Kansas Statutes Chapter 46. Legislature § 46-249. Same; content of statement

___________________________________________________________________________________________________

(name)

(office or position of employment for which this statement is filed)

___________________________________________________________________________________________________

(address)

(body of statement in form prescribed by commission)

    “I declare that this statement of substantial interests (including any accompanying schedules and statements) has been examined by me and to the best of my knowledge and belief is a true, correct and complete statement of all of my substantial interests and other matters required by law. I understand that intentional failure to file this statement as required by law or intentionally filing a false statement is a class B misdemeanor.”

______________________

_____________________________________________________________________________

(date of filing)

(signature of person making the statement)