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McCulloch, Douglas 03.06.2023 Planning and Zoning Commission AFFIDAVIT STATE OF TEXAS § § COUNTY OF WICHIT § /fir, 'Q; eica aoci4 . I, f �/ /► 1 . as a member of the / / zc (-4-i make this affidavit and hereby on oath state the following: I and/or a person or pet ons relateSto 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 Co v),Y11, 316r) , as those terms are defined in Chapter 171 of The Texas Local Government Code. Date of Meeting: /T ho2 `o 3 Item No. Y The business entity is ��1� D-4C , ?/o/)/29'� a( J 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 received from the business entity exceed 10%of my/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. 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 I / day of 416 1,tt i- , 20 ) j jfA) Signature of Official P41 Cumn„1 rd ernbk". Title /� �r BEFORE ME, the undersigned authority, this day personally appeared / (�o1. i PlcCLIIOW- and by oath stated that the facts herein stated are true and correct to the best of his/her_knowledge and belief. -�,�n Sworn to and subscribed before me on this the y�v day of I ► 'ar(-h 20 . My Commission Expires: of ry Public in and for the . I TI-IC]fP State of Texas %„ e'\ Notary Public,State of Texas 4,t * My Commission Expires ;•��.4'/ October 26,2023 `°,''', NOTARY ID 1173®®2-1