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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 Cir ?c? (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 'rt-xa. s S;(-L { <br />!j:" UVLA-V a.c <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 />y 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 ^4er-27 . 2,003(date) agenda of the governmental <br />body, and is described as follows: X+?? ? YV? .? c'.?.oCs,.-sf? ?,.d.'w? y ytty?n <br />EXECUTED on l-" I (date). <br />U OF Signature -I la <br />COSM Form 4/02 <br />Printed Name