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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 4.1t!, Cot es. C?a (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 So v-1-/4 we-s- + " F-e z- <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 />X._ 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 KbLi4 21, Zv o 1 (date) agenda of the governmental <br />body, and is described as follows: 37+4-" 2 - L? f ca"S-eey&k- W-A P (GN vt ? n: j : ¢4 w,s•.?s# w H-1 <br />U 1) SWT'S' V <br />EXECUTED on y, Z (? Z O I (date). <br />JAMS K. WOMACK• <br />"WI P Texas <br />"?ll?•`.o': NotefyPublic,'-' E)gres <br />SWORN TO ore me on <br />Notary Si <br />FILED on <br />L. <br />Signature ``? <br />Printed Name A-l s?n <br />COSM Form 9/99