Lee, Andy 11.26.2019AFFIDAVIT
STATE OF TEXAS )(
COUNTY OF WICHITA )(
1, 46`14i , as a member of the 44ao""k#49, make this affidavit and hereby on oat
state the(following: I and/or a person or persons related to me, have a sulpistantial interest in a
business entity that would be peculiarly affected by a vote or decision of the AkA4*a4
, as those terms are defined in Chapter 171 of The Texas Local Government Code.
Date of Meeting: or Item No.
The business entity is 19G9e0,tS L)A)tt ztL-.,j1- LLC (go l�otwi, F`��
I (have/has) a substantial interest in this business entity for the following reasons: (Check all which
are applicable.)
Ownership of 10% or more of the voting or shares of the business entity.
xC 4.1W L,I#r1 i✓
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 will abstain from voting on any
decision involving this business entity and from any further participation on this matter whatsoever.
Signed this .244-k'
Signature of Official
Title
day of tom.. 20JI
40 . C� qk SS i Bev a CVL
BEFORE ME, the undersigned authority, this day personally appeared LLt
and on oath stated that the facts hereinabove stated are true to the best of`liis/her knowledge and
belief. -
Sworn to and subscribed before me on this the e° day of . 20 I T
My Commission Expires: C_9C
••�AY�v'" MARIE BALTHROP Aoty Public in and for tie
?° Notary Public, State of Texas
"Y �,reS State ofTexas
o°" NOTARY ID 1g ?�.1 i