Wolfe, Richard P - Mayor FORM 11(REVISED 1980)MILLER-DAVIS CO.,MINNEAPOLIS
AFFIDAVIT OF CANDIDATE & RECEIPT FOR FILING
TOWN OR CITY ELECTIONS �
State of Minnesota No.
County of— A Ro sf
I, 1G�l4/L d 6iWe-
(Print name as wanted on ballot)
swear(or affirm)that I am qualified under the Constitution and Laws of the United States and State of Minne-
sota to seek the elective public office indicated below. I am a qualified voter in the subdivision where I seek
election. I will be 21 years of age or more on assuming office. I will be a resident of my election district for at
least 30 days by election day. I have not filed for any other office at this election.
I am seeking election to the office of 4
I reside in the city or township o I le
My post office ad ress is: 7XQ /,4- /N
(Zip)
71
(Sign n6rel as wanted on ballot) al
Subscribed and sworn to before me this da of , 19
�`•. MARY MARGARET SMITH
'•' ` � (T6A), it ) C erk----Rotary Public
NOTARYPIKIC-MINNESOTA
SEAL ANOVA COUNTY County,Minn.
'�«•�'°� My Commission Expires Jan.31.2000
NOMINATION PETITION
We, the undersigned, registered voters of the City of Fridley,
hearby nominate ei w® / � , whose residence is
9� e- J�r� �� ' for the office of
- o �� �� Ll to be voted for at
the election to be held on the J`il� day of D✓= 19 ;
and we individually certify that we are registered voters and that
we have not signed more nomination petitions of candidates for this
office than there are persons to be elected thereto.
DATE NAME STREET AND ADDRESS
-T ` tom\
Qe - t 3 r�G `� ASoo - ��� 2.
=i3_44 i6-(,� Nf2 Op_
Rd
GJo1're being duly sworn, deposes and says, "I am
(Name of Circulator)
the circulator of the foregoing petition paper containing signatures,
and that the signatures appended thereto were made in my presence and
are the genuine signatures of the persons whose names they purport to
be. "
I wish my name to appear on the ballot exactly as follows:
?- UA0lf'e
(Please Print)
_ Signator of Nominee)
Subscribed and sworn to before me this /45 _ day
of , 19�
PArn�C"Al WjHM
�• NOTARY PU9LIC•�INNE80TA
ANOKA COUNTY
(N a ry Pu 1 i c) My CO"Bsion Expires Jan.81,2000
This petition, if found insufficient by the City Clerk, shall be returned
to at Number ��G ��71/n e'L"'4-1 Street.
I hearby indicate my willingness" to accept the office of
_ if duly elected thereto.
( ignature of �aminee)
6/94 �/
NOMINATION PETITION
We, the undersigned, registered voters of the City of Fridley,
hearby nominate R- `) P- �4.c3 /"C f whose residence is
for the office of
C' P , to be voted for at
the election to be held on the day of , 19-L;
and we individually certify that we are registered voters and that
we have not signed more nomination petitions of candidates for this
office than there are persons to be elected thereto.
DATE NAME STREET AND ADDRESS
VU
a� 9?-N-
?-int-fib (0 ac)o (0tII-X sT n
Lo
,
_-
U;
(Name of Circulator) being duly sworn, deposes and says, "I am
the circulator of the foregoing petition paper containing signatures,
and that the signatures appended thereto were made in my presence and
are the genuine signatures of the persons. whose names they purport to
be. "
I wish my name to appear on the ballot exactly as follows:
L e
(Please Print)
"Isignaturof Nominee)
Subscribed and sworn to before me this day
Of , 19PA TtA &MUHIdl
�=' NOTARY PUBLIC.MMEMA
ANOKA COUNTY
My Commission EXPIM Jath.31,gppp
(Not Public)
This petition, if found insufficient by the City Clerk, shall be returned
to A4 at Number Street.
I hearby indicate my willingness to accept the office of
if duly elected thereto.
(Signature of inee)
6/94
CITY OF FRIDLEY
PUB,�IC DISCLOSURE S
jTAM1ENT BY CITY COUNCIL OR COUNCIL CAMIDATES
NAM fC G2LcrC � _ DATE 7 Z�
TO: CITY CLERK
In conformance with Sec. 5 . 04 of the City Code, I hereby make the following
declarations regarding my financial and personal interests:
1. Names- of all business corporations, partnerships, other business
enterprises, or governmental agencies doing business with .the City of
Fridley or located within the City of Fridley:
a. With which T_ have a financial inter(-t.
(As used in Chapter 51 the term financial interest shall be deemed
to include ownership of more than 10% of: The outstanding stock in
a corporation, an interest in a partnership, proprietorship, or
other business entity, or an interest in real property. Financial
interest shall apply to real or personal properties owned by the
person making the disclosure and by said person's spouse.)
b. With which I have a personal interest.
(As used in Chapter 5 , the term personal interest shall be deemed
to apply whenever a person required to make a disclosure under this
code of ethics shall be associated with a business as an employee,
officer, director, trustee, partner, advisor or consultant.)
NAME OF BUSINESS FINANCIAL PERSONAL
PA MERSHIP, EIC. ADDRESS INTEREST IlNTEREST
t' 1 1/e µ.
(Use additional paper if necessary.)
2. A list of the norr-homestead real property located within the City of
Fridley in which I currently have a financial interest:
NON-HOMESTEAD REAL PROPERTY ADDRESS
(Use additional paper if necessary.)
i
3. A list of the non-homestead real property located within the City of
Fridley in which I had a financial interest within the preceding three
(3) years:
NW-HOMESTEAD REAL PROPERTY ADDRESS
(Use additional paper if necessary.)
4. A list of the names and nature of bu.siness of all corporations,
partnerships, or other business enterprises with which I have a
financial interest and in which I know one or more other persons covered
by this code of ethics also having a financial interest in said
enterprise. (This list shall indicate the name or names of such persons
or persons having such interest in said enterprise.)
NAMME OF BUSINESS - OF ALL ODRPORATIONS
WMES PAMNERSHIPS, OR aMER BUSINESS WrMR ISES
(Use additional paper if necessary.)
I do swear (or affirm) that this report is a full and true statement
pursuant to Sec. 5. 04 of the City Code. /, t
Note: This statement must be filed annually or when there is a material
change in financial interest or in position held.