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CONFLICT OF INTEREST AFFIDAVIT <br /> THE STATE OF TEXAS § <br /> COUNTY OF HARRIS § <br /> I, ail as a member of the City of La Porte 6o‘-'uc r� <br /> , make this affidavit and hereby on oath state the following: 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 nk N Z , 20 / / , affecting this business entity or real <br /> property is: i 7 .44 � A A/ i 13 " e (Ee,c,L fro.„ 1(Z-e5 Z oe / -44 ) <br /> COMPLETE (A) OR (B): (A) The business entity is Oe.. ,e.� 44ri ex (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 entity. <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 that 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 debttt <br /> Singed this Z- day of (44.4 /1-c 6 20 //' <br /> .' Signature of Official <br /> THE STATE OF TEXAS § <br /> COUNTY OF HARRIS § <br /> fore me i ie ,� on this day personalty appeared <br /> - t /PM • , • ! I to me to be the person whose name is subscribed to the <br /> foregoing 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 __ day of LL 20 1/ . <br /> Notary Public in and r the State e exas • <br />