Consolidated CM - Annual 2011STATEMENT OF ECONOMIC INTERESTS
A PUBLIC DOCUMENT COVER PAGES 2012
Please type or print in ink. �` CLERKS L - :,
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NAME OF FILER (LAST) (FIRST)
Johnson Dan
1. Office, Agency, or Court
Agency Name
City of Gilroy
Division, Board, Department, District, if applicable
Your Position
Project Manager
► If filing or multiple positions, lit below or on an attachment.
/
Agency:
Position:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ Multi- County
❑ County of
❑x City of Gilroy
❑ Other
3. Type of Statement (Check at least one box)
x Annual: The period covered is January 1, 2011, through
❑
❑ Leaving Office: Date Left __J I
December 31, 2011.
(Check one)
-or-
The period covered is I
through O The period covered is January 1, 2011, through the date of
December 31, 2011.
leaving office.
❑ Assuming Office: Date assumed I 1
O The period covered is I through
the date of leaving office.
❑ Candidate: Election Year 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
(
E -MAIL ADDRESS (OPTIONAL)
( 408 ) 846 -0454
dan.johnson @ci.gilroy.ca.us
I have used all reasonable diligence in preparing this statement.
I have reviewed this statement and to the best of my knowledge the ir)fo ation 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