Medellin, Marcela 01.25.2022 Landmark Commission AFFIDAVIT
STATE OF TEXAS §
COUNTY OF WICHITA I§ (A), Mal(CA/1/0/ ACiI , as a member of the � M( ( 1 ke 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 or real property that may receive a special economic effect that is
distinguishable from the effect on the public by an action contemplated by the
, as thoseterms are defined in Chapter 171 of The Texas Local Government Code.
Date of Meeting: b 1 9- 6 ' '22 Item No.
The business entity is m 161,4, ' fib'
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:
Own of 10%or more of the voting or shares of the business entity.
Own10%or more of the fair market value of the business entity.
Own $15,000 or more of the fair market value of the business entity.
Funds receive from t bu iness entit eed 10%of my/his/her income for the previous year.
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Real property is invc lved and his/her has an equitable or legal ownership with a fair market value
of at least$2,500.
Upon filing of this affidavit with the City Clerk, 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 2, i
day of c I , 20 2 2
Signature of Official
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Title
BEFORE ME, the undersigned authority, this day personally appeared kkourt,GIA NI-PGAPA1i el
and by oath stated that the facts herein stated are true and correct to the best of his/her knowledge
and belief.
Sworn to and subscribed before me on this the 7-4t day of v1 vat , 20 2- —.
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M Commission
'3 / 2,, Notary Public in and for the
23 to of Texas
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.� 1",,�J , THEODORE STOLL
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