Brancheau, Tim-CL 2011-07-12AFFIDAVIT OF CONFLICT OF INTEREST
THE STATE OF TEXAS
COUNTY OF DALLAS
I, TL IA/1 �V'CtV1CIAW u as a member of the C�4y CQLA 1Ci
make this affidavit and hereby on oath state the following: I, and /or a person or persons related to me in
the first degree by either affinity or consanguinity, have a substantial interest in a business entity that
would be peculiarly affected by a vote or decision of the l Z, 13 f 1 ct as those
terms are defined in Chapter 171 of the Local Government Cofte.
Date of Meeting:
Agenda Item Number: 14 nz L ZT � / �j�• r
The Business Entity is : 52 lo r i t, y' ! s"��5 / C O Y% 4 of 54 Df vi Oww r u� LLC j
YOCI VA v� 'F { 7 �t � C l
I have a substantial interest in this business entity for the following reasons: (check all which are
applicable)
Ownership of 10% or more of the voting stock or shares of the business entity.
Ownership of 10% or $15,000 or more of the fair market value of the business entity.
Funds received from the business entity exceed 10% of my gross income for the previous
year.
Real property is involved and I have an equitable or legal ownership with a fair market
value of at least $2,500.
Upon the filing of this affidavit with the Official Record Keeper of the City, I affirm that I will abstain
from voting on any decision involving this business entity and from any further participation on this
matter whatsoever.
Signed this 2.' day of
C tore of Official
6; co nci I .
Title
BEFORE ME, the undersigned authority, this day personally appeared - JA - N4 PQns e A, �-t and on
oath stated that the facts hereinabove stated are true to the best of their knowledge or belief.
SWORN TO AND SUBSC I ED BEFORE ME on this day of
1(5 i 0 TEL 6 7 1. "
on I so
NO~
otary Public in and for the State of Texa