APPENDIX A: FORMS

OFFICIAL FORM 1

   FINANCIAL DISCLOSURE FORM

   CALENDAR YEAR           

Elected Official or Candidate:                                                                          

Address:                                                                          

Name of Spouse:                                       

Names of Dependent Minor Children:

Principal Employer or Employment:                                                                             

   Description of Financial      Principal Type of Economic Activity

   Interest over $10,000

   €   Stocks                                                                                   

   €   Bonds                                                                                   

   €   Realty                                                                                   

   €   Proprietorship                                                                                

   €   Partnership                                                                                

   €   Other                                                                                   

List of Offices or Directorship held by Official or Candidate: (Entities may be identified by the principal type of economic activities in which it engages)

   Office or Directorship         Principal Type Business or Economic

                  Activity in which Engaged

I certify that the above financial disclosure form is true and accurate to the best of my belief and knowledge. I understand this form is a public record.

   Dated:                                                , 20                    

(Ord. passed 11-15-1994, Official Form 1)

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