Gordon, Craig - Mayor FORM(REVISED 4980)MILLER-DAVIS CO.,ST.PAUL,MN
AFFIDAVIT OF CANDIDATE & RECEIPT FOR FILING
TOWN OR CITY ELECTIONS
State-o Minnesota N0
SS.
Countv of 1r
I, QlcOt`
(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 o ce address is
(Zip)
(Sig ame as wanted on ballot) p,
of , 19152
S
NOTARY PUBLIC•MINNESOTA
COUNTY
HNOKA COUNTY ��s71`� Notary Public
My Comm.Ev.Jan.N,,=0 ` � County,Minn.
NOMINATION PETITION
We, the undersigned, registered voters of the City of Fridley,
hearby nominate S ��d` whose residence is
for the office of
1 Cyd to be voted for at
the election to be held on the day of tkN MDQ 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
ok '7-- 2--IG <'L Z " 27!—�
�2,
0 k-7-- I- I c� t2 T-m'CIL
y
I OV
0 C? G _moi c..�. �_ �5 7�' ��:a�af�, le- scl, <'r:d 1@ss�l3?a
M►' -554M '"
J f lam= �I /di �S5/riG,. t `aGl�c1 /i*�i✓ S3Y3{
being duly sworn, deposes and says, "I am
(Name f 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 bal of exactly as follows:
GC6Q'01
lease Print)
(Sig a re of Nominee)
Subscribed and sworn to before me this .��o da
of •, , 199-O
_ 1Mq�rwliMriR�.�
(Notary blic)
This petition, if found insufficient by the City Clerk, shall be returned
toQ-�- "t'N ber Street.
I hearby indicate my willingness to accept the office of 0
if duly elected thereto.
(Signat of Nominee)
6/94
NOMINATION PETITION
We, the undersigned, registered voters of the City of Fridley,
hearby nominate �� C 0 whose residence is
for the office of
k J1
to be voted for at
the election to be held on the day of (hl r, ', 19 `O ;
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 personsto be elected. thereto.
DATE NAME STREET AND ADDRESS
I
being duly sworn, deposes and says, "I am
(Name di 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. "
1. wish my name to appear on the allot exactly as follows:
(Please Print
(Sig ure of Nominee)
SL.zbscr' d and sworn to before me this . Ao day
of , 19 �� --- --- k
ARM
-- rdawww. Mr.M
(Notar ublic)
'rhiss petitii�oln, ' f found insufficient by the City Clerk, shall be returned
r •y- JUOt�1 �S �ic"at Number Street.
I hearby indicate my willingness to accept the office of
I if duly elected thereto.
(Signatu of ominee)
6/94
- n
CITY OF FRIDLEY
PUBLIC DISC EDSURE STATEMENT BY CITY OOUNCIL OR OOUNCIL CANDIDATES
NAME �� hoc d DATE
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 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 FINANCIAL PERSCNAL
PARMERSHIP, ETC. ADDRESS INTEREST INTEREST
(Use additional paper if necessary.)
I
i
2. A list of the non-homestead real property located within the City of
Fridley in which I currently have a financial interest:
NM-HOMESTEAD REAL PROPERTY ADDRESS
(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:
NON-HOMESTEAD 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.)
NAZURE OF BUSINESS - OF ALL ODP"MIONS
NAMES PARNMSHIPS, OR aMM BUSINESS E[ MIPRISES
(Use additional paper if necessary.)
I do swear (or affirm) that this report is a full and tr a state ent
pursuant to Sec-. 5.04 of the City Cod P j
'gnature)
Note: This statement must be filed annually or when there is a material
change in financial interest or in position held.