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Home My WebLink AboutFinancial Disclosure Statements-Financial Disclosure Statements-06/01/2021RECEIVED nisi oierinaa:a mar{ kiiCinBSS Conflict of Interest Forms silty ul coiteyvii e i iiiaiida ✓�+... v..v... ..�. �� julli O INTERESTS IN REAL PROPERTY Section 1 Describe the location, size, and current use of all property owned within the included held in trust by the filer, spouse, and any dependent minor children, or any map, or business entity in which the person has a financial interest. When reporting information about a dependent child's activity, indicate the child about by the number under which the child is listed on the whom you are reporting providing Information Statement. HELD OR ACQUIRED BY LJFILER L SPOUSE DEPENDENT CHILD #_ DESCRIPTION �ON1 �i Lot City VO 1 County Block �j 1 C l Subdivision !A iWtP ! vS T Ad Valorum Tax Account Number Acre(s) and Tract s STREET ADDRESS STREET ADDRESS, INCLUDING CITY, COUNTY, AND STATE ° NAME LIST THE NAMES AND ADDRESSES OF OTHER PERSONS OR BUSINESS ENTITIES WHICH OWN AN INTEREST IN THE REAL PROPERTY ❑ INDIVIDUAL Q BUSINESS HELD OR ACQUIRED BY FILER F71 SPOUSE DEPENDENT CHILD #_ DESCRIPTION k city �r�: "� Lot c�,.,,.�c:al nn �i1ik5 Block t'C County Subdivision Ad Valorum Tax Account Number Acre(s) and Tract , 4 a STREET ADDRESS STREET ADDRESS,t INCLUDING CITY, COUNTY, AND STATE 2CAob -i: 1V Si d� ° NAME LIST THE NAMES AND ADDRESSES OF OTHER PERSONS OR BUSINESS ENTITIES WHICH OWN AN INTEREST IN THE REAL PROPERTY Q IJyDIVIDUAL BUSINESS COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY ❑ NOT APPLICABLE INITIAL HERE 1021 DATE: alrt City of Colleyville Financial Disclosure and Business Conflict of Interest Forms INTERESTS IN REAL PROPERTY Section 1 Describe the location, size and current use of all property owned within the included map, or held in trust by the filer, spouse, and any dependent minor children, or any business entity in which the person has a financial interest. yy ld When reporting information about viing the numberhunderctivitwhich, the lch Id is list cate the id nbthe out whom you are reporting by p Information Statement. OR BUSINESS FILER Lot CHILD # city � �- county Ad Valorum Tax Account Number re(s) and Tract __ i!� t f STREET ADDRESS, INCLUDING CITY, COUNTY, AND STATE L1a, -- BUSINESS ENTITIES WHICH OWN AN INTEREST IN THE REAL PROPERTY - By rjFILER nSPOUSE nDEPENDENTCHILD #_ IESCRIPTIONTBlock,'-4- 0:ur I j � 1 City �1� r &MW,e,r GilCounty/Ad Valorum Tax Account Number Acre(s) and Tract :roecr AnnRESS STREET ADDRESS, INCLUDING CITY, COUNTY, AND STATE NAME INDIVIDUAL BUSINESS d� f Oa W LIST THE NAMES AND ADDRESSES OF OTHER PERSONS OR BUSINESS ENTITIES WHICH OWN AN INTEREST IN THE REAL PROPERTY NOT APPLICABLE .CABLE INITIAL HEREs DATE:�� ❑ City of Colleyville Financial Disclosure and Business Conflict of Interest Forms INTERESTS IN REAL PROPERTY Section 1 Describe the location, size, and current use of all property owned Within the included map, or held in trust by the filer, spouse, and any dependent minor children, or any business entity in which the person has a financial interest. When reporting information about a dependent child's activity, indicate the child about whom you are reporting by providing the number under which the child is listed on the Information Statement. OR Lot FILER - 7 city, hp_rd d County�"LA— Tax Account Number re(s) and Tract / STREET ADDRESS, INCLUDING CITY, COUNTY, AND STATE NAME BUSINESS ENTITIES WHICH OWN AN INTEREST IN THE REAL PROPERTY �� Swo(•-Eiev+ ❑ INDIVIDUAL E2 BUSINESS uFi n OR ACOUIRED BY nFILER LS USE r] DEPENDENT CHILD #_ County Ad Valorum Tax Account Number STREET ADDRESS, INCLUDING CITY, COUNTY, AND STATE NAME LIST THE NAMES AND ADDRESSES OF OTHER PERSONS OR BUSINESS ENTITIES WHICH OWN AN INTEREST IN THE REAL PROPERTY ❑ INDIVIDUAL ❑ BUSINESS COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY ❑ NOT APPLICABLE INITIAL HERE: DATE:QAlhi ,:... -e �-a—... we Fin ,W nicrInairP and Business Conflict of Interest Forms FEE, SALARY, OR GIFT Section 2 The name and address of any person or corporation which currently has or during the preceding twelve (12) months has had a direct or indirect contractual relationship with the City and from which the person(s), their spouse, or dependent minor children have received a fee, salary, or gift of value exceeding one hundred dollars ($100.00). When reporting information about a dependent child's activity, indicate the child by the number under which the child is about whom you are reporting providing listed on the Information Statement. 1 RECIPIENT = FILER =SPOUSE =DEPENDENT CHILD #_ 2FEE, SALAR , GIFT NAME AND ADDRESS DESCRIPTION OF FEE, SALARY, GIFT 1 RECIPIENT =FILER =SPOUSE =DEPENDENT CHILD #_ 2 FEE, SALARY, GIFT NAME AND ADDRESS DESCRIPTION OF FEE, SALARY, GIFT 'RECIPIENT =FILER =SPOUSE =DEPENDENT CHILD #_ 2 FEE, SALARY, GIFT NAME AND ADDRESS DESCRIPTION OF FEE, SALARY, GIFT COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY dNOT APPLICABLE INITIAL HERE: DATE: (7l9/fJUL� rity of Collevville Financial Disclosure and Business Conflict of Interest Forms BUSINESS INTERESTS Section 3 The name and address of any corporation or business, which currently has or in the preceding twelve (12) months has had a direct or indirect contractual relationship with the City, of which person(s), their spouse, or any dependent minor children own more than two percent (2%) of the outstanding equity interest or more than two percent (2%) of the assets. When reporting information about a dependent child's activity, indicate the child about whom you are reporting by providing the number under which the child is listed on the Information Statement. 1 HELD OR ACQUIRED BY =FILER =SPOUSE =DEPENDENT CHILD #_ Z DESCRIPTION NAME AND ADDRESS AL - 3 NATURE OF BUSINESS 1 HELD OR ACQUIRED BY =FILER =SPOUSE =DEPENDENT CHILD #_ Z DESCRIPTION NAME AND ADDRESS 3 NATURE OF BUSINESS 'HELD OR ACQUIRED BY =FILER =SPOUSE =DEPENDENT CHILD #_ Z DESCRIPTION NAME AND ADDRESS 'NATURE OF BUSINESS COPY AND ATTACH ADDITIONAL PAGES AS NECESSARY NOT APPLICABLE INITIAL HERE. DATE: City of Colleyville Financial Disclosure and Business Conflict of Interest Forms PERSONAL FINANCIAL STATEMENT AFFIDAVIT Financial Disclosure and Business Conflict of Interest Forms shall be provided by candidates for Mayor and City Council and by applicants seeking appointments to the Planning and Zoning Commission or the Zoning Board of Adjustment, and shall file such forms within two (2) business days following the end of the candidate filing period, or if for appointment, within (2)business day following the end of the application period stated in the official City advertisement for application for the position. The city manager and the city manager's senior staff members (including any staff member who is appointed with City Council approval) shall also file the same within thirty (30) days of hiring. All person(s), as outlined above, shall have a duty to file supplemental disclosures annually and within five (5) business days of an occurrence of any change in the information reflected in the forms previously filed by the individual. Before me, the undersigned authority, personally appeared: `oI • _ oa d who, after being duly sworn upon their oath and deposed and stated as follows "My name is s "Z `4a and I hereby submit for filing the attached Financial Disclosure and Business Conflict of Interest forms. I have personal knowledge of all information contained in said forms and all information contained in the forms is true and correct." "Further, all information contained in the forms is complete. There is no information that has been withheld or not d' osed which is responsive to or required to be disclosed by the forms. 0 / -7y/ to and subscribed before me, this the Y o, W l"4 TAMI M UNDAMOOD :®r Notary ID #3762850 » My commission Expires +rfortt+ May 13, 2022 nt day of S V1✓=__. , 20 e Notary Public, State of Texas INITIAL HERE: DATE: Financial Disclosure and Business Conflict of Interest Disclosure Area Map WE The map includes Tarrant, Denton, and Dallas Counties.