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First Name: Phillip E <br />Last Name: Payiie <br />Address: 575 Laurel Lane <br />City: Paris <br />State: TX <br />Zip:75460 <br />Telephone <br />(903) 123-4567: 903-737-0531 <br />Areas of Interest: Airport Advisory Board,Economic Development Corporation,Housing Authority Board of <br />Commissioners,Planning & Zoning Commission,Public Library Advisory Board <br />Please note any special knowledge, education, or experience you have that is applicable to the function of the <br />board, commission, or committee of interest (attach additional pages if necessary). If applicable, list dates of <br />service on any City boards, commissions, or committees.: MS Electrical Engineering, Fighter Pilot USAF <br />Served in Turkey, Saudi Arabia, Korea, Japan, Viet Nam, Thailand & Guam. <br />C,ertification and Authorization <br />1 acknowledge that I am aware and agree to the prohibitions of the City of Paris Charter and the laws of the <br />State of Texas regarding nepotism and conflicts of interest of appointees to City boards, commissions, and <br />coinmittees. I also certify that if appointed I will attend at least 75 percent of all regular meetings and shall not <br />have any delinquent indebtedness to the City during my term. I understand that the number of positions on a <br />given board, commission, or committee is limited and that I may not be appointed; however, if I am not <br />appointed, I agree to be placed in a database for possible future notification of topics of interest. I certify that <br />the information given by me in this application is true and conect and any false information or <br />misrepresentation is sufficient grounds for disqualification. 1 authorize the City of Paris to verify all information <br />provided in this application. In accordance with Section 552 of the Local Government Code, 1 understand that <br />information provided in this application may be available to the public upon request.: Agree <br />Additional Information: <br />Form submitted on: 5/10/2011 8:22:25 AM <br />Submitted from IP Address: 74.195.69.45 <br />Referrer Page: http://www.paristexas.gov/Forms.aspx <br />Form Address: http://www,paristexas aov/forms asax?FlD gg <br />z <br />- ~ 109 <br />