HomeMy WebLinkAboutPatinoMaryAugust Affidavit Disclosure 1994 REFERRED TO THE
BOARD OF ETHICS
CITY OF LANSING 00,0
AFFIDAVIT OF DISCLOSURE
OF
CONFLICT OF INTEREST
�cl'D
TO: [ ] CITY CLERK or
[ ] CITY ATTORNEY and
( ] MAYOR and DEPARTMENT HEAD or
[ ] CITY COUNCIL PRESIDENT
(Name) Police Technician Marie Patino 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 (Title) Police Technician
in the 1 nsij Police
Department. This position is: [X] Fulltime [ ] Parttime ( less than
25 hours/wk) [ ] Unpaid.
2. [ ] I, [ ] and/or my (Relationship)
a member of my immediate family as defined in Ordinance 290 .02 ( i ) ,
N and/or (Name) i-h 1 9 P 7 " A+hl +' 7 T_ , 7 c -I
a business with which I an associated as defined in Ordinance
290 . 02 (b) , ( c) and (d) :
(Select the option or options that apply)
[ ] a. may receive a financial benefit of more than a de
minimus. nature which is distinguishable from the benefits to the
person as a member of the public or as a member of a broad segment
of the public from a decision I would otherwise make or participate
in as an officer or employee. The decision involved is described
as follows: does not apply
The financial benefit will be received by the following persons in
the following amounts: 1 will not receive a financial benefit of and amot t.
;and/or
[ ] b. intend to have business dealings with the City of
1
Lansing, either directly or indirectly. The business dealings are
specifically described in detail as follows ( include names of each
party, the duration of the dealings, the financial consideration
between the parties , the governmental facilities or services
involved, the nature and degree of assignment of government
employees for fulfillment of dealings, and the nature of any
pecuniary interest) : T can a member of the L4nsin1 Police Athletic Lenm,e, Inc.
a non-profit, tax-exempt organization and T serve on the organization's board of
The Lansing Police Athletic Leen,e Inc is enteri yr i„+a 3 mrtn+} C. „tract
with the City of Lansing for which P.A.L. will receive $3,000. from the City to provide
,Wuth bocce, wig people M various ing not g r s. All of the
money will pq towards the line itms specified in the cant - +_-„an, 4 include
personnel costs, wages or benefits. T will receive no financial benefit based on my
ng is contract with e t y o resin
;and//or
[ J c. may derive income or benefits , either directly or
indirectly, in addition to official remuneration, as a result of
Council action. The action involved is described as follows :
7 ; 77 + ,ae x.. „fits as a ve6w4t ..Vc Ce :_I motion.
The income or benefits, in addition to official remuneration, that
will be derived, either directly or indirectly, is described as
follows: does not a»nly
;and/or
( ] d, may derive income or benefits, either directly or
indirectly, in addition to official remuneration, as a result of
a contract with the City. The contract is specifically described
in detail as follows ( include names of each party, the duration of
the dealings, the financial consideration between the parties , the
governmental facilities or services involved, the nature and degree
of assignment of government employees for fulfillment of the
contract, and the nature of any pecuniary interest ) :
T will not receive or derive any income or benefits as a result of this Contract.
2
;and/or
[ ) e. have a conflict between a personal interest and the
public interest as defined by state law, the Lansing City Charter,
or ordinance. The personal interest that conflicts with the public
interest is described as follows : I have no such conflict.
The public interest that the personal interest conflicts with is
described as follows : does not apply
3. I have attached additional detail on the reverse of this
form or on attached sheets, including copies of all relevant
documents, memos , resolutions, and contracts. (SEE ,gTTpaIED)
4 . (Select one) M I will not make or participate in the
making of the affected decision and/or governmental decisions
concerning the contract and/or governmental decisions concerning
the business dealings and/or governmental decisions concerning the
conflict, OR
[ ) Despite the conflict of interest, I am able to make or
participate in the making of the affected decision and/or
governmental decisions concerning the contract and/or governmental
decisions concerning the business dealings and/or governmental
decisions concerning the conflict, fairly, objectively, and in the
public interest because: does not apply
3
5. I hereby certify that this disclosure is complete and
accurate to the best of my knowledge, information and belief.
6. I hereby certify that I have not solicited or entered
into any agreement with the City of Lansing prior to filing this
affidavit.
The foregoing Affidavit of Disclosure of Conflict of Interest
was executed on the J7 day of ,July 1994
C �G
Subscribed and sworn before me the day of �.
199, in ;� li2n' _ County, Michigan
MARILYNN SLADE Notary Public/or
Mytaty Public, Ingham County„ml , Deputy Clerk
My Comm. Expires Feb. 20. 1995 County, Michigan
My Commission Expires:
FOR
CITY CLERK/CITY ATTORNEY USAGE
DATE FILED: G
COPIES SENT TO: Mayor
City Council President
N Department Head
c/ �y (�+ Board of Ethics
DATE SENT: b 3 (
BY: . Crop
4
cj,ESTIGN #3 EU1,1"TICN
The LANLSIN15 fl)LICE ATHLETIC LE4C7[lE, INC. is a private, non-profit, tax-
exempt organization affiliated with the N4TIONdL ASI;CCTATION OF POLICE ATHLETIC
L 4q'IIES, INC. The purpose of the Lansing P.A.L. is to provide recreational ,
sporting, educational, and cultural activities for disadvantaged Lansing boys
and girls.
The City of Lansing employees involved with Lansing P.A.L.--predominately
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 renuneration as a
result of this Contract.
No City of Lansing employee involved with the LANISIN15 FMICE AT1ilETIC
LEAGUE, INC. has any conflict of interest of a personal or public nature as a
result of this Contract.
THE LAHS186 POL ICE A THLETIC LE4 CUE, INC_
WHO WE ARE:
The Lansing Police Athletic League, Inc. (P.A.L.) is a non-profit organization formed
and run by Lansing Police officers working together with the community to provide
recreational, sporting, educational, and cultural activities for Lansing kids.
We care about the young people in this city. We want to reach out to kids in a positive
way to show that cops are more than just law enforcers. We want to open lines of
communication, build trust, and develop a positive relationship between Lansing youth and
the community's police officers.
WHAT WERE DOING:
We recognize that there are too many kids in our city that don't have anything to do
after school except get in trouble. We know that good role models for young people are
harder and harder to find these days. These are things we want to change.
This year, we are organizing soccer and basketball leagues for pre-teen and early
teen-age boys and girls from neighborhoods throughout the City. P.A.L. also sponsors a
variety of field trips and special events for neighborhood youth. Lansing Police personnel
and other volunteers donate their time to coach, officiate, and work with the kids.
Participants in our sports programs attend "program nights" during which we
coordinate with other youth service agencies to provide kids with important information,
generate discussion about issues, and involve young people in community problem solving.
The boys and girls in P.A.L. are from all social, racial, and ethnic backgrounds.
Our sports programs are free of charge to all participants. All needed equipment is
provided at no cost. Many of the kids we involve in P.A.L. have never participated in team
sports before and are at risk for getting into trouble at school, at home, or on the streets. In
our leagues, everyone plays. The emphasis is on teamwork, good sportsmanship, and
building skills—both on and off the court. In the months to come, we hope to expand our
program to include other sports, special events, and cooperative efforts with the Lansing
School District, the City's Parks and Recreation Department, and Michigan State University.
HOW YOU CAN HELP:
We're starting small but we still need financial support for equipment, supplies, and
administrative costs. We have already received some donations from police officers, but now
we're reaching out to concerned citizens, civic groups, and local businesses. Your help is
vital to assure we can work with all the kids who want to participate in our program.
Please let us know if you can make a financial contribution, donate equipment, or
volunteer your time. We are a non-profit, tax exempt organization. Contributions to the
Lansing Police Athletic League, Inc. may be sent to 310 Seymour St., Lansing, MI 48933.
We welcome your questions or requests for additional information at 483-6022.
City of Lansing - Board of Ethics
TO: Marie Patino, Police Technician, L.P.D. p��J
FROM: Marilynn Slade, Secretary, Board of Ethics ff •CSC
DATE: September 28, 1994
SUBI: Affidavit of Disclosure of Conflict of Interest: Police Athletic League
The Board of Ethics reviewed your Affidavit of Disclosure of August 3, 1994, at its meeting of August
23, 1994.
We appreciate your bringing this to our attention. The Board received and placed your Disclosure on
file. No further Board action in this matter is anticipated at this time.
(517) 483-4130 City Clerk's Office, 124 W. Michigan Ave. Lansing, M148933-1695
CITY OF LANSING �U,0
AFFIDAVIT OF DISCLOSURE >q
OF
CONFLICT OF INTEREST 5
TO: [ ) CITY CLERIC or
[ ] CITY ATTORNEY and
[ ] MAYOR and DEPARTMENT HEAD or
[ ] CITY COUNCIL PRESIDENT
(Name) Police Technician Marie Patino 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 (Title) Police Technician
in the Lansigg Police
Department. This position is: [Y] Fulltime [ ) Parttime ( less than
25 hours/wk) [ ) Unpaid.
2. [ ] I , ( ) and/or my (Relationship)
a member of my immediate family as defined in Ordinance 290. 02 ( i ) ,
W and/or (Name) ftho 1 ., ;$ Pn1;,-o A+hto+;.- I oa''4,,.1 7.,,- r
a business with which I am associated as defined in Ordinance
290 . 02 (b) , ( c) and (d) :
(Select the option or options that apply)
[ ] a. may receive a financial benefit of more than a de
minimus. nature which is distinguishable from the benefits to the
person as a member of the public or as a member of a broad segment
of the public from a decision I would otherwise make or participate
in as an officer or employee. The decision involved is described
as follows: does not apply
The financial benefit will be received by the following persons in
the following amounts: I will not receive a financial benefit of anU amount.
;and/or
[ ) b. intend to have business dealings with the City of
1
Lansing, either directly or indirectly. The business dealings are
specifically described in detail as follows ( include names of each
party, the duration of the dealings, the financial consideration
between the parties, the governmental facilities or services
involved, the nature and degree of assignment of government
employees for fulfillment of dealings, and the nature of any
pecuniary interest) : I am a member of the Lansing Police Athletic Leaave, Inc. ,
a non-profit, tax-exempt organization and I serve on the organization's Board of
The Lansing Police Athletic LeggIL-, Inc i ent 'ram t 3 .,,,+h Contract
with the City of Lansing for which P.A.L. will receive $3,000. from the City to provide
young peop e in vartovs tWislng neLghborhoods. 1 of the
money will go towards the line items spLi,-fi ed in 1-ho cm frac+--.,oma q-f ...h:�h incitde
personnel costs, wages or benefits. I will receive no financial benefit based on my
ng P.AX. aM rMs czynrract with e Gity o to
a Y/or
( ] C. may derive income or benefits , either directly or
indirectly, in addition to official remuneration, as a result of
Council action. The action involved is described as follows:
The income or benefits, in addition to official remuneration, that
will be derived, either directly or indirectly, is described as
follows : does not acnly
;and/or
( J d. may derive income or benefits, either directly or
indirectly, in addition to official remuneration, as a result of
a contract with the City. The contract is specifically described
in detail as follows ( include names of each party, the duration of
the dealings, the financial consideration between the parties, the
governmental facilities or services involved, the nature and degree
of assignment of government employees for fulfillment of the
contract, and the nature of any pecuniary interest ) :
I will not receive or derive any income or benefits as a result of this Contract.
2
;and/or
[ ] e. have a conflict between a personal interest and the
public interest as defined by state law, the Lansing City Charter,
or ordinance. The personal interest that conflicts with the public
interest is described as follows: I have no such conflict.
The public interest that the personal interest conflicts with is
described as follows : does not apply
3. I have attached additional detail on the reverse of this
form or on attached sheets, including copies of all relevant
documents, memos, resolutions, and contracts. (SEE ,gTrqCI�Ep)
4. (Select One) M I will not make or participate in the
making of the affected decision and/or governmental decisions
concerning the contract and/or governmental decisions concerning
the business dealings and/or governmental decisions concerning the
conflict, OR
[ ] Despite the conflict of interest, I am able to make or
participate in the making of the affected decision and/or
governmental decisions concerning the contract and/or governmental
decisions concerning the business dealings and/or governmental
decisions concerning the conflict, fairly, objectively, and in the
public interest because: does not apply
3
5. I hereby certify that this disclosure is complete and
accurate to the best of my knowledge, information and belief.
6. I hereby certify that I have not solicited or entered
into any agreement with the City of Lansing prior to filing this
affidavit.
The foregoing Affidavit of Disclosure of Conflict of Interest
was executed on the �2-7 day of JuIp 1994 .
c �z-t
Subscribed pand sworn before me the day of
199, in ��fi[fiy� County, Michigan
MARILYNNSLA[)E Notary Public/or
Notary Public, Ingham County,Ml 1 Deputy Clerk
My Cbmm. Expires Feb. 20. 1955 County, Michigan
My Commission Expires :
FOR CITY CLERK/CITY ATTORNEY USAGE
DATE FILED:
COPIES SENT TO: Mayor
City Council President
[ J Department Bead
�}+ Board of Ethics
DATE SENT:
BY: �Q ¢�
4
CXIESTIGN #3 EXF3.AP34TION
The LANSIP45 POLICE Alt;LETIC LEAtjt E, INC. is a private, non-profit, tax-
exempt organization affiliated with the NATIONAL ASSCCYATION OF FMICE ATHLETIC
LEAy'FiES, ZNC. The purpose of the Lansing P.A.L. is to provide recreational,
sporting, educational, and cultural activities for disadvantaged Lansing boys
and girls.
The City of Lansing employees involved with Lansing P.A.L.--predominately
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 renuneration as a
result of this Contract.
No City of Lansing employee involved with the LAMD45 POLICE ATHLETIC
LEAGI/E, RE. has any conflict of interest of a personal or public nature as a
result of this Contract.
THE LANSING POLICEATHLETIC LEAGUE, INC_
WHO WE ARE:
The Lansing Police Athletic League, Inc. (P.A.L) is a non-profit organization formed
and run by Lansing Police officers working together with the community to provide
recreational, sporting, educational, and cultural activities for Lansing kids.
We care about the young people in this city. We want to reach out to kids in a positive
way to show that cops are more than just law enforcers. We want to open lines of
communication, build trust, and develop a positive relationship between Lansing youth and
the community's police officers.
WHAT WERE DOING:
We recognize that there are too many kids in our city that don't have anything to do
after school except get in trouble. We know that good role models for young people are
harder and harder to find these days. These are things we want to change.
This year, we are organizing soccer and basketball leagues for pre-teen and early
teen-age boys and girls from neighborhoods throughout the City. P.A.L. also sponsors a
variety of field trips and special events for neighborhood youth. Lansing Police personnel
and other volunteers donate their time to coach, officiate, and work with the kids.
Participants in our sports programs attend "program nights" during which we
coordinate with other youth service agencies to provide kids with important information,
generate discussion about issues, and involve young people in community problem solving.
The boys and girls in P.A.L. are from all social, racial, and ethnic backgrounds.
Our sports programs are free of charge to all participants. All needed equipment is
provided at no cost. Many of the kids we involve in P.A.L. have never participated in team
sports before and are at risk for getting into trouble at school, at home, or on the streets. In
our leagues, everyone plays. The emphasis is on teamwork, good sportsmanship, and
building skills--both on and off the court. In the months to come, we hope to expand our
program to include other sports, special events, and cooperative efforts with the Lansing
School District, the City's Parks and Recreation Department, and Michigan State University.
HOW YOU CAN HELP:
We're starting small but we still need financial support for equipment, supplies, and
administrative costs. We have already received some donations from police officers, but now
we're reaching out to concerned citizens, civic groups, and local businesses. Your help is
vital to assure we can work with all the kids who want to participate in our program.
Please let us know if you can make a financial contribution, donate equipment, or
volunteer your time. We are a non-profit, tax exempt organization. Contributions to the
Lansing Police Athletic League, Inc. may be sent to 310 Seymour St., Lansing, MI 48933.
We welcome your questions or requests for additional information at 483-6022.