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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 Son Marcos ? Ic 0V K ? j (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 Abu J"Ltt'j e t 1 oaf <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 f irst 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 t,- Imo' 15 Z001(date) agenda of the governmental <br />body, and is described as follows: T-+e 17 - VlAt iv?e T S?-ree aL.w? w.C.ASr ot," 144-1,,. <br />22 - T;A car ?,o,?,l <br />EXECUTED on ?v <br />W?4M -3W-TT <br />SWOR a or <br />°?pY?gas4 JANIS K. WOMACK <br />Notary Public. State of Texas <br />Notar My Commission Expires <br />1O Z22" August 13, 2005 <br />FILED on <br />COSM Form 9/99 <br />(date). <br />Signature <br />Printed Name