GR COI 2016-04-12AFFIDAVIT OF CONFLICT OF INTEREST
THE STATE OF TEXAS
COUNTY OF DALLAS
1. G#KY PVCAOV1 aq a member of the
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 C i l" C.GL.c ti C ;1 as those terms are
defined in Chapter 171 of the Local Government Code.4*ZA C wft of. 01-44" lcrS
Date of Meeting: /aT r; 1 ZpI [_
Agenda Item Number:
The Business Entity is
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.
5a4 1-t3-15 C•kraiiw�etM�tlr 12ao4n is 4 louaih•ys �.Itty, Ve-
Upon the filing of this affidavit with the Official Record Keeper of the City, I affirm that I will abstain
voting on any decision involving this business entity and from any further participation on this matter 1lte��
whatsoever.
Signed this 17 _ day of
Signature k Official
GD�ti�l �+liN!r/!I� /I%i�./Bv f'►?7 /LJyl
Title
BEFORE ME, the undersigned authority, this day personally appeared and on
oath stated that the facts hereinabove stated are true to the best of their knowledge br belief.
SWORN TO AND SUBSCRIBED BEFORE ME on this 12 f—k day of Apr,
2.o i co
t�, Nor. i'Uk
JEAN:OWINNELC
-My commission Expires
June 15; 2@17
otary Public in and for the State of Texas