HomeMy WebLinkAboutUristaKatrina Affidavit Disclosure 1997 LPN S IBC
CITY OF LANSING
AFFIDAVIT OF DISCLOSURE
cHIGP
TO: CITY CLERK DATE: 10/6/2021
[,Katrina Urista make the following disclosure under oath:
Name (please print)
PLEASE CHECK THE BOX AND FILL IN THE APPROPRIATE BLANKS FOR EACH OF THE FOLLOWING
ITEMS
Yes No
1. P ❑ 1 am an ❑ elected or ❑ appointed ❑ officer or a employee of the City of Lansing
holding the position of Contract Management Administrator in the Hum° R.1.0-&C.-MyS.M..(HRCS)Department.
❑ da 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
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. ❑ a 1 may derive income or benefit directly or indirectly from the bidding of,
negotiation of, solicitation of or entry into a contract with the City or from any City action detailed
below. (Charter 5-505.1)
❑ b 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]
❑ 10 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 ❑ 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 Ordinance as provided for in the Code
of Ordinances and in the City Charter.
3. My City of Lansing position is:
e Full-time ❑ Part-time (less than 25 hours/wk) ❑ Unpaid
4. Name of the activity/business in question:State of Michigan grant-Covid Emergence Relief Assistance(CERA)
5. Do you have ownership or interest in the activity/business? Yes x No
Updated July 2019
6. Does this activity/business conduct business with the City of Lansing? Yes X No
If yes, please explain Funds from the CERA grant may be used to pay back rent from a property my husband and I own.
7. Does the activity/business depend on you being an employee of the City of Lansing?
Yes No X
If yes, please explain:
8. Who are the clients/customers of the activity/business?
Tenants/Renters with past due rent
9. Does this activity/business require your using equipment/facilities of the City of Lansing?
Yes No x
If yes, please explain:
10. Does the activity/business use any advertisements or circulars that reference your employment
with the City of Lansing? Yes No x
If yes, please attach copies.
11. Explain what you will be doing in the activity/business:
My husband and I own a property within the City of Lansing(630 Cameo Street).The tenant(who is also my son and his family)applied for assistance
from the CERA grant.As the landlord,the rent assistance would be used to pay back rent to my husband and me for this property.
12. Explain why you believe a conflict may/may not exist with this activity/business:
HRCS-City of Lansing acts as the fiduciary for some MSHDA-Ingham County Grants. The CERA grant is part of the portfolio
of grants HRCS is responsible for.Although I don't directly handle the participants in the grant, I help oversee the grant.
This information was disclosed to Stephanie Oles from MSHDA. The MSHDA administration moved the application
from Ingham County to Eaton County.
13. Is there any additional information that you believe would assist the Board of Ethics in its
review of your business or personal activities for potential conflicts of interest? Yes No X
If so, please describe:
In providing t(isadditional 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.
Updated July 2019
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 thijAday of OG+y b-tr, 20 ';0
Signature of Filer
STATE OF MICHIGAN )
_ )ss.
COUNTY OF-114
The foregoing instr nc-t was acknowle ecjbrefore me this Cf 7'day of D �
___ (year), by C (Notary Signature)
(Print Name)
Notary Public, lJ'r County,
Acting in_ �61-;,A-nn County,
My Commission Expires:
RENEE FREEMAN
Notary Public-State of Michigan
County of Ingham
My Commission Expires Jul 11,2028
Acting in the County of ��gdr+vj
Updated July 2019