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Barnette, Bob - Council at Large FORM 11(REVISED 1980)MILLER-DAVIS c0.,MINNEAPOLIS AWDAV 7 OF CANDIDATE & RECEIPT FOR FLING TOWN OR CITY ELECTIONS State of Minnesota No. JJ. County of (1-TZ I, jS _ k0F, 77 - (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 officeindicated 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 I reside in the city or township of 0 Q My post office address is: rgn name as wanted on ballot) Subscribed and sworn to before me this 1 :2 day of 19 (Tow ,(City)Cler —Notary Public SEAL ( County,Minn. NATION'PETI= We, the undersigned, registered voters of the City of Fridley, hereby nominate 1?0,_3 Efz,T • �� 7E whose residence is ,541 ,q ce5- /r)iv , for the office of /9- /Ak6C _, to be voted for at the election to be held on the day of NovF 19 _Z2% 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. am STREET AND NUMBER X 57 5 MomaoE ST, N,E , a 54a 57' Wvr_ i J q 1 S �� . /1Q0&6,e T 46/4,eA✓E i�� , 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 genuine signatures of the persons whose names they purport to be." I wish my name to appear on the ballot exactly as follows: 43 013 64 oCA1 c 71_t�_ (Please Pri (SignAture of Naninee) bsworn to before me i. nnn,s 1�day ^^�nnnn, n ��,1Ann.1AA. f IE! , 19 • CAROLYN M. OLSON } NOTARY PUBLIC - MINNESOTA z ANOKA COUNTY My Commission Expires Feb.20,111 (Notary Public) xvvvvvvvvvv,. s " This petition, if found insufficient by the City Clerk, shall be returned to 8060 7' L. 69 &_17f , at Number 55(/ 4liff elegy&Vo Street. I hereby indicate my willingness to accept the office of i9 - 4.9"67- if duly elected thereto. r (Sigr#ture of Nominee) �f ' 3/0/1/9 v i ' 4Vf �� '� - � �rvu�Tuam7pNVPE,TIT�ON we, the undersigned, registered voters of the City of Fridley, hereby nominate -�6" . whose residence is 13LV0 F21DZEY 1"vif , for the office of II to be voted for at the election to be held on the 7 day of /V0 , 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. IM SXRMARD NEM s71N H&CGnAAn1r/el 919P-A1677TE , 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 genuine signatures of the persons whose names they purport to be." I wish my name to appear on the ballot exactly as follows: ,808 890P-A)&772 — (Please Pr' _ (Si ure of Nominee) Subscr i bed and sworn to before me this —day .A„AAAAAAAAMAAAAAMAMAAAAAAAA/V Aw Of ” , 19�. ? CAROLYN M. OLSON ? NOTARY PURLiC MINNESITA ANOKA COUNTY otary Public) MyCommission Expires Feb.20,1991 X V\A'Vvwvvvwvv Vvvvwvvvvv."V dvvvvv• This petition, if found insufficient by the City Clerk, shall be returned to R©g&�e-T L. '� , at Number / R/CE Cg&-&i &VD Street. I hereby indicate my willingness to accept the office of f061''C1z-1'*241V 7 /41a& E if duly elected thereto. (Si ture of Nominee) 3/0/1/9 A CITY OF FRIDLEY PUBLIC DISCLOSURE STATIIMERr BY CITY COUNCIL OR OCUNCIL CAIMMATFS NAME 104554- ' ,�. � � � DATE 7 / 7-Y 9l 70: 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 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 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 BUSIMSS FINANCIAL PERSONAL PARMERSHIP, ETC. ADDRESS INTEREST INTEREST (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.) C 3. A list of the norr-homestead real property located within the City of -, Fridley in which I had a financial interest within the preceding three (3) years: NOWHOMESSTEAD REAL PROPERTY ADDRESS (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 NAME'S PARMERSHIPS, OR OTHER BUSINESS UEE PRISES We-� (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 r!;Z� (Signature) Note: This statement must be filed annually or when there is a material change in financial interest or in position held.