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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 Co "."t c' 1 , (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 />is S ok+jj WCS+ TcX•?S 5{-.t-C 14K 1VtjrSi +y <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 e- FQ,brka (2 , 1996 agenda of the <br />r .? <br />governmental body, and is described as follows: +ytm S- 0v-VL a6a"-Aom; at <br />of Pte^r. S}rtafi• a4.Or*vj-•vj talc- o? iZet rcakt-of•war, -1-e So,,+lkwer?-T-eu?r <br />t) A "vt vr; ? <br />EXEUTED this day of <br />Signature <br />Printed Name LA r ? ?z' <br />r <br />SWORN TO AND SUBSCRIBED before me on the 4day/of 9. <br />A ) ? / <br />Notary Stamp: <br />JANIS 199 <br />Not Public - <br />State of Texas <br />FILED this _ Lday of , 199 <br />o N0t2tyPW o,9MaT.x6i ecretary ?sl y MyC T0ft1d e??a1%19i7 <br /> <br />Of