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CITY OF SAN MARCOS <br />BOARD AND COMMISSION DISCLOSURE FORM <br />Name: E40, L__- MmEL zi , a2-, <br />Address: l 12 (A ?S L' <br />Gas <br />Board or Commission on which you serve: <br />List the names of business entities (including for-trofit, non-profit or government entities) in which <br />you have a substantial interest (See note 1 below) that may be involved in the discussions or <br />your tspMa or, <br />1. <br />2. <br />3. <br />4. <br />ssion: ranach anAadditional sheet if necessary] <br />List tracts of real property in which you have an interest $2,500 or more in value that may be <br />involved in the discussions or decisions of your Board or Commission (give street address, or <br />location and approximate size): [attach an additional sheet if necessary] <br />1. <br />2. <br />3. <br />4. <br />Certification: I certify that I have read this s <br />to it is true, complete and correct. <br />hed <br />Notes: <br />1. You have a substantial interest in a business entity if you 1) own 10% or more of its voting stock, 2) own <br />10% or $15,000 or more of its market value, or 3) received more than 10% of your gross income for the <br />previous year from the entity. <br />2. Whether your business or real property interests may be involved in your Board or Commission's <br />discussions or decisions depends mostly on the nature of the routine business that comes before your <br />Board or Commission. Two questions to ask are: a) Does my Board or Commission make <br />recommendations on purchases from businesses such as those in which I have an interest? b) Does my <br />Board or Commission regulate businesses or real property such as those in which I have an interest? <br />If the answer to either question is yes, you must disclose the business/real property interests involved on <br />this form. <br />3. If an item on an agenda of your Board or Commission may have a special economic effect on a <br />business entity or real property interest of yours, state law requires you to disclose that interest on a form <br />provided by the City, and to abstain from any discussion or vote on the item. <br />If you have any questions, please call the City Attorney's office at 393-8150.