(130000042 (sheet 0.: ujhefz/ Affidavit of Salary Donation Texas Local Government Code, sections 152.002 and 152.052 On oath and under penalty of perjury, swearthat the following statements are true: 1. My name is m?ez?ry 2. i am at least eighteen years of age. 3. I am W1 in Travis County, Texas, and as such am an elected of?cial. (position held) 4. i elect to reduce the amount of my services to an annualized total ofS for the Fiscal Year ending September 30, 1919. 5. I understand that the effective date of this af?davit will he the later of October, 1, 9 Di; and the date on which it is filed with the county auditor. if ?led later than October 1, ill the reduction will be applied to the salary payments during the remainder of the county fiscal year. Oi it? Date Sig atu re Gemm?m J5 new L1 Printed Name State of Texas County of Travis fore me, the undersigned authority on this day personally appeared (all: PC (position held), known to me to be the person whose name is subscribed to this Affidavit; acknowledged to me that he/she executed it as his! her personal act and deed in his/her official capacity, as stated in this affidavit. Given under my hand and seal of office, this i Sinai; of 20 i/in/ Notary Pubi?in MorTravis County, Texas MANSON A. GESSNER 5'5 ?i Mi? an.? Printed name: DC I (CK SSW Fehmam?t'ams My commission expires: i'?i lg,