, tax-
exempt organization with which I am associated as defined in
Ordinance 290 . 02 (b) , (c) and (d) , does not receive a financial
benefit, this includes salaries , wages, income or remuneration of
any kind.
6 . I do not have any conflict between a personal interest
and the public interest as defined by state law, the Lansing City
Charter, or ordinance.
7 . The City of Lansing employees involved with the Lansing
P .A.L. , who are predominantly Lansing Police Department personnel,
are all unpaid volunteers who .participate in P.A.L. on their own
time . No City of Lansing employees associated with this Contract
will receive any income, benefits, or other forms of remuneration
as a result of this Contract.
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I hereby certify that this AFFIDAVIT OF DISCLOSURE regarding
the Contract between the Lansing P.A.L. and the Neighborhood
Partnership is complete and accurate to the best of my knowledge,
information and belief .
Date ¢-Z7 -95 Yet
Na
Subscribed and sworn before me the day of
1995, in Ingham County, Michigan.
City Clerk/Notary
Ingham County, Michigan
My Commission Expires :
TERESA AINSUE
Notary Public, Eaton County, MI
My Commission Expires Nov. 1.9, 19W
Acting in kit u*,Ag
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