Laserfiche WebLink
CITY OF SAN MARCO5 <br />DISCLOSURE AFFIDAVIT-BUSINESS ENTITY <br />STATE OF TEXAS <br />COUNTY OF HAYS <br />The undersigned member of the City of San Marcos C+ -? <br />, Gy-? C-/ (name of City Board, <br />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 governmental body <br />described above, and the vote or decision may have a special economic effect on the business entity that is <br />distinguishable from the effect on the public. The name of the business entity isc?ov?t?.1Qft ) Pxc.I <br />54n-te L I,-versi •f-Z <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 $15,000 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 the previous year. <br />,c_ The interest described above belongs to a person related to me in the first degree by consanguinity (natural <br />kinship) or affinity (marriage). Relative's name and relation: <br />Alta r e + - i.? -F e <br />The vote or decision involving this interest is on the 0C4-069-?l1, Vg 99 (date) agenda of the governmental <br />body, and is described as follows: Ang,,...,( mo,,44t,?a ce„1s? 6? USQ v? Prr c4n'c,e P e l ds <br />EXECUTED on 0Lfb6 2-f 19g9 (date). <br />Signature <br />r, <br />Printe Name <br />f i <br />SWORN TO AND SUBS e me on (date). <br />"'aY JANIS K. WOMACK <br />Nota y.=? ?c s Notary Public, State of Texas <br />My CommlWon DOM <br />ZZZZ <br />AUG. 13, 2001 Nota y Public <br />'??•- - State of Texas <br />FILED on L (date). <br />9?a ?--? <br />City cretary <br />COSM Form 9/99