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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 C;J:Rzj Ccw,--Lc? (name <br />of City Board, Commission, etc.) states under oath as follows: <br />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 />is f3?t..) vt i ern- T-Cw; s,c . <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 <br />body, and is described as follows: .Lfic N-, 13 , <br />EXECUTED this ?+-I q day of <br />6Q,r 199 <br />Signature <br />agenda of the governmental <br />Printed Name r--re-d G Ke w, <br />SWORN TO AND SUBSCRIBED before me on the day of-?? <br />Notary Stamp: <br />Notary public <br />State of Texas <br />R <br />t. <br />FILED this day of? <br />Cit?-Secretary