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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 t-o?.v?rt (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-t'Lt?? S't" 1 x p-s <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 />_ CX 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 N1AVCLA 2002- (date) agenda of the governmental <br />body, and is described as follows: ?.1 2?•S - w?.P.h.rl-dce Dole ac44vLz k*t" <br />EXECUTED on tH Rrc,fil Z S, ZO aL (date). <br />Signature <br />IV V <br />Printed Name d IV1 kuv? ? ?1 <br />SWORN TO AND SUBSCRIBED before me on <' (date). <br />N m :JANIS K. WOMACK <br />Notary Public, State of Texas <br />My Commission Expires Not 'y Public <br />1i,?EUi'tp August 13, 2005 State of Texas <br />h i <br />FILED on ?CJt-0'`?' (date). <br />City Sicretary <br />COSM Form 9/99