08.01.2017 Regular Meeting - Laserfiche WebLink

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CITY OF SAN MARCOS DISCLOSURE AFFIDAVIT STATE OF TEXAS COUNTY OF HAYS I, a member of the City Council of the City of San Marcos, make this affidavit, and hereby on oath state the following: I have a substantial interest in the below named entity that may be involved in a vote or decision of the governmental body described above, and the vote or decision may have a special economic effect on the named entity that is distinguishable from the effect on the public. The name of the business entity is: The real property is: � � 1 -Tko r The nature and extent of my interest in the business entity is as follows: (check all that apply) Ownership of 10 percent or more of the voting stock or shares of the business entity. Ownership of 10 percent or more of the fair market value of the business entity. Ownership of $15,000 or more of the fair market value of the business entity. Funds received by me from the business entity exceed 10 percent of my gross income for the previous year. The interest described above belongs to a person related to me in the first degree by consanguinity (natural kinship) or affinity (marriage). Relative's name and relation: I am abstaining only to avoid the appearance of impropriety. The vote or decision involving this -,interest is on the AA&G w " 9 , (date) agenda of the governmental body, and is described as follows: 1 EXECUTED on _ C- _ (date). Signature Printed Name` , a A SWORN TO AND SUBSCRIBED before me on Notary Stam FILED on�` of the City of San COSM Form 11/10 17 F, (date). FILED on�` of the City of San COSM Form 11/10 17 F, (date).