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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 0,j" (name <br />of City Board, 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 <br />governmental body described above, and the vote or decision may have a special economic effect on <br />the business entity that is distinguishable from the effect on the public. The name of the business entity <br />is u4'Lrwed -T2eCas S n4se-, UlniJ2t-Si4:?i <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 $5,000 or more of the fair market value of the business entity. <br />Funds received by me from the business entity exceed 10 percent of my gross income for <br />the previous year. <br />The interest described above belongs to a person related to me in the first degree by <br />consanguinity (natural kinship) or affinity (marriage). Relative's name and relation: <br />The vote or decision involving this interest is on +kk 144,c":2 Z.c, z-&u 2- agenda of the governmental <br />body, and is described as follows: s+Nm i -' 5i i6e A A-cl r4z.V elh- - 44-6,;"QT prvie-'T. <br />EXECUTED this Z6,yh day of <br />Signature <br />Printed Name v 7. 14 ivy <br />S SC BED before me on the <br />Y rys`L Notary Public, Stete Of Texas <br />m Commission Expires <br />No Sta „st 0, 2005 <br />Not public <br />Stat of Texas <br />FILED this ° day of <br />day of <br />nnn. A 0 <br />,,WbD-- <br />City