HomeMy WebLinkAboutFuller_Alex - ZBA 04.13.2017 COICouncil / Board / Commission: Zo n n .&G t - d off' hcJ �L&s l /Dien t
Meeting Date: Apr I 13 r 90 r
Agenda Item Number: 15
STATEOF TEXAS
COUNTY OF WILLIAMSON CONFLICT OF INTEREST AFFIDAVIT
I, n 1 eX Rd I e r reside at 15 -SI /-t 5 k, George 6,3,3 - ` . I am a member of the
ZOn i n a r3oc2rd of IrSfMrnf�ity Council, City Board, Committee or Co fission) of the City of Georgetown, and I
hereby a this affidavit an 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 first or second degree have an equitable or legal ownership or interest in real property with a
fair market value of $2,500 or more.
B. "Economic 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 vot ove-referenced agenda item whatsoever.
.�yo, KAREN E FROST
Further, Affiant Sa r "p4vkNOTARY FUSLIC-STATE OF TEXAS �1 r
COMM. EXP. 05.24 A2020 printed Name: I 2 X I 114r,
NOTARY ID 1053808-4 Affiants Signature: 6
Date: Lll+t / 17
BEFORE ME, the undersigned authority, on this day personally appeared the above-named person who on oath stated that the facts
hereinabove stated are true to the best of his/her knowledge or belief.
SWORN TO AND SUBSCRIBED before me on this day of 17
Notary Public in and for the State of Texas
County of Williamson
THISAFFIDA FIT SHALL BE KEPT WITH THE OFFICIAL MINUTES OF THISMEETING. IFAFFIANT HAS CHECKED ANY OF THE ITEMS UNDER
SECTION A"RELATING TO "SUBSTANTIAL INTEREST,"A COPYOF THISAFF/DA YIT MUSTALSO BE SENT TO THE CITYSECRETARYFOR THE CITY OF
GEORGETOWN. Conflict of Interest Affidavit Revised 7.19.2011