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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;A7, Cau1+c i (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 />that is <br />described above, and the vote or decision may have a special economic effect on the business ere)CAY <br />distinguishable from the effect on the public. The name of the business entity is So µ-' k W (2-F - 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 />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 6c-+z b W go 1- 00 1 (date) agenda of the governmental <br />body, and is described as follows: -T+Crn -5-- Me i v?e?S Vy-eet a L AY, C-ov rj-. F af?vo.?dv 2:-- r 3O <br />l,Cre? vf"eU C Tf-w+? ?.wt - ?M¢.iHerr $f-,tee?.t? r?,., paxc 4 <br />EXECUTED on _ Qe-4-0 b Q.r 20 y (date). U <br />Signature 4a/-VN4 ?- 51,Y\-- <br />Printe ame ri ??-?;?5 d h <br />SWO me on (date). <br />JANIS K. WOMACK <br />`o??•' •?l44 <br />?ZC °' Notary Public, State of Texas <br />Nota a My Commission Expires 4 CAL <br />August 13, 2005 <br />Not Public <br />State of Texas <br />FILED on 0 (date). <br />City <br />COSM Form 9/99