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06-03-2014 (Planning & Zoning) Conflict of Interest AFFIDAVIT THE STATE OF TEXAS § COUNTY OF Co (({\ § I, me h !C� Q55{ , a member of the Wylie � make this affidavit and hereby on oatstate the pi'?ollowing: 1. I, and/or a person or persons related to me in the first degree by consanguinity or affinity, as determined under Chapter 573, Government Code, (hereinafter referred to as "relative") have a substantial interest in (place an "x" by the paragraph(s) that apply): a business entity which could receive a special economic effect on the business entity that is distinguishable from the effect on the public; and/or real property which is reasonably foreseeable to receive a special economic effect on the value of the property distinguishable from its effect on the public, as a result of a vote or decision of the City Council as those terms are defined in Chapter 171, Local Government Code. 2. Complete as applicable (place an "x" by the paragraph(s) that apply): The business entity is I riNnr}s c d I,, (l�, 5ej i ep I/we have a substantial interest in this business entity for the !lowing reasons(place an "x" by the paragraph(s) that apply): I and/or my relative own 10% or more of the voting shares of the business entity or I and/or my relative own either 10% or more or $15,000.00 or more of the fair market value of the business entity; and/or funds received by me and/or my relative exceed 10% of my and/or my relative's gross income for the previous year. The real property is described as and is generally located at . I/we have a substantial interest in this property because the interest is an equitable or legal ownership with a fair market value of $2,500.00 or more. A relative of mine has substantial interest in the business entity or property that would be affected by my decision of the public body of which I am a member. Other: CONFLICT OF INTEREST AFFIDAVIT—Page 1 '.,WYSANFS011Homelmbradley\City CouncillConflict of Interest Form.doc Upon the filing of this affidavit with the City Secretary of the City of Wylie, Texas, I affirm that I will abstain from voting on any decision involving this business entity and/or real property and from any further participation on this matter whatsoever. Signed this Al* day of .kAnt , 20lf OFFICIAL Title: BEFORE ME, the undersigned authority, this day personally appeared Mic pot,k (ric,C sin and on oath stated that the facts hereinabove stated are true to the best of their knowledge and belief. AASworn to and subscribed before me on _day of Une. , 20 f1. 4 MARY V. BRADLEY u ,�, r z mot_ NOTARY PUBLIC Nota Pt4lic in and for th State of Texas � * ,rr, f y STATE OF TEXAS i .4.OF 1i� My Comm.Expires 01-31-2017 My commission expires: CA-5(ao117 CONFLICT OF INTEREST AFFIDAVIT—Page 2 '‘WYSANFS011Homelmbradley\City CouncillConflict of Interest Form.doc