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Nee, William - Mayor FORM 11(REVISED 1980)MILLER-bAVIS CO.,MINNEAPOLIS AFFIDAVIT OF CANDIDATE & RECEIPT FOR FILING TOWN OR CITY ELECTIONS StateDf Mi esota ff No 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 I reside in the city or township of ` My post office address is: Sigrk ame as wanted on ballot) Subscribed and sworn to before me this day of , 19 (To n), ( y) Cler Nota Public SEAL --1� County, Minn. r Affidavit of Candidate Filed in the office of the ------------------------------------------------------ of-------------------------- County -----------------------------------------------------of-------------------------- Countyof------------------------------------------ I I Minnesota, this----------------------------:day of ---- - -------------------------.A. D. 19------ ----------------------------------------------------- ------------------------------------------------------------------ MILLER-DAVIS CO., MINNEAPOLIS s� Nota uioN PLTITION We, the undersigned, registered voters of the City of Fridley, hereby nominate < < N e- e. , whose residence is �. 1 LO $a n Pa-rk UJM , for the office of r IJ le y to be voted for at o the election to be held on the rj. day of vPy+16 e-y 199�L ; and we individually certify that we are registered voters and that we have not signed more nomination petitions of candidates for this office than there are persons to be elected thereto. FFr ANS N. r 573L;' S G 78 3 Gtr (V 7 SSy3� icz" Willi .�. being duly sworn, poses and says, • cT l" ee (Ikbe of Circulator am the circulator of the foregoing petition paper containing signatures, and that the signatures appended thereto were made in my presence and"are the genuine signatures of the persons whose names they purport I wish my name to appear on the ballot exactly as follows: Nee (Please Print) W , (Signature of ) Subsgxibed and sworn to before me this /T—day of CLYDE V.MORAVETZ , 19 _. �•� Nor wo�wANOVACOUNTY 4►&■►K to tory Public) This petition, if found insufficient by the City Clerk, shall be returned to Wm, J, [tel ec , at Number ),14 !o$ Pa I k W44 Street. I hereby indicate my willingness to accept the office of a- I9_ if duly elected thereto. (Signatupt of Nominee) 3/0/1/9 ;j. i i TNATTON PETITION we, the undersigned,, registered v'o'ters of the City of Fridley, hereby nominate wj j j j awe. J. Nee , whose residence is ;0 q LaBar Park wad, N� . FY, ��y , M , for the office of Y C a F r to be voted for at the election to be held on the 3y 1 day of Nay e w j* , 19 12—; 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. 9'M AND RRIM W1 l h im l Nee , 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: C,tJ�I (Please Print) _ (Signature Nominee) Subscr�'be�,and sworn to before me is day of _=10 L y , 19 ,r-�, CLYDE V.MORAVETZ � ANOKA� 1hOuwal�ia�►t� tary Public) This petition, if found insufficien by the City Clerk, shall be returned to UJ-m, J , Nee , at Number }f g �o�a� I�a�k lAfay street. I hereby indicate my willingness to accept the office of if duly elected thereto. w � (Signatur f Nominee) 3/0/1/9 Y ' \ CITY OF FRIDLEY PUBLIC DISCLCSURE STATEMENT BY CITY COUNCIL OR CIOUNCIL CANDIDATES NAr� I�tJ�� ate, tTN e e HATE U l - 117-2-- 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 5 , 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 FINANC M PERSCM PARTNE1:0HIPF EPC. ADDRESS INTEREST II�PEREST Pe JerSbr j4py=og -i-Nee aj°I Lp6av% Park Way awhev OFGCe✓ (Use additional paper if necessary.) 2. A list of the norrrhomestead real property located within the City of Fridley in which I currently have a financial interest: N04-HaMESTEAD REAL PROPERTY ADDS �Jv y) e (Use additional paper if necessary.) 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: mm-mnMR9TEW 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.) MATURE OF BUSINESS - OF ALL CORPORATIONS NAN1S PA NERSHIPS, OR OMM BUSINESS IIdMURISES (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.W (Si ture) Note: This statement must be filed annually or when there is a material change in financial interest or in position held.