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The following form was submitted via your website: Application for Boards / Committee / Commission <br />First Name: Zach <br />Last Name: Saffle <br />Address: 2995 Hubbard <br />City: Paris <br />State: TX <br />Zip: 75460 <br />Telephone <br />(903) 123-4567: (903)517-7515 <br />Areas of Interest: Building & Standards Commission <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.: As a previous member of the Building and Standards <br />Commission, I understand the importance of the work the commission does to provide a safer and more <br />attractive community. I have also served on the Paris Main Street Advisory Board as a board member and board <br />chairman. <br />Certification and Authorization <br />I 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 />committees. 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 rny 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 correct and any false information or <br />misrepresentation is sufficient grounds for disqualification. I authorize the City of Paris to verify all information <br />provided in this application. In accordance with Section 552 of the Local Government Code, I understand that <br />information provided in this application may be available to the public upon request.: Agree <br />Additional Information: <br />Form submitted on: 2124/2011 5:26:59 PM <br />Submitted from IP Address: 99.64.232.61 <br />Referrer Page: http://www.paristexas.gov/Forms.aspx <br />Form Address: http://www.paristexas.gov/forms.aspx?FID=69 <br />f1. 8 <br />