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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 C I'N CDu .4 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 Souilit u/es? eye L s <br />54-10-e, tl,•'L'4 <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 />V 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 A42r;1 iIt. 2,003 (date) agenda of the governmental <br />body, and is described as follows: _14-44,% 7- Fre-eCPi?-P? c?crbwrg 5'e-t? a5a??(w??newt c?,r-+? <br />- pesa s?-?-ems- s- - rcEc.?s? <br />Zf.c.-r. 20 <br />EXECUTED on a ri ? 1 , z"0 03 (date). <br />Signature ?/?? <br />COSM Form 4/02 <br />Printed Name 019 1^'f H't f:q;V% y r"v-'Ill2,r-