Fehling, Margery A - Council at Large FORM 11(REVISED 1980)MILLER-DAVIS CO.,MINNEAPOLIS
AFFIDAVIT- OF CANDIDATE & RECEIPT FORu HUNG
TOWN OR CITY ELECTIONS
State sof Milinesota No.�
JJ.
County of
(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 / all
I reside in the city or township of
My post office address is ti
/ -
r• n j
_ (Sign name as wanted ballot)
Subscribed and sworn to before me this sra of , 19
(Tow ,(City) Clerk dVotary Public
SEAL County, Minn.
Y
' TION PETITION
We, the undersigned, registered voters of the City of Fridley,
hereby nominate C. r j - , whose residence is
- ter/ z , for the office of
to be voted for at
the election to be held on the day of , 19 S ;
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.
NSTPZLV AND MWER
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being duly sworn, deposes and says, "I
(Name of Circulator)
am the circulator of the foregoing petition paper containing signatures,
and that the signatures appended thereto were made in my presence and are
- - - -the wine signatures of the persons whose names they purport to be."
I wish my name to appear on the ballot exactly as follows:
(Please Print) _
(Signature of Nominee)
Subscr'bed and sworn to before me this ) 5 qday
of , 19 4'
4c 'dwmkhWALTER J. MULCAHY
J NOTARY PUPLIC-MINNESOTA
L RAMSEY COUNTY
( ry P 11C) Mycommission ExwresOct.07,1986 `
tc
This petition, if found insufficient by the City Clerk, shall be returned
at Number PHc,:-. �3/- Street.
I hereby indicate my willingness to accept the office of
P Z JJ>_t't if duly elected thereto.
_
(Sighal
3/0/1/9
BOMINATION PETITION '
We, the undersigned, registered voters of the City of Fridley,
hereby nominate , whose residence is
for the office of
to be voted for at
the election to be held on the day of , 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.
NAM STREET ADD NQH3M
%27
ELL '44—
being duly sworn, deposes and says, "I
(Name of Circulator)
am the circulator of the foregoing petition paper containing signatures,
and that the signatures appended thereto were made in my presence and are
of the persons whose names they purport to be."
I wish my name to appear on the ballot exactly as follows:
(Please Print)
u �
(�ig&t7re of Nmnin6e)
Subscrib d d sworn to before me this _.'qday XAAAAAAAAAAAAAAAAAAAAAAAA-AAMN AM
of 8, 19�. WALTER I MULC�11Y
NOTAd E' OTA
RAMSEY COUNTY
Z MyCommissionLxWies0d.01,19W 0i
( ry lic) Y r
This petition, if found insufficient by the City Clerk, shall be returned
to , at Number Street.
I hereby indicate my willingness to accept the office of
if duly elected thereto.
(Signature of Nominee)
3/0/1/9
CITY OF FRIDLEY
74=77
CITY COUNCIL OR COUNCIL CANDMA'
E
NAME DATE
T0: 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
cies doing business with the City of
enterprises, or governmental agen
Fridley or located within the City of Fridley:
a. With which I have a financial interest.
(As used in Chapter 51 the term financial interest shall be deemed
to include ownership of more than 10% of: The outstanding stock or
in
a corporation, an interest in a partnership, proprietorship,
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 51 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
PAR'INER.SH I P EPC. ADDRESS IRIEREST INTU=
(Use additional paper if necessary.)
2. A list of the nornccmestead real property located within the City of
Fridley in which I currently have a financial interest:
(Use additional paper if necessary.)
r
3. A list of the non-hcmestead real property located within the City of
Fridley in which I had a financial interest within the preceding three
(3) years:
NOW TEM REAL PROPERTY ADZES
I
(Use additional paper if necessary.)
4. A list of the names and nature of business 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.)
NATURE OF BUSINESS - OF ALL CORPORATIONS
NAMES PARTNERSHIPS, OR OTHER BUSINESS MUMPRISES
(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.
&Z"A
(Signature)
Note: This state,ent must be filed annually or when there is a material
change in financial interest or in position held.