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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 (?0I.11 c; I (name <br />of City Board, 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 <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 ent y <br />is 5oVk-fkwes+ ? ex zs 5+--t-e Uo; Derr; <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 />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 on4l e_ _Tkot- S? 19 9F? agenda of the governmental <br />body, and is described as follows: <br />EXECUTED this " h day of 7u-1, e , 199 FS <br />Y / <br />Signature ^I?, <br />Printed Nam ?Gi y? t 1 +vt 14 s'6v1 <br />SWORN TO AND SUBSCRIBED bef re me on the da of 199-L. <br />Notary Stamp: J? , I A) At U <br />id 2 <br />No?bfi public <br />Sta e of Texas <br />FILED this day of 199' ; <br />City qq 6retary