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STATEMENT OF <br />ELECTED/APPOINTED OFFICER <br />I, Jay Martin, do solemnly swear (or affirm) that I have not directly or indirectly paid, <br />offered, promised to pay, contributed, or promised to contribute any money or thing of <br />value, or promised any public office or employment for the giving or withholding of a <br />vote at the election at which I was elected or as a reward to secure my appointment or <br />confirmation, whichever the case may be, so help me, God. <br />UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING <br />STATEMENT AND THAT THE FACTS STATED THEREIN ARE TRUE' <br />May 12, 2025 <br />Date Signature c fficer <br />Counciloerson District 5 <br />Position to Which Elected/Appointed <br />Form No. 2201 <br />