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Drake Haglan & Associates - Annual 2011STATEMENT OF ECONOMIC INTERESTS COVER PAGE Please type or print in ink. NAME OF FILER (LAST) Haglan Dennis 1. Office, Agency, or Court Agency Name City of Gilroy Division, Board, Department, District, if applicable Engineering Department ► If filing for multiple positions, list below or on an attachment. Agency: 2. Jurisdiction of Office (Check at least one box) ❑ State ❑ Multi- County ❑x City of Gilroy (FIRST) Your Position Engineering Consultant Position: d CLERKS C€ tG c CODDLE) Mark ❑ 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, 2011, through ❑ Leaving Office: Date Left I I December 31, 2011. (Check one) .or- The period covered is —J 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 —J 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: 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- None - No reportable interests on any schedule 5. Verification MAILING ADDRESS STREET CITY STATE ZIP CODE (Business or Agency Address Recommended - Public Document) Rancho Cordova CA 95670 DAYTIME TELEPHONE NUMBER E -MAIL ADDRESS (OPTIONAL) ( 916 ) 363 -4210 dhaglan @drakehaglan.com 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 FPPC rm 700 (2011/2012) FPPC Toll -Free Helpline: 866/275 -3 2 www.fppc.ca.gov