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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 0 u K C 1 , (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 />S So uf?w ¢ s1?' Te,? u r <br />distinguishable from the effect on the public. The name of the business entity is <br />Uyr,ycrs? fz,, <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 $15,000 or more of the fair market value of the business entity. <br />Funds received by me from the business entity exceed 10 percent of my gross income for the previous year. <br />The interest described above belongs to a person related to me in the first degree by consanguinity (natural <br />kinship) or affinity (marriage). Relative's name and relation: <br />The vote or decision involving this interest is on the deb. 2-f4 Zoo 3 (date) agenda of the gover <br />body, and is described as follows: 0 F jt!! ? Use 673- w; -ek SaT-9 0 (Slew, 9 <br />U -TV, +V-,- L-4a 41 r4A C O %t <br />EXECUTED on a f9rklr H Z f , 2.0 03 (date). <br />Signature <br />SWORN TO AND SUBSCRIBED before me of <br />Notary St ":'b"4 JANIS K. WOMACK <br />: Notary Public, State of Texas <br />$ ' •?,, My commission Expires <br />yrS'FpF`t?r•?• August 13, 2005 <br />&41 5WTSLJ- arr,Graeoto5-'c44 ser?lccs <br />(Stem 2 i) <br /> <br />PrintedN`ame 2-vV??'?" a. j-?-u ?:v?C?feiL,/ <br />state of I exas <br />FILED on c ' J ?w e). <br />City Ckrk of the City of San Marcos <br />COSM Form 4/02