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<br />EXHIBIT "A" TO ETHICS POLICY <br />OF THE CITY OF FALCON HEIGHTS, MN. <br />STATE OF MINNESOTA <br />COUNTY OF RAMSEY <br />The undersigned, as a public official of the City of Falcon Heights, Minnesota, being first <br />duly sworn upon oath, deposes and states: <br />1. That the following constitutes the address and/or legal description of each parcel <br />of real estate, situated in the City of Falcon Heights, Ramsey County, Minnesota (other than real <br />estate occupied by the undersigned as a personal. residence), in which the undersigned, directly <br />or indirectly, holds any Financial or. Personal Interest including the right to occupy said <br />property: <br />2. That the following constitutes the names of all businesses, corporations, <br />companies firms, partnerships, or other business enterprises, doing business with or in the City of <br />Falcon Heights, in which the undersigned is connected, as an employee, owner, director, officer, <br />• adviser or consultant, or in which the undersigned has a Direct Financial or Personal Interest. <br />3. That the undersigned has. read and is familiar with the provisions of the Ethics <br />Policy approved. by the Council of the City of Falcon Heights on <br />Subscribed and sworn to <br />before me this day of <br />20 <br />Notary Public <br />• <br />~9 <br />