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Shawna Freels - Annual 2011 CALlFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION A PUBLIC DOCUMENT STATEMENT OF ECONOMIC INTERESTS COVER PAGE Please type or print in ink. NAME OF FILER Freels (LAST) (FIRST) (MIDDLE) Shawna Arlene 1. Office, Agency, or Court Agency Name City of Gilroy Division, Board, Department, District, if applicable City Clerk's Department Your Position City Clerk ~ If filing for multiple positions, list below or on an attachment. A Gilroy Community Development Agency gency: P 't' Agency Clerk oSllon: 2. Jurisdiction of Office (Check at least one box) DState D Multi-County [81 City of Gilroy D Judge or Court Commissioner (Statewide Jurisdiction) D County of DOther 3. Type of Statement (Check at least one box) [2SJ Annual: The period covered is January 1, 2011, through December 31,2011. -or- D Leaving Office: Date Left-1-1 (Check one) o The period covered is January 1, 2011, through the date of leaving office. The period covered is -1---1 , through December 31,2011. D Assuming Office: Date assumed -1-1 o The period covered is -1-1 the date of leaving office. Office sought, if different than Part 1: , through D Candidate: Election Year 4. Schedule Summary Check applicable schedules or "None." ~ Total number of pages including this cover page: D Schedule A.1 - Investments - schedule attached D Schedule A-2 - Investments - schedule attached D Schedule B - Real Property - schedule attached D Schedule C - Income, Loans, & Business Positions - schedule attached D Schedule 0 - Income - Gifts - schedule attached D Schedule E - Income - Gifts - Travel Payments - schedule attached -or- D None - No reportable interests on any schedule 5. Verification MAILING ADDRESS STREET (Business or Agency Address Recommended - Public Document) CITY STATE ZIP CODE 7351 Rosanna Street Gilroy DAYTIME TELEPHONE NUMBER E-MAIL ADDRESS (OPTIONAL) ( 831 ) 846-0204 shawna.freels@cLgilroy.ca.us I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of m1kn wledge the information contained herein and in any attached schedules is true and complete. I acknowledge this is a publi document. I certify under penalty of perjury under the laws of the State of California that th,e (l ( I I ' i Signatur Ca 95020 Date Signed February 3,2012 (month, day, year) FPPC Form 700 (2011/2012) FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov