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Consolidated CM - Annual 2012CALIFORNIA •. STATEMENT OF ECONOMIC INTERESTS �P zPCeive FAIR POLITICAL PRACTICES COMMISSION A PUBLIC F�4� 2a1 DOCUMENT COVER PAGE 3� Please type or print in ink. NAME OF FILER (LAST) (FIRST) (MIDDLE) Johnson Dan 1. Office, Agency, or Court Agency Name City of Gilroy Division, Board, Department, District, if applicable Your Position Engineering COYyy,t,�Library Project Manager ► If filing for multiple positions, list below or on an attachment. Agency: 2. Jurisdiction of Office (Check at least one box) ❑ State ❑ Multi- County ❑ Cily of Gilt Position: ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ County of ❑ Other 3. Type of Statement (Check at least one box) 0 Annual: The period covered is January 1, 2012, through ❑ Leaving Office: Date Left December 31, 2012. (Check one) -or- The period covered is through December 31, 2012. ❑ Assuming Office: Date assumed ❑ Candidate: Election year _ 4. Schedule Summary Check applicable schedules or "None." ❑ Schedule A -1 - Investments – schedule attached ❑ Schedule A -2 - Investments – schedule attached ❑ Schedule B - Real Property – schedule attached O The period covered is January 1, 2012, through the date of leaving office. O The period covered is — the date of leaving office. and office sought, if different than Part 1: ► Total number of pages including this cover page: through ❑ Schedule C - Income, Loans, & Business Positions – schedule attached ❑ Schedule D - Income – Gifts – 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) Gilroy CA 95020 ( 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 information contained herein and in any attached schedules is true and complete. I acknowledge this /2013) FPPC Advice Email: advice @fppc.ca.gov FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov