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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 (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 ?-? r =' ? e- <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 />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 (Je i:-abe r- 13, zoo3 (date) agenda of the governmental <br />body, and is described as follows: 1 EE V - ? ogre <br />r.- 4&-..-A c4-iio_ (aaa.4&w, <br />EXECUTED on Cc-4-a b ??' i Zoo3 (date). <br />Signature G <br />SWORN TO AND U <br />Jo PpY Poe ?i1 JANIS K. WCMACK <br />Notary Public, State of Texas <br />Notary _f MY Commission Expires <br />August 13, 2005 <br />FILED on <br />PrinteclAlame C- d <br />ifit,^I ??a"'to <br />on ?? ?r7©'S (date). <br />? t <br />Noto ublic <br />State f Texas <br />?_(date). <br />CitVClerk of the City of San Marcos <br />COSM Form 4/02