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CITY OF SAN MARCOS <br />DISCLOSURE AFFIDAVIT-BUSINESS ENTITY <br />STATE OF TEXAS <br />COUNTY OF HAYS <br />(name <br />The undersigned member of the City of San Marcos 0-,, 1 fZ, C4" C- I' <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 entity <br />is n, V e ry i lz j <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 on-J2fo- ULt"c4i 13, (qqg agenda of the governmental <br />body, and is described as follows: 4-f?m 4 D (s) - A+i(e?Hz --iddr t c tkrc ! .5 reewa,-t-,, d <br />7. p. (6? - W atw s !,? (? a (? C-44, s e ag leew?e, " <br />EXECUTED this Z day of (LtA„ , 1 ? <br />Signature <br />Printed Name i 1 ??. ?1/fro ov-e - <br />r JANIS C. dl IBED before me on the day of J , 1., 9 9 <br />`t Notary Public, State of Texas / <br />b eta „pp (wiasion Evir" <br />AU6.13, 2001 Not public <br />State of Texas <br />FILED this o? day of LI ??`(1??,? J 199 <br />City 44cretary