Lee, Andy 08.22.2017AFFIDAVIT
STATE OF TEXAS )(
COUNTY OF WICHITA )(
I A00 , as a member of the�make this affidavit and hereby on oath
state th& 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
, as those terms are defined in Chapter 171 of The Texas Local Government Code.
Date of Meeting: Ll Z/Zo I Item No. Mrs
The business entity i
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ilk
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.
Ownership of $5,000 or more of the fair market value of the business entity.
60 JSvt' oetb- &,&-, �--
zlz 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 '%%y✓o
Signature of Official
Title
day of , 20 % 7
BEFORE ME, the undersigned authority, this day personally appeared _end.. Lee_
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 cl;t day of Aru,H) t , 201-7.
Expires:
My Commission Ex p
Notary Public in and for the
1tlorck S Ica I State of Texas
KIA BOONE
r = My Notary ID # 131047080
• ;.F:af t� �` Expires March 15, 2021