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CONFLICT OF INTEREST AFFIDAVIT <br /> THE STATE OF TEXAS § <br /> COUNTY OF HARRIS § <br /> 1 i <br /> I, o ` v\\ 1 CC as a member of the City of La Porte l Vb <br /> C oin N (` \ , 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 ite on \ \ <br /> ■ <br /> (\ \ , 20 1 , affecting this business entity or real <br /> property e is: "`t1 s t <br /> COMPLETE (A) OR (B): (A) The business entity is C-\ C \``° > \ 1 �' C■SC'Kname); 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 /> V 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 debate. <br /> Singed this �� day of , 29.. ( <br /> � �N\;\ 1: ,\— <br /> Signature of Official <br /> THE STATE OF TEXAS § <br /> COUNTY OF HARRIS § <br /> Bef e me t L . LL. i I t 11- tj (\ on this day personally appeared <br /> V t i l V i 431 Cf ((. - - known to me to be the person whose name is subscribed 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 11 day of A fyti,/ , , 20 1 1 • <br /> (SEAL) F , <br /> 7 , s. <br /> L L j\ i LL, ( )'L -\-- -, 0 : ^i ; YVONNE GARRISON <br /> No Public in and for the State of Texas ' ' ' "' MY COMMISSION EXPIRES <br /> 7 , , .f i �� : October 28, 2013 <br />