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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 G-}+? ?t&,, c-. I (name <br />of City Board, Commission, etc.) states under oath as follows: T <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 />V 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 It-a / Vr. I tZ, i 9 9 9 agenda of the governmental <br />body, and is described as follows: Co w.a,v c.4 ? Wf- (r- tx . o &"- <br />EXECUTED this 11+U day of r? I __ 199d) <br />Signature, ?'lx_ (. ?' <br />c <br />Printed Nam ' ?-J = ! f , <br />S III StelftRIBE- before on the l ay o 1991- <br />?'?? °?- J NIS K. WOMACK <br />c? t <br />Notary Public, State of Texas <br />No My Commission Expires <br />OF 1f'Pl AUG. 13, 2001 Notary UbIiC <br />State of Texas <br />FILED this day of I 199 <br />l <br />City S retary <br />(,?/