In accordance with Ordinance No. , this statement of financial interest shall be filed with the Board of Ethics, or the administrative official designated as the custodian of its records by the Board of Ethics, no later than 4:30 p.m. on January 31st, yearly. A newly-appointed must file this statement no later than 30 days after the date of appointment. A for office must file this statement no later than thirty (30) days after the date on which the becomes a for elected office.
1. Name:
2. Current Address
a. Business (including telephone number and email address):
b. Home (including telephone number and email address):
3. Occupation
a. Filer:
4. Please identify the primary source of income of the filer during the
calendar
.
a.
Signed Dated
(Am. Ord. O-02-14, passed 2-19-14)