Schneider, Denns - Ward 2 - Withdrew JUL-21-1998 17:10 FROM CITY OF FRIDLEY TO 7663294 P.02i02
CTTY OF FMLEY
AFFIDAVIT OF W1MRAWAL
Daze
PUBS MT To bMgNESMA STATE STATUTE 204B.12
hereby request that the
City of Fridley withdraw my name as a candidate from the ballot for
the Office ofiTv�
Candidate Name
Shaer Add=
city,state and zip
5 171
Tekphom Number
2 C � c
Subscribed and sworn before me this day ofd
ev
Notary public or other offi empowered to take and certify acknowledgements.
My commission is County,State of ta,expires an
OF 0 2C040
ZWICKY
SINN SOTA
•
HN"COUNTY TOTAL P.02
'•, � Womw E00iesian.31.2000
FORM(REVISED 1980)MILLER-DAVIS CO.,ST.PAUL,MN
AFFIDAVIT OF CANDIDATE & RECEIPT FOR FILING
TOWN OR CITY ELECTIONS
State of Minnesota No.
County of
MSS.
I, tr
(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/ �dNe�� "-Rloa `d �-
I reside in the City or Township of ✓
My post office address is__ '41 L31,1,4
Frr'J e IZ (Zip)
(Sign name as wanted on ballot)
Subs dy,Qpn this day of9
19JL
(Town), (City)Clerk Notary Public
SEAL �_ County,Minn.
- NOMINATION PETITION
We, the undersigned, registered voters of the City of Fridley,
hearby nominate LRe,il(115 Sc- _, whose residence. is
�qe' f� B(✓�� , for the office of
1
cto be voted for at
the election to be held on the �d day of f�4., , 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
< X-1 �5 5y
iDK -0 ��T L 1
c K
E
-7L )i CII
OK JX
12 C2 U(IY� CLILP
being duly sworn, deposes and says, "I am
(Nam 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:
(Please Prin /7
(Signature of Nominee)
R�
Subscribed and sworn to before-me this I d
---------
of J.9 _. '`► JOAN M.SUDNICK
� NOTARY PUBLIC.NOTA
— t tL'L. wca..�mo.Esxr.amo
(No ry Public)
This petition, if found insufficient by the City Clerk, shall be returned
e
to11141-5..
_ .� , at Number �C�� // �in ��c( Street.
I hearby indicate my willingness to accept the office of
if duly elected thereto.
'ignature of Nominee)
6/94
- NOMINATION PETITION
We, the undersigned, registered voters of the City of Fridley,
hearby nominate ar , whose residence. is
8/11j , for the office of
% ►� 1 ;��. I "' l -.rc� Z 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.
DATE NAME STREET AND ADDRESS
D K r
(Name of Circulator)f 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:
(Please Print, ,
t C7(Signature of Nominee)
Subsc ibed and sworn to before this o d
------------------
of , 19 � JOAN M.BUDMCK
s
MARY PUMC-NOMA
(Notar Publ=ic)
This petition, if found insufficient by the City Clerk, shall be returned
to L-[nol 5 -6c h at Number � j Street.
I hearby indicate my willingness to accept the office of e14c
if duly elected thereto.
(Signature of Nominee)
6/94
�43�
CITY OF FRIDLEY
PUBLIC DISCLOSURE STATEMENT BY CITY COUNCIL OR COUNCIL CANDIDATES
NAME Vrlzli�n "i- /t e rCt-°ef 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 PERSONAL
PARTNERSHIP, ETC. ADDRESS INTEREST INTEREST
/VOA,0--
(use additional paper if necessary)
2. A list of the non-homestead real property located within the City
of Fridley in which I currently have a financial interest:
NON-HOMESTEAD REAL PROPERTY ADDRESS
11109 Let-
(Use additional paper if necessary.)
3. A list of the non-homestead real property located within the City
of Fridley in which I have had a financial interest within the
proceeding three(3)years:
NON-HOMESTEAD REAL PROPERTY ADDRESS
IUv�.e-
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 ENTERPRISES
(Use additional paper if necessary. )
I do swear (or affirm) that this report a full and true statement
pursuant to Sec. 5.04 of the City Co
(Signature)
Note: This statement must be filed annually or when there is a
material change in financial interest or in position held.