David Chung - Annual 2012Please type or print in ink.
NAME OF FILER
(LAST)
STATEMENT OF ECONOMIC INTERESTS
Chung David
1. Office, Agency, or Court
Agency Name
City of Gilroy
COVER PAGE
(FIRST)
Division, Board, Department, District, if applicable Your Position
Building Division /Community Development Department Building Plan Check Engineer
► If filing for multiple positions, list below or on an attachment.
Agency:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ Multi- County
z City of Gilroy
3. Type of Statement (Check at least one box)
Annual: The period covered is January 1, 2012, through
December 31, 2012.
-or-
The period covered is I I through
December 31, 2012.
❑ Assuming Office: Date assumed I I
❑ Candidate: Election year
Position:
Date Received
AR 2013
WY CCERKC t,., r
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ County of
❑ Other
❑ Leaving Office: Date Left —J I
(Check one)
0 The period covered is January 1, 2012, through the date of
leaving office.
0 The period covered is I I through
the date of leaving office.
and office sought, if different than Part 1:
4. Schedule Summary '
Check applicable schedules or "None." ► Total number of pages including this cover page:
❑ Schedule A -1 - Investments – schedule attached ❑ Schedule C - Income, Loans, & Business Positions – schedule attached
❑ Schedule A -2 - Investments – schedule attached ❑ Schedule D - Income – Gifts – schedule attached
❑ Schedule B - Real Property – schedule attached ❑ Schedule E - Income – Gifts – Travel Payments – schedule attached
.or-
None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
7351 Rosanna St. Gilroy CA 95020
(OPTIONAL)
( 408 ) 846 -0451
I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my knowledge the information contained
herein and in any attached schedules is true and complete. I acknowledge this is a public document.
I certify under penalty of perjury under the laws of the State of California that the foregog is true and correct.
Date Signed 03/13/2013
(month, day, year)
Signature
(File the
with your riling ofBaal )
FPPC Form 700 (2012/2013)
FPP dvice Email: advice@fppc.ca.gov
FPPC Toll -Fre elpline: 866/275 -3772 www.fppc.ca.gov
FPPC Toll-FLe