Loading...
Shawna Freels - Annual 2012ri CALIFORNIA FORm 700 STATEMENT OF ECONOMIC INTERESTS FAIR POLITICAL PRACTICES COMMISSION • • COVER PAGE N*_ 0'Please type or print in ink. : _ Al NAME OF FILER (LAST) (FIRST) D Freels Arlene Shawna 1. Office, Agency, or Court Agency Name City of Gilroy Division, Board, Department, District, if applicable Your Position City Clerk's Department City Clerk ► If filing for multiple positions, list below or on an attachment. Agency: Gilroy Community Development Agency Position: Agency Secretary 2. Jurisdiction of Office (Check at least one box) ❑ State ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ Multi- County ❑ County of © City of Gilroy ❑ Other 3. Type of Statement (Check at least one box) Annual: The period covered is January 1, 2012, through ❑ Leaving Office: Date Left I I December 31, 2012. (Check one) .or- The period covered is I I through O The period covered is January 1, 2012, through the date of December 31, 2012. leaving office. ❑ Assuming Office: Date assumed —J 1 O The period covered is I I through the date of leaving office. ❑ Candidate: Election year and office sought, if different than Part 1: 4. Schedule Summary Check applicable schedules or "None." ► Total number of pages including this cover page: 1 ❑ 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- FA 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 Street Gilroy CA 95020 DAYTIME TELEPHONE NUMBER E -MAIL ADDRESS (OPTIONAL) ( 408 ) 846 -0204 shawna.freels @cityofgilroy.org I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my knowled a 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 forogo g i ' rue and correct. Date Signed 02/04/2013 Signature 9 g (month, day, year) ` (Fie the oVnaly signed sta en( with your filing orfival.) FPPC Form 700 (2012/2013) FPPC Advice Email: advice Ofppc. ca. gov FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov