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CITY OF SAN MARCOS <br />DISCLOSURE AFFIDAVIT-BUSINESS ENTITY <br />STATE OF TEXAS <br />COUNTY OF HAY5 <br />The undersigned member of the City of San Marcos Ci -h,, 6,0 (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 '76 t'--M WC-r4- '(` O-S <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 />-,K-- 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 M AH 21, 7 c00 I (date) agenda of the governmental <br />body, and is described as follows: 14-en-. ?-7oti. t?A o 3S. 4S a av?t f'--or-cf- <br />EXECUTED on 1?l k v? 2 4 t 2-0 y (date). <br />5 <br />FILED on <br />Signature <br />Printed Name u K G ?w? ?-t0 1,? <br />AND SUBSCRIBED before me on <br />JANIS K. <br />yypMA <br />Mary public, State of Texas <br />My Commission Expires <br />August 13, 2005 <br />date). <br />City <br />COSM Form 9/99