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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 (-eDLyh C4 (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 S&JAJ2A 5-1'eQ <br />(12M V K t2 wi f lv "k 'r <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 VA 1-6 2.c0 2- <br />body, and is described as follows: G D G Ait o <br />EXECUTED on 0,4 Z 0 1, Z D 0 Z <br />SWORN e me or <br />FILED on I/k? <br />r agD <br />Notary Public, State of Texas <br />Noi;ary Sta{#p: My Commission Expires <br />` ?° August 13, 2005 <br />State of Texas <br />date). <br />City rxertmF? <br />date) agenda of the governmental <br />COSM Form 9/99