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Home My WebLink AboutSchuylerMichael Affadavit Disclosure 2010 -f-EDP CITY F LANSING AFFIDAVIT OOF DISCLOSURE , 1 MAY G� �o1d DAT TO: CITY CLERK, � CITY ATTORNEY, or I° BOARD OF ETHICS ' Lansing City � ttorne I 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. ❑ 1 am an ❑ elected or ❑ appointed ❑ officer or "mployee of the City of Lansing holding the position of 7�e-�.�h"on c��'�d�e.✓ in the 'Po 1:Ce r department ❑ Er" 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. ❑ F/� 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. ❑ 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) ❑ 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(1) of the Code of Ordinances] ❑ z/" 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] ❑ d 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 or Ordinances and in the City Charter 3. This position is: Va ull time F—Part time (less than 25 hours/wk) ❑ Unpaid 4. My Address is: 5. My Business (daytime) Phone# is: CONTINUED ON PAGE 2 AFFIDAVIT OF DISCLOSURE-PAGE 2 6. PLEASE DESCRIBE IN DETAIL YOUR REASON(S) FOR SUBMITTING THIS DISCLOSURE AND EXPLAIN WHY YOU THINK A CONFLICT MAY/MAY NOT EXIST. 17 ci rn s b�,;-�-� ;•. -f �,:S c�;s as f c oo �-}� 0-92ir 6'/0.- -- be i 0b. A Cu_-In 1 1c4- 41I-r- S�COru pb Ct O F r. DES /104- cam Co� Ct�� n �5 pren v ' c1 w o�1�zd h e- go" on c ,rs and Aa,ve. 1lOr �J0 �>°r1G u S I t/w`1 roY� 6✓ 1� ��C] v�'� L113 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 i3 day of Ate, 20 4C Signed ('\I( Y.S q State of Michigan, County of T Subscribed and sworn to before me this��J day of (oR 1� 20 I b RANDALL L DAVl�S ota u r Deputy Clerk N0TAWP'UBW,ETA7E0FM1 County, Michigan =Nn OF CLINTOUid fYIY COMMISSION EXPIRES P,Dr i 0,2012 A'-'MNG IN CDl1AA.OF fwfla,' My Commission Expires: PLEASE INCLUDE AND SUBMIT A COPY OF YOUR CURRENT JOB DESCRIPTION DRAFT 5A;REVISED 11-05-04 ATTACHMENT A Please provide additional information about your outside business or employment. Of special interest to the Board is how the activities of the business or employment may directly or indirectly affect the City. This disclosure is about information and is not an indication of any anticipated conflict of interest or suspected wrongdoing. Therefore, please describe for the Board what it is you actually do and be detailed and specific. You are not required to limit your disclosure only to the following questions. For each business, include in your answer such things as: ■ What is the form of your business entity and what percentage do you ` own? ir0,hS,9-�ci ■ Are you self-employed? n�c ■ Who is your employer, if applicable? L c".n5i n!$ ■ What are the things you actually do in the business? (�saay��eX 7L-X1f i C f c,Ce ssi..c, 'F o•rlm S ■ Who are your clients and who receives your goods or services? G'U►1 ht.�5 cti 4 *', - Q'ec-ke- L CZ.rN s i roc, a"rCQ_ C ay),m y-n i 4'es t-J`,o o A'F e i \ec,e e=� L cc ■ How and where are your services performed? Se-vV ices c_,-e, n�� m Pcl' i•n o,YN nj2L11 CC I Page 1 of 3 ■ How often do you do outside work? N'e...;r.V ■ Does your business or employer contract with the City? Nf o ■ In performing your business or outside employment, do you use any City facilities or equipment? Af If so, describe: ■ Is any of your business or employment conducted in the City? es If so, describe: L CC, ;s pY�-�.�r�\.� c c- cAc a-Ack ■ Does your business advertisement or circulars, if any, contain any reference to the City or your City employment? Ne ■ If your business uses advertisements, circulars, applications, or order forms that you have designed or have had designed for you, please attach a copy of the applicable form(s). Page 2of3 ■ If you provide training or education as part of your business: Do you identify yourself to your clients or students as being employed by the City of Lansing? Njo, Do you include in any of the written materials or aids or reference in any way in your presentations reference to policies, procedures, methods or materials as being those also used by the City of Lansing? Nfe If so, attach a copy of the material or aid and explain the reference in your presentation. ■ Is there any additional information that you believe would assist the Ethics Board in its review of your business or personal activities for potential conflicts of interest? N'O If so, please describe: In providing this additional information, the Board of Ethics asks that you give special attention to the Conflicts of Interest section of the Charter found at 5- 505.1- 5-505.3. A copy is enclosed for your convenience. Page 3 of 3 �PNSI,yc OFFICE OF THE CITY ATTORNEY C H t G P� MEMORANDUM TO: CHRIS SWOPE, City Clerk FROM: JOHN M. ROBERTS J OW! City Attorney DATE: MAY 10, 2010 SUBJECT: AFFIDAVIT OF DISCLOSURE; LPD OFFICER'S SUPPLEMENTAL EMPLOYMENT I have been asked by LPD to forward to you the attached affidavit about an officer's suppleintal employment. I understand this is for the Ethics Board. Thank you for your assistance. _= CD =� JMR/sp v Attachments S:\Attomey_StafABOARDS&COMMITTEES\Ethics Bd\Swope aff disclosure.doc 7-10 Council Meeting Packet _rERRED TO THE BOARD OF CITY OF LANSING ETHICS AFFIDAVIT OF DISCLOSU E . ' i MAY 05 2010 DAT TO: CITY CLERK, CITY ATTORNEY, or BOARD OF ETHICS L-ainsingkY Attorney I ffj;c� C e,1 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. ❑ I am an ❑ elected or ❑ appointed ❑ officer or 2-6mployee of the City of Lansing holding the position of -)De-Fr�on o-PF ce-✓ in the Fo 1;cr. department ❑ Er 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. ❑ 2"' 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. ❑ rB"' I may derive income or benefit directly from a contract with the City or from any City action detailed below. (Charter 5-5051) ❑ 2"' 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] ❑ Rr' 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] ❑ d 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 or Ordinances and in the City Charter 3. This position is: P"Full time r"'Part time (less than 25 hours/wk) ❑ Unpaid 4. My Address is: 5. My Business (daytime) Phone# is: CONTINUED ON PAGE 2 AFFIDAVIT OF DISCLOSURE-PAGE 2 6. PLEASE DESCRIBE IN DETAIL YOUR REASON(S) FOR SUBMITTING THIS DISCLOSURE AND EXPLAIN WHY YOU THINK CONFLICT MAWMAYNOT EXIST, Cil1 1 S G '+/'-p G1 Y o v A I b 0. S c a Cl D�j, Gc+,-} 11 C4- b e 4w c c,, v / C± W 0r1c,6J h g- -Cojr c ,ems CL^d Agve, r►o �� i�nc s i+u-,4�bn or I'c1�,n-1- w o J . n 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 r3 day of 20 V) Signed .S State of Michigan, County of YV Subscribed and sworn to before me this day of A PR I L— 201 b RWAI.d.L,DAMS ota u r Deputy Clerk NOTARY PLWC,STATE OF MI County, Michigan COU?M OFGUNTON MY COMMISSION EXPIRES Apr 18,412 4QNG IN tBlM of INQNAM My Commission Expires: PLEASE INCLUDE AND SUBMIT A COPY OF YOUR CURRENT JOB DESCRIPTION DRAFT6A;REVISED 11.06.04 ATTACHMENT A Please provide additional information about your outside business or employment. Of special interest to the Board is how the activities of the business or employment may directly or indirectly affect the City. This disclosure is about information and is not an indication of any anticipated conflict of interest or suspected wrongdoing. Therefore, please describe for the Board what it is you actually do and be detailed and specific. You are not required to limit your disclosure only to the following questions. For each business, include in your answer such things as: ■ What is the form of your business entity and what percentage do you own? 0 `1 Are you self-employed? n�c> Who is your employer, if applicable? LanShr� (o ■ What are-the things you actually do in the business? qtXuice- c9.rd DR"Ce°sSirN!� -fu" s ■ pW� W- ho are your clients and who receives your goods or services? I I\P.. ,ems (1 h. -hv- !z('eAe-i- /_ci.v�si,p a_a' t C ova,m i i es �-J C-C, c4 e C'�' �C C ■ How and where are your services performed? �Nj,ce s cxc e� m eJ 1 o,v\ c)Xm1 Wc>`L LCL s om rA : n C a,22 .s Page 1 of 3 How often do you do outside work? l J'e,�je:V • Does your business or employer contract with the City? f�-Po ■ In performing your business or outside employment, do you use any City facilities or equipment? nro If so, describe: • Is any of your business or employment conducted in the City? -e" If so, describe: LGC. ;s p i�j ko c 4 L-4 uccN-C'�A-es i r� �[•.e._ LAY\s�v�a e c-�� ;Vm� -�-s ■ Does your business advertisement or circulars, if any, contain any reference to the City or your City employment? file ■ If your business uses advertisements, circulars, applications, or order forms that you have designed or have had designed for you, please attach a copy of the applicable form(s). Page 2 of 3 ■ If you provide training or education as part of your business: Do you identify yourself to your clients or students as being employed by the City of Lansing? N)o Do you include in any of the written materials or aids or reference in any way in your presentations reference to policies, procedures, methods or materials as being those also used by the City of Lansing? c) If so, attach a copy of the material or aid and explain the reference in your presentation. Is there any additional information that you believe would assist the Ethics Board in its review of your business or personal activities for potential conflicts of interest? N'O If so, please describe: In providing this additional information, the Board of Ethics asks that you give special attention to the Conflicts of Interest section of the Charter found at 5- 505.1- 5-505.3. A copy is enclosed for your convenience. Page 3 of 3