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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 _12 C o wy, C; ( (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 SD (,, t G<wQ ff 1 e es r <br />k- K J P.YS % <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 Ovta(?u Z-0 y 1 (date) agenda of the governmental <br />body, and is described as follows: 2 S- M ,4+&,-A -J; n? <c-JTS L) ?++ 4 <br />0 {'GAS <br />EXECUTED on o?, be,.- 2,001 (date). <br />5W <br />Not <br />N?tary `t §IN o me or <br />MY Commission Expires <br />August 13, 2005 <br />Signature <br />Notary Poblic <br />State of Texas <br />FILED on? (date). <br />City <br />r <br /> <br /> <br />COSM Form 9/99