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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 ? 42.-% c.i (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 is 450LA- k'.Je.r+ 1 P,«r <br />S-(A 7te t)Yt -verrf <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 />_2!?_ Funds received by me from the business entity exceed 10 percent of my gross income for the previous year. <br />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 />The vote or decision involving this interest is on the UC-a be--11, 1131-9 (date) agenda of the governmental <br />body, and is described as follows: Ph,,Ay,_ mo ,Nt-1, L_? ce Asa. &.y- USa vF P,? cE-?'c:e 1-i e I ds <br />EXECUTED on QL+-t>bey 1 1 r l 9q °1 (date). <br />M <br />vl,(t <br />Signature &dZ41, <br />SWORN TO AND SUBSCRIBED <br />w? <br />f. <br />Notary Sta <br />if fi <br />my Canmiesioires <br />jot <br />-,.. <br />tat <br />I (date). <br /> <br />FLED on s <br />(date). <br />JANIS K. WOMACK <br />Notary Public, State of Texas <br />AUG. 13, 2:0 1 014 <br />Printed Name ?G?-??? ?.a (ILa pt 'yi <br />Public <br />e of Texa <br />COSM Form 9/99