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CITY OF SAN MAPCO5 <br />DISCLOSURE AFFIDAVIT-BU5INE55 ENTITY <br />STATE OF TEXAS <br />COUNTY OFHAYS <br />The undersigned member ofthe City of Son Marcos (name nfCity Board, <br />Commission, etc.) states under oath as follows: <br />I have substantial infaroof in o business entity that may be involved in o vote or decision of the governmental bn6v <br />described above, and the vote or decision may have u special economic effect the business h <br />distinguishable frorn the affmcf on the pub Uc. The name nf the business entity is - <br />The nature and extent of my infarayf in the business anfifv is as follows: (check all that oppk'\ <br />Ownership of 10porcanf or more of the voting stock orshares of the business entity, <br />Ownership of 10 percent or more of the fair market value of the business entity. <br />Ownership of $15,000 or more of the fair market value of the business entity. <br />Funds received by me from the business entity exceed 10 percent of my gross income for the previous year, <br />The interest described above belongs fooperson related to nna in the first degree 6vconsanguinity (natural <br />kinship) nraffinity (marriage). Po|ufiva'y name and relation; <br />Iomabstaining only foavoid the appearance ofimpropriety. <br />The vote or decision involving thi interestisonthe �11_1)14 — (date) agenda of the governmental body, <br />and is described as follows: <br />EXECUTED on (date). <br />Signature <br />SWORN TO AND SUB5CPIBE[) before me on <br />JAM|E LEE PETT/JOHN <br />wo/a/vpumic' Sm/en/ rewo <br />mvCommission E^p/mo <br />MorohO4. 2018 <br />Printed Name <br />L~�/ <br />/J <br />~ `City �_, tee City ^��_ <br />COSK8Form 11/1U <br />