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CITY OF SAN MARCOS <br />DISCLOSURE AFFIDAVIT-REAL PROPERTY <br />STATE OF TEXAS <br />COUNTY OF HAYS <br />The undersigned member of the City of Son Marcos 4-71 6'C'' (name of City Board, <br />Commission, etc.) states under oath as follows: <br />I have a substantial interest in real property that may be involved in a vote or decision of the governmental body <br />described above, and it is reasonably foreseeable that the vote or decision will have a special economic effect on the <br />value of the property, distinguishable from its effect on the public. <br />The real property is described as follows (give street address, or location and approximate size): <br />I acknowledge that my interest in this real property has a fair market value of $2,500 or more. <br />'1.00. (date) The vote or decision involving this interest in real property is on the J-" ( (1, agenda of the <br />governmental body, and the subject matter of the vote or decision is as fol ows: <br />CheckW applicable: <br />The interest described above belongs to a person related to me in the first degree by consanguinity <br />(natural kinship) or affinity (marriage). Relative's name and relation: <br />EXECUTED on <br />Printed name <br />SWORN TO AND SUBSCRIBED before me on (date). <br />_=a??`,prru'e., JANIS K. WOMACK <br />Notary Public, State of Texas <br />My Commission Expires Notpry Public <br />':'rFO August 13, 2005 <br />State of Texas <br />FILED on <br />(date). <br />CityVllerk of the City of San Marcos <br />COSM Form 4/02 <br />0 I/l r. ?Vl. U vvt.a ? Cis