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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 ?- Ca64'KC: (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 ? public. The name of the business entity is T? a r Sfi?? <br />( J.A. i ve v-rl hi - C,06" The nature and extent of my interest in the business entity is as follows: (check all that apply) <br /> <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 A1o%/ew6a s -XZjUV4(date) agenda of the governmental <br />body, and is described as follows: T+r- . Zo - F,ce.(? ? o? P..ar a-?.f'? - ? 2 <br />17-Gw% 2(0" ¢S•!wh tSF+?b(iSlx; $} G L;aisal?t8osi+:D-? <br />EXECUTED on T?Iv?/2 w?.liG? 7,2, Loo (date). <br />Signature F <br />Printed Name M 1 /tA(I-a K "^ <br />SWORN TO AND SUS re me on JU?'1? (date). <br />JANIS K. WOMACK <br />NO ?O' •• pNotary Public, State of Texas <br />My Commission Expires <br />?ioarEaF?t+;a' AUQust 13, 2005 Not y Public <br />State of Texas <br />FILED on L/4 (date). <br />n <br />Citi/Clerk of the City of San Marcos <br />COSM Form 4/02