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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: 1 W Cl. �`Ikk (r`4a —3640wV
Name: AA
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Who gave the item? 'U P. �1 V�•�GC� b`�is
For what purpose?
Describe the Item:
What is the Items Estimated Value?
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:
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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'sub 't by il' on.If you prefer,you can also print,sign
and mail or deliver to the clerk's office. Thank you!
Signature:
If you have questions about the gift provision please call or e-mail the City Attorney at(406)582-2309.