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CONFLICT OF INTEREST AFFIDAVIT <br />THE STATE OF TEXAS I <br />COUNTY OF HARRIS § <br />I, v\N N 1 � L� as a member of the City of La Porte i �J <br />(Lc -I \ , make this affidavit and hereby on oath state the foIlowing: I have a <br />substantial interest in a business entity or real property as defined in Chapter 171, Texas Local <br />Government: Code, and a vote is to be taken or a decision is to be made that will have a special <br />economic effect on this business entity or real property. <br />The agenda item on � C) r t +i.� , 20 D I , affecting this business entity or real <br />Ply is: \ (It 5C <br />COMPLETE (A) OR (B): <br />(A) The business entity ist f ��� 1J CC4C 01,,; (name); or <br />(B) The real property is located at: <br />I have a substantial interest for the following reasons: (check all which are applicable) <br />Ownership of 10% or more of the voting stock or shares of the business entity. <br />Ownership of 10% or more or $15,000 or more of the fair market value of the <br />business em ity. <br />Funds received from the business entity exceed 10% of gross income for the <br />Previous year. <br />Real property is involved and I have an equitable or legal ownership of the <br />property with, a fair market value of at least $2,500. <br />A relative of mine has a substantial interest in the business entity or real <br />property flat would be affected by a decision of the public body of which I <br />am a member. <br />Upon filing of this affidavit with the City Secretary, I affirm that I will abstain from voting on any <br />decision involving this business entity or real property and from any further participation on this <br />matter by discussion or debate. <br />(� r <br />Singed this U�v day of C , 20,t Li <br />Signature of Official <br />THE STATE OF TEXAS $ <br />COUNTY OF HARRIS $ <br />Before me C '1 i ' i� on this day personally qpmrd <br />known to me to be the person whose name is mbscn'bed to the <br />foregoing instrument and acknowledged to me that he/she executed the same for the purposes and <br />consideration therein expressed. <br />Given under my hand and seal of office this Lk��day of , 20 <br />(sem-) - <br />` q, LL rq, 1 jy <br />1:t 1 <br />N lic in and Tor the Stale of Teras <br />MARTHA SILLETT <br />MP Corr wabn Ercpkri <br />timet 91, 2013 <br />