HomeMy WebLinkAboutPitts_Kevin - Council 08.25.2020 COICHAPTER 2.20 CONFLICT OF INTEREST AFFIDAVIT
Council / Board / C mi ission: Y 6—JU A
Meeting Date:p
Agenda Item Number:
STATE OF TEXAS
COUNTY OF WILLIAMSON
7Y z�
reside atGeo . . I am a member of the
G%thw, C0(41K,t4City 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 have a conflict of interest pursuant to Chapter 2.20 in the above -referenced agenda matter for the following reason(s): (check all that
are applicable).
11 The item involves my outside employer or the outside employer of a member of my family or household.
The item involves a business entity I or my family owns five percent more of a voting stock or share or five thousand
dollars or more of FMV.
The item involves a business entity from which I receive or my family member receives more than 10% of our gross income in
the previous year.
The item involves real property in which 1 or a family member or member of my household have an equitable interest or legal
ownership.
The item involves a person or business entity from whom 1 or a member of my family solicited or received and did not reject a
good faith offer of employment within the past six months.
"1 further attest that if I have not also submitted a Chapter 171 Conflict of Interest Affidavit that I do not have a conflict of interest under
Chapter 171 of the Local Government Code."
"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. 11
Further, Affiant sayeth not." D �{
Printed Name:
Affiant's Signature: `
Date:
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 2-q— day of&ausp, AoAD__.
/1 1
p,RF-NOTARY
CANDACE C HAMPTON �No Public in and r the State f Texas
r PUBLIC •STATE OF TEXAS
ID#12987804.2 aunty of WilliamsonCOMM. EXP.07.08.2022
A COPY OF THIS AFFIDAVIT MUST ALSO BE SENT TO THE CITY SECRETARY FOR THE CITY OF GEORGETOWN.
Chapter 2.20 Conflict of Interest Affidavit Revised 4.16.2019