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HomeMy WebLinkAbout16- Gift Disclosure Form - C. Taylor - KISS Concert Tickets oFBO?.�. rj' tl�,.•��C 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: -)� �;)Z)lb Name: Department: C, C Phone#: Email address: CvT n Loa Q �o 2em� f A / Who gave the item? a P�J For what purpose? f ( SfWAi Describe the Item: l l C ��-�� —� k What is the Items Estimated Value? � �� � „ I 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: :�TJ �l,,,�7��� c ►fiy'r S ���rX��� (J��a,,,J -� s!�� rp�'�c F ks l I'R-,s a-4 -mac �r c y �Q bA`Ar/)' Ct �'✓✓ w�wj - �s s va�s � Ger7� By submitting this form,you are confirming that the informakiAn 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! Signature: If you have questions about the gift provision please call or e-mail the City Attorney at(406)582-2309.