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If you are an active, dues paying member of a political party, please indicate that party:
I hereby certify, in accordance with Fitchburg Ordinance 1.44(2)(B), that I do not hold stocks or bonds in any corporation subject to the jurisdiction of the Transportation and Transit Commission nor am I in any manner pecunialily interested in any such corporation. I also agree, that should I be appointed to the Transportation and Transit Commission, That I shall not acquire any investments in any corporation or organization that violates this section of the Ordinance during the term of my appointment. Signature:
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