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Updated: 06/25/20 FINANCIAL INTEREST DISCLOSURE FORM GUIDELINES City ordinance requires that all individuals with a material interest in a decision of the City Council must be disclosed. The following is for your assistance in completing the attached disclosure form: 1. For all of the below, corporate names/LLC’s/limited partnerships are not acceptable in and of themselves, all individuals with an interest of $2000 or more must be disclosed in these cases. 2. Individuals with a material interest include all property owners. 3. Individuals with a material interest include any developer. 4. Individuals with a material interest include any architect, engineer, or other design professional. 5. Individuals with a material interest include the applicant’s attorney or other representative. 6. Individuals with a material interest include any real estate agent who is party to the transaction. 7. Individuals with a material interest include any contractor constructing the project for which the contract has been arranged by the time of the hearing. The above is for guidance only and not an inclusive list of all individuals at interest. You have a responsibility to determine and list all individuals in accordance with the Tests of Materiality as set forth on the attached. ---PAGE BREAK--- Updated: 06/25/20 FINANCIAL INTEREST DISCLOSURE FORM All persons included within the meaning of either of the following tests have a material financial interest in an agreement, or application for development rights, submitted for approval or disapproval by the City Council, and shall be identified by the applicant, by name. Tests of Materiality: 1. Whether it is foreseeable to a reasonable person that the value of their interest in property available for use by an applicant, or their interest in the applicant itself, may increase or decrease by an amount greater than $2,000.00 as a direct or indirect result of Council action on the applicant’s agreement or application for development rights. 2. Whether it is foreseeable to a reasonable person that the person’s gross income from the applicant may increase or decrease by a sum greater than $2,000.00 as a direct or indirect result of Council action on the agreement or application for development rights. It is the legal obligation of all applicants for approval of an agreement or of an application for development rights to verify in writing, under penalty of perjury, that the identity of each person having a material financial interest in the agreement or application or development rights is true, correct and complete. The applicant understands that this information is provided under penalty of perjury, and that intentionally supplying misinformation or deception may result in either invalidation of the agreement or application, or criminal prosecution for misdemeanor violation of the Modesto Municipal Code, or both. Negligent provision of misinformation shall be grounds for invalidation. In accordance with the Modesto Municipal Code, each applicant has a continuing obligation to maintain the truth, accuracy and completeness of the financial interest disclosure information provided below until after final consideration by the City Council of any matter arising out of or relating to the agreement or application. PROJECT: APPLICANT SIGNATURE APPLICANT NAME (type or print) In accordance with the requirements of Title II of the Americans with Disabilities Act (“ADA”) of 1990, the Fair Employment & Housing Act (“FEHA”), the Rehabilitation Act of 1973 (as amended), Government Code section 11135 and other applicable codes, the City of Modesto (“City”) will not discriminate against individuals on the basis of disability in the City’s services, programs, or activities. For more information, please visit the City of Modesto website: SIGN ---PAGE BREAK--- Updated: 06/25/20 NAMES Property Owner(s) – (Please list name of company and names of individual names of said company) Developer(s) – (Please list name of company and names of individual owner(s) of company) Architect(s), Engineer(s) or Other Design Professional(s) – (Please list name of company and names of individual owner(s) of company) Attorney(s) or Representative(s) – (Please list name of company and names of individual owner(s) of company) Real Estate Agent(s) – (Please list name of company and names of individual owner(s) of company) Contractor(s) Other – (Investors, Trustees, etc.)