Carda, Leo F - Ward 3 FORM 11(REVISED.Y80)MI!LER-DAVIS CO.,MINNEAPOLIS �, `
Jt
w
AFFIDAVIT OF CANDIDATE & RECEIPT FOR FILING
Statof M* nesota TOWN OR CITY ELECTIONS
sf 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: `Y'V,3
/Lc (zip)
Subscribed and sworn to before me this C� (Sign na a as wanted on ballot)
AMMMMA day of , 19
IWIRLEY A. HAAPAALA
M9WY PUBLIC-MINNESOTA (T (City) lerk— otary Public
SEAL ARMA COUNTY County, Minn.
�wr�.NNi
NOMINATION PETITION � y
We, the undersigned, electors of the City of Fridley, hereby nominate
hose residence is
for the office of _ L to be voted for at the
election to be held on the day of 19(�'41, and we
individually certify that we are qualified electors and that we have not signed more
nomination petitions of candidates for this office than there are persons to be
elected thereto.
Name Street and Number
� hlou�) µ
1.
V
. .3
(k Q c 1 41, 1!:
1' r.
`s
) r
2a -- , being duly sworn, deposes and says that s/he
Name of Nominee
is the circulator of the foregoing petition paper containing signatures, and that
the signatures appended thereto were made in his/her presence and are the genuiene
signatures o� the persons whose names they purport to be.
I wish my name to appear on the ballot exactly as follows:
"J'W e a r 0 /f- J. A
SHIRLEY A. HAAPALA (Please Print
NOTARY PUBLIC-MINNESOTA
ANOKA COUNTY
Mycommistion ExpiresMV233*6
vv"vvvvvvvvvvvvvvvvvvvvvvvvvtowwv 0
Signature of Nominee
Subsc 'ted and s orn to bef= me this 4day
of 19
ju",
kNotary Pub ic,
his
` —pet'tio if found insufficient by the City Clerk, sball be r urned to
�!- at Number Street.
I ereby indicate my illingness to accept the office of
1 if duly elected thereto.,
Signature of Nominee)
CC1280
• - NOMINATION PETITION `
We, the undersigned, electors of the City of Fridley, hereby nominate
whpse residence is o�- ti►-�'2
for the office of - 7 to be voted for at the
election to be held on the _� day of 19-3:V1 and we
individually certify that we are qualified electors and that we have not signed more
nomination petitions of candidates for this office than there are persons to be
elected thereto.
Name Street and Number
PA j A
V�
elk
se-
�-
U
kvwhV J 1
--�—V , being duly sworn, deposes and says that s/he
Name of Nominee
is the circulator of the foregoing petition paper containing signatures, and that
the signatures appended thereto were made in his/hers s€rice an "are a ¢e►�u
signatures of the persons whose names they purport to be.
I wish my name to appear on the ballot exactly as follows:
C fC /I �� � '�'A (4 E
Please Print
Signature of Nominee
Subs c ibed and sworn to before e this day
of 19
SHIRLEY A. HAAPALA
NOTARY PUBLIC-MINNESOTA
ANOKA COUNTY
bl'iC MyCOmmiWonExpires Msy28,
Notary 1!!i
This petition, if found n ufficient by the City Clerk, shall be rnt®urned to
at NumberG Street.
1 hereby indica / willingness to accept the office of
if duly elected thereto.
ted '
Signature of Nominee)
CC1280
CI1•Y Of FRIDLEY
• PUBLIC MSCLOSURE STATEMENT BY CITY COUNCIL OR C0134CII_ CANDIDATES
DATE
TO: CITY CLERK
In conforvi3nce witm Section 30 of the City Code, I hereby make the following
declarai:io;is regar0;nq my financial and personal interests:
I. Marmes of all business corporations, partnerships, other business enterprises,
or governm,�M:al agencies doing business with the City of Fridley or located
within the City of Fridley:
a. b;;th v;hich I have a financial interest.
(AS used in Chapter 30, the term financial interest shall be deemed
t(% include o:-rnership of more than 10' of: The Outstanding stock in
a cc-purat-ion, an interest in a partncrsh p, proprietorship, or
other business entity, or an interest in real property. Financial
interest shall apply to real or personal properties owned by the
person malting the disclosure and by said person's spouse. )
b. With which I have a personal interest.
(As used in Chapter 30, the tern personal interest shall be deemed
to app] ,, 1-.,hen:?v r a person reauireu to Hake a disclos4re under this
code of ethics shall be associated with a business as an eliiployee,
officer, director, trustee, partner, advisor on consultant. )
higi�G (�F^_G�.J 1ti S-S, — - — FIfII�NCIr1L �I,rf:�OfV"l_
PARTNERSHIPS,—ETC. ACCRESS 114TEREST INTEREST
(Use additional paler if' necessary. )
-2-
2. Jl list of" the non-homestead real property located within the City of Fridley
t in which I currently havea financial interest:
NON-1110;R_ ND REAL PROPERTY
ADDRESS
(Use additional paper if necessary. )
-3-
; r
3. A list of the non-homesteacf real property
locai:ed a:ithin the city of Fridley
in %•jili.ch I had. a Financial interest within the preceding three years.
NOP!-f;Of4ES LAD REFI PZOPEftTI'
ADDRESS
f I
(Use additional paper if necessary. )
-3-
4. A list of the names, and nature of business, of all corporations,
parthp"rships, 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
NAMIES PARTNERSHIPS, OR OTHER BUSINESC.S ENTERPRISES
(Use additional paper if necessary . )
I do swear (or affirm) that this report
is a full and true statement pursuant
to Section 30 of the City Code. Signature
Note: This statement must be filed annually or when there is a material change
in financial interest, or in position held.
-4-