GR COI 2016-02-09 AFFIDAVIT OF CONFLICT OF INTEREST
THE STATE OF TEXAS §
COUNTY OF DALLAS §
I, CzsokitY i'1 as a member of the C;4 C 21010.
make this affidavit and hereby on oath state the following: I, and/or a pe son or persons related to me in the
first degree by either affinity or consanguinity, have a ubstantial interest in a business entity that would be
peculiarly affected by a vote or decision of the C. GDUtl\c. 1 as those terms a e 11
defined in Chapter 171 of the Local Government Codelsobb L#fld# 4tq Code of Corte tc# . . rive
Date of Meeting: .qi-tor L t ify Cl -01(p
Agenda Item Number: `2
The Business Entity is : $an oti engs
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.
S,OdO
Funds received from the business entity exceed of mygr ss inc me for the previous
year..0'5KASJ 4o Sic 1-0-5 C8) 'f' VI( C•pC.00 a ordi/litv/GQ
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 47414 day of 7.41VKa l , .
Signa/,re of Official
C Da nail, Mt mbar IPtaeo_
Title
BEFORE ME, the undersigned authority, this day personally appeared rt. 171 and on
oath stated that the facts hereinabove stated are true to the best of their knowledge r belief.
SWORN TO AND SUBSCRIBED BEFORE ME on this "I day of -4A421 ,
Zv ►f .
111 CHRISTEI B PETTINOS OM'lirC.
My Commission Expires Notary Public in and for the State f Texas
'/^`, May 10.2019