HomeMy WebLinkAboutConflict of Interest 10.28.2025 Parr_AmandaCHAPTER 2.20 CONFLICT OF INTEREST AFFIDAVIT
Coun ' /Board /Cam issi n:
Meeting Date: 4 Z� ' a^
Agenda Item Number:
STATE OF TEXAS
COUNTY OF WILLIAMSON
am a member of the �62inggz:
ity Board,
Committee or Commission) of the City of Georgetown, and I hereby make this affidavit and on my oath stat
"I have a conflict of interest pursuant to Chapter 2.20 in the above -referenced agenda matter for the following reason(s):
(check 11 that are applicable)
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 I 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 I or a member of my family solicited or received and did not reject a
good faith offer of employment within the past six months.
"I 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.
Further, Affiant sayeth not."
Printed Name: r
Affiant's Signature:
Date: (ell
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 ZU day of (:fL/ , GD 2tl
iu�++rr
�.•'irn; !�'•, KAREN FROST
Notary Public, St
- ate of Texas
+1 Comm. Expires 05-24-2028
'ti• Notary ID 10536084
Notary
State of Texas
County of Williamson
A COPY OF THIS AFFIDAVIT MUST ALSO BE SENT TO THE CITY SECRETARY FOR THE CITY OF GEORGETOWN.
C h a p t e r 2. 2 0 Conflict of Interest Affidavit Revised 9.11.2023
LOCAL GOVERNMENT CODE CHAPTER 171 CONFLICT OF INTEREST AFFIDAVIT
�Co-unci,,Y Board / Com ssi n: Date: IQ 28
Agenda Item Number:
STATE OF TEXAS
COUNTY OF WILLIAMSON
I, am a member of the (City Council ity Board,
Committee or Commission) of the City of Georgetown, and I hereby make this affidavit in accordance i e provisions of Chapter
171 of the Texas Local Government Code, and hereby on my oath state the following:
A. Business Entity Name of Entity: vt*
I and/or person(s) related to me have a substantial interest in a business entity that would be specially affected economically by the
agenda item listed above. The nature and extent of the interest is:
Ownership of 10 percent or more of the voting stock or shares of the business entity or ownership of $15,000 or
more of the fair market value of the business entity.
Funds received from the business entity exceed 10 percent of gross income for the previous twelve months.
B. Real Property
I and/or person(s) related to me, have an interest in real property that has a fair market value of $2,500 or more,
and it is reasonably foreseeable that the action presently pending will have a special economic effect on the value of
the property, distinguishable from the effect on the public.
"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:
Affiant's Signature:
,Jd&x!��
Date: [ o -2 �1195
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��� —
�u Ulm(.
��+�`,vp`'+• KAREN FROST
3 '' 'rgS Notary Public, State of Tox • i
Comm. Expires 05-24-20� ,,
''�. ,°;,;:•' Notary ID 10536084 f
cl%AlwC-Ae
Notary kblic in and for the State of Texas
County of Williamson
A COPY OF THIS AFFIDA VIT MUST ALSO BE SENT TO THE CITY SECRETARYFOR THE CITY OF GEORGETOWN.
Chapter 171 Conflict of Interest Affidavit Revised 9.11.2023