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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 Ct ?? Gcwnc.?-!' , (name <br />of City Board, 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 <br />governmental body described above, and the vote or decision may have a special economic effect on <br />the business entity that is distinguishable from the effect on the public. The name of the business entity <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 $5,000 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 <br />the previous year. <br />The interest described above belongs to a person related to me in the first degree by <br />consanguinity (natural kinship) or affinity (marriage). Relative's name and relation: <br />The vote or decision involving this interest is on +'L- • I 1Y, MI-7 agenda of the governmental <br />body, and is described as follows: T,4-et., 10.13 • -9; ?s-oV1:v>? <br />EXECUTED this day of 43 h / x,,199'7 <br />Signature <br /> <br />i <br />Printed Name - <br />before me on the Wdavy f V , 199 <br />rO? Mir vye` f? <br />JANIS K. WOMACK ? <br />t p6tary Public, State of Texas <br />OF T ' My COmmisslon Expires Aug.13,1997 Not public <br />State of Texas <br />FILED this day of , 199 <br />-LA <br />City ecretary