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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 ?+'hie+ G+ t , (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 _ ?? ?'t•1 s 7 e ycw.r <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 2- 00 g (date) agenda of the governmental <br />body, and is described as follows: Z-1-e,w. I I - 1-4 -LCt,- r4- o-E "LL e. g ,,, -4y /-}- "4.4 ;' <br />s CS W 7- Tr), L+4 <br />EXECUTED on ?s?•L 2,'3, 200 3 (date ` <br />Signature AKA <br />Pri <br />5 PP ;q44!9 SLIB ore me on <br />JANIS K. WOMACK <br />`?o??er r s.''•. <br />Notary Public, State of Texas <br />N il??QI1p: My Commission Expires <br />OAugust 13, 2005 I <br />FILED on <br />S,3 <br />Name t oC rV1 i lilac l k t yt, i h <br />t4, LWLA <br />iry Public <br />e of Texas <br />(date). <br />date). <br />CityZlerk of the City of San Marcos <br />COSM Form 4/02