Grassi, Michael 08.09.2023 Planning and Zoning Commission CONFLICT OF INTEREST AFFIDAVIT
THE STATE OF TEXAS §
COUNTY OF WICHITA §
I, Mi kJ (, (printed name of affiant), a local public official, make this affidavit and
hereby on oath state the following:
I 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 City of Wichita Falls.
The business entity or real property in which I have a substantial interest is: [name and address
of business and/or description Qf. c,
property]— 1 itr511,. ed, (Gm-W. eur04 -
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 [check 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;
J (5) have/has an equitable or legal ownership of real property with a fair market value of
$2,500 or more.
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 [` day of . 'k_ 2.)
Signature
BEFORE ME, the undersigned authority this day personally appeared ifitZatel [name of affiant] and by oath
stated that the facts herein stated are true and correct.
SWORN TO AND SUBSCRIBED BEFORE ME before me on this_ . , day of 1024
(j/G ---
Notary Public in and for the State of Texas
/SDi "'YP.,:r' THEODORE STOLL
My cammisson expires: -,}o.?" �B
` _Notary Public,State of Texas
...0 Comm.Expires 08-30.2023
�'' 0;,,t`� Notary ID 13215401-4