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CITY OF SAN MARC05 <br />DISCLOSURE AFFIDAVIT-BUSINESS ENTITY <br />STATE OF TEXAS <br />COUNTY OF HAYS <br />The undersigned member of the City of San Marcos GLGautAC; 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 />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 Airk -jej+ Terns <br /><tktc v'N ;*,rr;4? <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 Ja H v t Z? Zooo (date) agenda of the <br />body, and is described as follows: D. sc sc; u?. ov+ ac4wi S• ',?,? a-F /a-•,, ?,,?,P,w? SxJ,,;,?.c-i <br />EXECUTED on J a P% KA r22 2 Z oo d (date). <br />SWORN TO ore me or <br />JANIS K. WOMACK <br />No Q Notary Public, state of Texas <br />My Commission Expires <br />AUQ,13, 2001 <br />FILED on <br /> <br />Signature ?'d L 4, ?5? j <br />Printed Name YCVN e- S'D-" <br />-rl I /} eJ? a (date). <br />Not r Public <br />Sta. of Texas <br />City <br />date). <br />COSM Form 9/99