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DOC ID: 2803 i
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CITY OF SAN BERNARDINO—REQUEST FOR COUNCIL ACTION
Appointment
From: Patrick J. Morris M/CC Meeting Date: 12/02/2013
Prepared by: Aviana Cerezo, (909) 384-5133
Dept: Mayor's Office Ward(s):
Subject:
Appointment of Casey Dailey to the Planning Commission-Mayor Patrick J. Morris (#2803)
Current Business Registration Certificate:
Financial Impact:
Motion: Approve the appointment of Casey Dailey to the Planning Commission as
requested by Mayor Patrick J. Morris.
Supporting Documents:
Casey Dailey (PDF)
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Updated: 11/26/2013 by Linda Sutherland Packet Pg. 13
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CITY OF SAN BERNARDINO APPI 'W-1LiT'f CLEI*
- FOR APPOINTMENT TO BOARDS, COMMISSIONS AND COMMITTEES
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RM NOV 25 P12: 3 r
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List, in order of preference,the committee(s) on which you wish to serve.
1) e- � 3)
2) 4)
Name: ���'e 9�/C Date of Birth:
Home Address: Ci
ty: �Z Zip: Tz-y/t7
Horne Phone: Fax: ( ) E-Mail: C,4zA,2,t y3
Employer: �iq/U//�,,,Q Occupation: stf �.�.a/ y r7
Address: " City: Zip: y1a
Years lived/worked in San Bernardino: Work Phone:
Educational background/degrees: S A.
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I am []—am not❑a registered voter. Ward: �_ Marital Status:
Licenses or special certificates:
Previous City of San Bernardino Commissions/Committees: From/To:
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Organizations to which you belong(professional,technical,community):
The information provided is factual to the best of my knowledge. I understand that I may be required to
complete a Statement of Economic Interests Form as required by law, and that I will abide by all the codes,
ordina sand regulations of the City of San Bernardino and the State of California.
gnature Date
Note: Applications will be kept on file for a period of one(1) year.
Return to: Gigi Hanna, City Clerk,300 N. "D" Street,San Bernardino,CA 92418-0001
03/22/2012—Prepared by the City Clerk's Office