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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 (2i+,h CauMc (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 !9bh-114 'i er¢- l eyo-f <br />K ; ?L?S: -1ti, <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 0e-f-o Ver 21212.0 01 (date) agenda of the governmental <br />body, and is described as follows: _T4-r+ 14 - 4 6 ,, ,af s- t r,.? of KA,& c,A. Sfvte--f - <br />EXECUTED on 66+v L-74,e 22 2 O v 1 (date). <br /> <br />SWORN TO AND SUBSCRIBED be ore me or <br />??4Yjf•?' JAIS K. WOMACK <br />N lNotary Public, State of Texas <br />fl. : My Commission Expires <br />A August 13, 2005 <br />w <br /> <br /> <br /> <br /> <br />FILED on <br />Signature <br />State of Texas <br />Vl .r0-„t <br />date). <br />00 ? <br />City SaercTa-ry, <br />COSM Form 9/99 <br />Printed Name J 0--t 4-