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CITY OF SAN MARCOS <br />DISCLOSURE AFFIDAVIT -BUSINESS ENTITY <br />STATE OF TEXAS <br />COUNTY OF HAYS <br />The undersigned member of the City of San Marcos (name of City Board, <br />Commission, etc.) states under oath as follows: <br />I have a substantial interest in a business entity that may be involved in a vote or decision of the governmental body <br />described above, and the vote or decision may have a special economic effect on the business entity that is <br />distin uishable from <br />9 <br />the effect on the public. The name of the business entity is <br />ILL <br />The nature and extent of my interest in the business entity is as follows: (check all that apply) <br />Ownership of 10 percent or more of the voting stock or shares 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 to a person related to me in the first degree by consanguinity (natural <br />kinship) or affinity (marriage). Relative's name and relation: <br />I am abstaining only to avoid the appearance of impropriety. <br />The vote or decision involving th' interest is on the �a l �{ (date) agenda of the governmental body, <br />and is described as follows: S : [� , <br />EXECUTED on 13 I <br />Signat <br />Printed Name �®A',,1 el-mQ ( d(CS <br />SWORN TO AND SUBSCRIBED before me of <br />®Bik461VAPB <br />Notary JAWE LEE PET19JOHN <br />m Notary PUbk, State o6 sexes <br />;n�l,'F March 04, 2018 <br />COSM Form 11/10 <br />