WPC\  ie믐뚐2R;$9 q Eq:$IO&~"LKct`; LAcbƭweg7jG7.Qހ2m2Lghu0DCҡ6"re\B0McѥhOS7NVzn&Vе/2͔}|!).O.w++D_Uo"B‚ _^t0maCN 5 :bsj^e(@픡Hxa3fQ%kC,Q$O(t38s-ںce]x, MR*L>euy{ClX!)dqw*vp~3v <晢ΨD{~=1٧$Vi:XVo=LKk<"wwNʑ#Ӳđ*kD#UN % 0Dw 4 1 f@ aB UHV  UH  N m ^ B" B*2 2 2 D3\ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \  D3U B* B DK BB HP LaserJet 4100 Series PCL,,,,0(hH  Z 6Times New Roman RegularX(/`$8M43|xTABLE A*hH  0Times New Roman Bold*hH  0Times New Roman BoldUu4  d&0 d d'dxdi, ii, iii,Level 1Level 2Level 3Level 4Level 5>>>>'dxd&p d Pd  dCCCC?Thin/Thick 2dxd>Thin/Thick 2[ -d d /`!8  _88   XZXXXUNIVERSITYOFNORTHDAKOTA 8 NOTIFICATIONOFBUSINESSINTEREST $ cIncompliancewiththeUniversityConflictofInterestPolicy,Idiscloseandsubmitthe  followingconcerningmybusinessinterests.  * ddd Xdd Xdd X(#(#,xdd +  '   '  BusinessIdentification 9&!$   9BusinessName:<<"__________________________________________________ 0 l 0StreetAddress:0  <<" " "__________________________________________________ 0$   0POBox<<"__________________________________________________ 0l  0CityStateZip<<"__________________________________________________ 0$  0TelephoneandFax<<"__________________________________________________ 0l  0TaxpayerID#<<"__________________________________________________ 9A&$   9 TypeofBusinessEntity(checkone) 9A&!l"A 9Corporation:#X(XX XZo# XZXXX(#X(XX XZ# XZXXX(ԀPartnership:SoleProprietorship: $ Other:describe:_________________________________________________ 9A&A 9 DescribeBusinessProductorService:  X ̀ B/!,"A  B NatureofBusinessInterest(completethosethatapply): #X(XX XZ# XZXXX( B/!t"  B  PersonalOwnership:_____________________"#X(XX XZ# # XZXXX(ԀPercentage:#X(XX XZ # XZXXX(________________________#X(XX XZ{ #Ԉ B/!,  B  RelatedtoOwner: XZXXX(_____________________#X(XX XZ9 #$"Relationship:________________________ B/!!t B  Employment: XZXXX(_____________________#X(XX XZ. # "Position: XZXXX(________________________#X(XX XZ # XZXXX(Ԉ B/!,# B  Other:#X(XX XZ # XZXXX(_____________________#X(XX XZ # XZXXX(""Describe:#X(XX XZ# XZXXX(________________________#X(XX XZl# XZXXX(Ԉ1'%$t    1______________________________    Returnto: &|" PrintName `     h      p UNDDirectorofPurchasing 'h# #X(XX XZ# XZXXX(______________________________     p Stop_8381_ (T$ DepartmentTelephone#     p GrandForks,ND582028381 x)@% ______________________________ d*,&  Signature `    Date P+'! TheDirectorofPurchasingwillforwardacopyofthisnotificationtotheexecutiveheadof (-(# theemployeesdepartment.#X(XX XZ#$!$!B(# tXX((21400)#X(X tx#