HomeMy WebLinkAboutMcDowellJoel Affidavit Disclosure 2011 `.P14SrN OFFICE OF THE CITY ATTORNEY
��C g t G 9P MEMORANDUM
TO: CHRIS SWOPE, CITY CLERK
FROM: DONALD J. KULHANEK,ASSISTANT ITY TORN
DATE: JUNE 28,2011
SUBJECT: AFFIDAVIT OF DISCLOSRUE; BWL EMPLOYEE
I have been asked by Joel McDowell to forward to you the attached affidavit about his
supplemental employment. I understand this is for the Ethics Board.
Thank you for your assistance.
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Attachments
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' .I!!N 13 2091 (
CITY OF LANSING
AFFIDAVIT OF DISCLOSURE
Date:
To: City Clerk
City Attorney, or
Board of Ethics
I J0 r•/ Ne IJ n w elil make the following disclosure under oath '
(Name) l JUAI Z811 I,
PLEASE CHECK THE APPROPRIATE BOX OR FILL IN THE BLANKS FOR EiACH OF THE
FOLLOWING ITEMS
�
k 1
YES NO "
'.Jme:
1. ❑ 1 am an ❑elected or❑ appointed El officer or employee of the City
of LL�ansing holding the position of Pe,4 Aps u Jrr. in the
J/ LI��JL Department.
❑ �® 1 am an immediate family member related to an elected or appointed
officer or employee of the City of Lansing named holding
the position of at the Board of Water and
/ Light.
❑ [�* 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 tlie_ CiW.,pr
from any City action detailed below. (Charter 5-505.1)
b) c
❑ I may have a conflict between a personal interest and the pubic 1J,7;
interest, the nature of which is disclosed below (Charter 5-505.2)--
(.) CD
[Chapter#290.04(1) of the Code of Ordinances]. r , o
❑ L� I may have a financial interest in a matter proposed to be acted uppn I
by the City of Lansing as described below[Chapter 290.04(.) of the
Code of Ordinances]. i
❑ 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 Ordinances
provided for in the Code or Ordinances and in the City Charter.
3, This position is: Full time ❑//Part time (less than 25 hours/wk) ❑ Unpaid
4. My address is: brS/2 f{,�rw,,aW R �.d- ke i0AOC46r AAI° YV-rrVg
5. My Business(daytime) Phone# is: S-17 70.2- G 7R7 041F c r-
S 0e /! (pr *-ar-,Y)
Continued on page 2
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City of Lansing Affidavit of Disclosure
6. PLEASE DESCRIBE IN DETAIL YOUR REASON(S)FOR SUBMITTING THIS DISCLOUSRE
AND EXPLAIN WHY YOU THINK/A�CONFLICT MAY/MAY NOT EXIST.
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I herby certify that this disclosure is complete and accurate to the best of my knowledge,
information and belief.
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The foregoing Affidavit of Disclosure was executed on this day or1 f'` +"c�t, 20�
/ C or
Signed
State of Michigan, County of
(e1
Subscribed and swom to before me this 23 day of JLLFx ./ 20 ! I
Notary Public Deputy Clerk
County, Michigan
My Commission Expires: M'^tE) S, 2-017
DRAFT 5A REVISED 10-09-01
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