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Barnette, Bob - Council at Large 'l7 FORM(REVISED 1980)MILLER-DAVIS CO.,ST.PAUL,MN AFFIDAVIT OF CANDIDATE & RECEIPT FOR FILING TOWN OR CITY ELECTIONS State of Minnesota No. _ SS. County of Ayj��/� (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 40OA/C i c, 4 r Ahft6€ I reside in the City or Township of 02-10 4&'`1 My post office address is !( R t C.6 GZEEK 61-V.0 ,2ID n/ (Zip)S"SV32. (Sign name as wanted on ballot) Subscribed and sworn to before me this / day of _ ,�� (Town), Ci ) Clerk Notary Public SEAL County,Minn. Awl ri CT[roF City of;Fridley Nomination Petition FRIDLEY We,the undersigned,registered voters of the City of Fridley,hereby nominate 5r- whose Ewhose residence is Sql R J cE Cke-g-L 8 V-D , for the office of( )Alc1C,47-4R 6 E,to be voted for at the election to be held on the 7 day of ^ro J ,2000; 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: Printed Name and patur Address i n O G�/� �O 'y'f Flo r�Li c!r S---- '7-6 -od 5Lcsa, ljqA2n 4 a, Va.. AF I 1 dL 1- (4 -00 AL 4-J0LkVV) 575 ►'1rq-aaE �T• N.t• �i2�d�� �c eqL Qo C 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 by name to appear on the ballot exactly as follows: 1308 45ARA1: 6 (Please Print Name) i This petition,if found insufficient by the City Clerk, shall be returned to'566 B/}!'ddF)ZE at SZ/l eels Fk 6 L VD ,Fridley,Minnesota. I hereby indicate my wi gness to accept the office ofCduNC-« A� ka/Z G6- if duly elected thereto. (Signature of Nominee) Subscribed and sworn to before me this day of �2000. (Notary Public) W DEBRA x SKOGEl NOTARY RD-"MOM I'Ry COMMISSION E JIRES JANUARY 31,2C05 � � riCity of Fridley Nomination Petition CIIYOF FR 01 We,the undersigned,registered voters of the City of Fridley,hereby nominate e0,3 j whose residence is $y l R I c.,-- Ck 6 L,.k"p , for the office of Coa^�uj- T /-&4j ,to be voted for at the election to be held on the '7 day of W'V ,2000; 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: Printed Name and°Si nature Address - AC)DD ,11r� 1n0 7 4), c66 T 7").rm�rlll, d( a sin (. �sY3 7-1G 40e Z01 rN er 7 j0, -},goo '�K c� T � fir` 1?0 ,0 3 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 by name to appear on the ballot exactly as follows: 8 A134RA16-7T'6 (Please Print Name) This petition,if found insufficient by the City Clerk, shall be returned to &8 4*1&V`16-7 & at S'ql /?/C6` 'CCC.,a -L V0 ,Fridley,Minnesota. I hereby indicate my willingness to accept the office of 69VAt'e4i- �9-7-L- 2� F- if duly elected thereto. , (Signature of Nominee) Subscribed and sworn to before me this day of ,2000. 2L)4D.; �aa mcswcrsa�cs�w-nrU , aW A S!(OGEN (Not ry Public) .� NOTAW MY COMMISSION EXPIRES . .. .� x JANUARY 31, Skogen, Deb From: Irene Meier[Irene.Meier@co.anoka.mn.us] Sent: Wednesday,July 12, 2000 7:57 AM To: SkogenD@ci.fridley.mn.us Subject: Registered Voters Deb, I looked up the names you sent me and found the following: Nancy Jorgenson, 5730 Polk Street NE- Reg. 12/01/82 Richard Wolfe, 960 Hathaway Lane- Reg.4/25/91 Christine Anderson, 1070 Hathaway Lane- Reg. 10/19/84 Sue Culburtson, 1358 Hillcrest Drive-Culbertson Reg. 12/02/95 Linda Wolf, 6446 Arthur Street NE- Reg. 12/01/75 Jan Harris, 470 Rice Creek Boulevard- Purged You sent me six names so I am hoping the one you did not find in February was the name that I found purged. Let me know if you have any other concerns. Thanks. Irene li 1 City of Fridley Public Disclosure Statement By City Council Members or City Council Candidates Name: z?(965/ZT Z. 3A W,,c7T&7 Date Position Title: (pyrJc1& I-t T In conformance with Section 5.04 of the Fridley 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 one 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, Address Fifiancial Interest Personal Int test' Partnership,Etc: 4 G i (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: Noxi: omestead Real Property Address WO Wr (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 years. Nbn Homest ad Ileal Property Address i✓'oW6 (use additional paper if necessary) 4. A list of 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 Wo-/VC-- (Use ✓C(Use additional paper if necessary) I do swear(or affirm)that this report is a full and true statement pursuant to Section 5.04 of the Fridley City Code. (Signature) Note: This statement must be filed annually or when there is a material change in financial interest or in position held.