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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 C, G (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 Sore W rf T4,x^-t <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 />V/ 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 71~Ke ZS, ZOO (date) agenda of the governmental <br />body, and is described as follows: 1+ew.1°!" ??+?^S2?yiGCS G?^h'? ??SW?? <br />EXECUTED on J" vs -e 2 5, Z 0 0 1 (date). <br />Signature ;#tj'61jx'? <br />Printed Name EY'e? 0 ' lti0t(14a vt i N <br />SWORN TO AND suRSCRre p. k-c-on-M #_W414/ of A 00) (date). <br />JANIS K. WOMACK , <br />otary Stam 1 Notary Pubiic, State of Texas <br />T 10k I ? <br />N <br />?i my commission Expires <br />AUG. 13, 2001 of Public <br />tate of Texas <br />4' / (date). <br />FILED on yl/vVV}7/f/ ?( ,,) ??O <br />City <br />COSM Form 9/99