HomeMy WebLinkAboutShermanSteven Affadavit Disclosure 2014 XVB4
'- CITY OF LANSING
AFFIDAVIT OF DISCLOSURE
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TO: CITY CLERK, DATE:
CITY ATTORNEY or
BOARD OF ETHICS
I Sre.0 C✓1 make the following disclosure under tTbth:
(Name)
PLEASE CHECK THE BOX AND FILL IN THE APPROPRIATE BLANKS FOR EACH OF THE
FOLLOWING ITEMS
Yes No
1. ❑ 1 am an ❑ elected or❑appointed ❑ officer oryemployee of the City of
Lansing ho ding the position of C'�-0T?'
in the Vi rc c Department
❑ 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
❑ 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. `t ❑ 1 may derive income or benefit directly or indirectly from the bidding of,
ll negotiation of, solicitation of or entry into a contract with the City or from
and 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(I) of the Code of Ordinances]
❑ ' 1 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]
I ❑ 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 of Ordinances and in the City Charter.
3. My City of Lansing position is;
Full-time ❑ Part-time (less than 25 hours/wk) ❑ Unpaid
4. PLEASE DESCRIBE IN DETAIL YOUR REASON(S)FOR SUBMITTING THIS DISCLOSURE
AND EXPLAIN WHY YOU THINKA CONFLICT MAY/MAYNOT EXIST.
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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 day of
20j_j_.
Signe
State of Michigan, County of��< � .,..
Subscribed and sworn to before me this day of 20 ► '� _
CHR,STOPHER TRUMBLE Notary Public/or Deputy Clerk
NOTARY pMIC,STATE OF MI
DOUNTyoF,NQHAM 1��3 a County, Michigan
W COMMWON EXPIRES NovW 20a1 y
AOVNG W COUwy OF ( ..�
My Commission Expires: NOV. )0 .iT