HomeMy WebLinkAboutBrashear_Ercel - P&Z 08.21.2012 COICouncil / Board / Com"i ssr
Meeting Date: _ e G/ �Zp t Z
Agenda Item Number: .07cale
STATE OF TEXAS
COUNTY OF WILLIAMSON CONFLICT OF INTEREST AFFIDAVIT
1, reside at _ $. I am a member of the
?MrWtNI. AtgJffM6 &w,*s. (City Council, City Board, Committee or Commission) of the City of Georgetown, and I
hereby make this affidavit and on my oath state the following:
"I, and/or a person or business entity whose interest is imputed to me under Chapter 171 of the Local Government Code and/or
Chapter 2.20 of the City of Georgetown Code of Ordinances, have a "substantial interest" in a business entity or in real property (as
defined by Chapter 171 of the Texas Local Government Code and Sec. 2.20.020.M of the City of Georgetown Code of Ordinances)
and/or an "economic interest" (as defined in Sec. 2.20.020.E of the City of Georgetown Code of Ordinances) in the matter that is
identified and described on the above - referenced agenda item.
"I have a conflict of interest in the above - referenced agenda matter for the following reason(s): (check all that are applicable).
A. "Substantial Interest"
I or a person related to me in the first or second degree have an ownership of 10% or more of the voting stock or shares of the
business entity
_ I or a person related to me in the first or second degree have an ownership of 10% or more of the fair market value of the
business entity or have an ownership of $15,000 or more of the fair market value of the business entity.
I or a person related to me in the first or second degree received funds from the business entity in excess of 10% of my /his/her
gross income for the previous year.
I or a person related to me in the fast or second degree have an equitable or legal ownership or interest in real property with a
fair market value of $2,500 or more.
" conomic Interest"
I or a person or entity whose interest is imputed to me under Chapter 2.20 of the City of Georgetown Code of Ordinances have
a legal or equitable interest in real or personal property or a fiduciary obligation to such property or contractual right in such
property that is more than minimal or insignificant and would be recognized by reasonable persons to have weight in deciding a
case or an issue. A City official may not take any official action that the official knows is likely to affect the substantial
economic interests of:
• the City official's family member or a business entity for which the city official serves as an officer, director, or in a
policy- making position,
• a person or business entity from whom, within the past 12 months, the City official or official's spouse, directly or
indirectly, has solicited, . received and not rejected or accepted an officer of employment, or is engaged in negotiations
pertaining to business opportunities.
C. "Other"
For reasons other than those listed above, I have a conflict of interest (Please specify, e.g. Sec. 2.24.170 or other reason):
"Upon filing of this affidavit with the recording secretary and/or the City Secretary, I affirm that I will abstain from all participation,
discussion and voting involving the matter identified in the above - referenced agenda item whatsoever.
Further, Affiant sayeth not."
Printed Name: f
Affianfs Signatm
Date: / _...
BEFORE ME, the undersigned authority, on this day personally appeared the above -named person who on oath stated that the facts
heremabove stated are true to the best of his/her knowledge or belief.
SWORN TO AND SUBSCRIBED before me on this J[_& day of 2 C NA r %12 .
Notary b c i d f a State o as
,• ;!»rt CHELSEA KOIRIA County of Williamson
THIS AFFIDAVIT SHALL BE KEPT
SECNON"A "RELATING TO "SUBS'
GEORGETOWN. Conflict of Interest
': ]FAFFIANTHAS CHECKED ANY OF THEITEMS UNDER
MUSTALSO BE SENT TO THE CITYSECRETARY FOR THE CITY OF