Inman, Anthony 11.14.2018RECLIVLV uv
CITY CLERK'S OFFICE
AFFIDAVIT DATE: STATE OF OF TEXAS )( gYI __ TIME: ?..c) Pt►+
COUNTY OF WICHITA )(
I, L11014%s a member of the Z make this affidavit and hereby on oath
state the following: I and/or a person or persons related to me, have a substantial interest in a
business entity that would be peculiarly affected by a vote or decision of the 7t.4c -9 Z& iI('% )
Vc"Ti, , as those terms are defined in Chapter 171 of The Texas Local Government Code.
Date of Meeting: I � A�Ut ?oI 6,
The business entity is
Item No. S' 0 tg - 3 `T
I (have/has) a substantial interest in this business entity for the following reasons: (Check all which
are ap licable.)
IL-1_ t11'k
Ownership of 10% or more of the voting or shares of the business entity.
Ownership of $5,000 or more of the fair market value of the business entity.
Funds received from the business entity exceed 10% of his/her income for the previous year.
Real property is involved and his/her has an equitable or legal ownership with a fair market
value of at least $2,500.
A relative of mine has a substantial interest in the business entity or property that would be
affected by a decision of the public body of which I am a member.
Upon the filing of this affidavit with the City Clerk„ I affirm that I v�ill abstain rom voting on any
decision involving this business entity and from any further participation on this matter whatsoever.
Signed this ` L� day of A-)Jv' , 20 ly
Signature of Official ,
Title
BEFORE ME, the undersigned authority, this day personally appeared k l a, ,a_
and on oath stated that the facts hereinabove stated are true to the best of his/her knowledge and
belief.
Sworn to and subscribed before me on this the _ lr'k day of )Vovovib ?- , 20 IS -
My M Commission Expires:
Notary Public in and for the
0 3 - 15 _ _ State of Texas
M.
My Notary ID # 131047080
%F E; Expires March 15, 2021