HomeMy WebLinkAbout14- Gift Disclosure Form - C. Taylor - Park County Community Foundation Trip and Tour BOzc
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Submit by Email Print Form
City of Bozeman
P.O.Box 1230/121 North Rouse Avenue
Bozeman,Montana
agenda@bozeman.net
59771
Phone:406-582-2320
-582-2344
Gift Disclosure Form ww.b zeman.ne
www.bozeman.net
Date: v 1-1 a-�}
Name: Ga.r•S o Y. T 4V—
Department: (A I (^ yi-,M\Sg?
Phone#: U ,— 6 d P 171 ;'�O ,�
Email address: �� �D n �" ►koL' ' , rA
Who gave the item? Pa f I♦/c J�� �%(�YYt l lJr\(t C, F,)J'o)+�)
For what purpose? !^ R>J v�1��`'` S P.� .��' b� Y�C ►�f'fe, SN (/(Av, )
Describe the Item: L P-O'V\jAf
What is the Items Estimated Value? 2 t! �� rf, eA
Have you reviewed the Gift Provision on page 10 of the City of Bozeman Ethics
Handbook to verify this is an item you can receive? Drop-down List
Comments: 0 j 1 6D 4 � Cw L ,,mil
By submitting this form,you are confirming that the information contained herein is correct and true to the best of your
knowledge. A digital signature can be created through the'submit by e-mail'button.If you prefer,you can also print,sign
and mail or deliver to the clerk's office. Thank you! r
Signature:-If you have questions about the gift provision please call or e-mail the City Attorney at(406)582-2309.