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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 (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 <,-.,"t-t4 .)e s f Te r- ..r <br />S -{? f dvt ; ? ews L <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 J",+ e Z `f' Zvv L (date) agenda of the governmental <br />body, and is described as f ollows: 3:4 t P" t'-{' - Ep,; 1 y-yo-A .r-V 4 sS u n5 00-9 r e.e,wa,n,,tit - fo r StV-ALA A <br />fc?a ?v ec?' <br />EXECUTED on T" v. e ZT 2-vo z_ (date 1 <br />Signature <br />SWO OKI <br />?NNI11I„? <br />o.?er ru?'cti. <br />1i?tF 0? `te? <br />? nNIN <br />FILED on <br />COSM Form 4/02 <br />Printed Name ?d Iv`/ 1 ?t