CL-COI 2022-07-12 THE STATE OF TEXAS §
§
COUNTY OF DALLAS §
I, e'i f 14 W11 (printed name of of ant), a local public official,
make this affidavit and h by on oath state the following:
I have a substantial interest in a business entity or real property that may receive a special eco omic effect
that is distinguishable from the effect on the public by an action contemplated by the City of
Agenda Item:ealSelit•WkekKAA,&B
The business entity or real property . w ich }gave e.substantial •' terest is;[name and address of business
and/or description ofproperty] f i( 4-1 So c.1 4418_,
I or a person that is related to me within the first degree of consanguinity (blood) or affinity (marriage) as
defined by state law has a substantial interest in this business entity or real property for the following reasons
[circle all that apply]:
(1) own 10%or more of the voting stock or shares of the business entity;
(2) own 10%or more of the fair market valued of the business entity;
(3) own$15,000 or more of the fair market value of the business entity;
(4) receive from the business entity funds that exceed 10%of [my, his, her]gross
income for the previous year;
(5) have/has an equitable or legal ownership of real property with a fair market value of$2,500 or
more.
(6) Violation of Chapter 171 of the Local Government Code.
Upon filing of this affidavit with the official record keeper of the city,I affirm that I shall abstain from voting
or further participating in any matter involving the business entity or real property, unless allowed by law.
Signed this 12 411A day of ,20 22
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Signature of ffi
0.1..gctardi -----,....,,,..,
Affiant 01'
BEFORE ME,the undersigned authority,this day personally appeared '
[name ofaffiant]and byoath stated that the facts herein stated are true an9.borrect.
.f}' 1 I
SWORN 2004.AD SUBSCRIBED BEFORE ME before me on this /2 day of dv 1,�
.��" 'ra, ASHLEY M. OWENS Notary Public in for the State of1'exas
.............
� P �y State of Texas
_'�'.'' �,LNotary Public, G-I/ n �
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��pl.. +�I Comm.Expires 02-24-2023 My commission expires:
f c�„t% Notary ID 130128128