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Susan Sweeney - Annual 2012Date Received STATEMENT OF ECONOMIC INTERESTS if n, Use orgy. PUBLIC DOCUMENT COVER PAGE FEB 2013 r�L r�. Please type or print in ink. ER KS C_ NAME OF FILER (LAST) (FIRST) Sweeney Susan Lee 1. Office, Agency, or Court Agency Name City of Gilroy Division, Board, Department, District, if applicable Your Position Physically Challenged Board of Appeals Vice-Chair ►��'� ► If filing for multiple positions, list below or on an attachment. Agency: 2. Jurisdiction of Office (Check at least one box) Position: ❑ State ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ Multi- County W] City of Gilroy ❑ County of ❑ Other 3. Type of Statement (Check at least one box) Annual: The period covered is January 1, 2012, through ❑ Leaving Office: Date Left December 31, 2012. (Check one) -or- The period covered is I through O The period covered is January 1, 2012, through the date of December 31, 2012, leaving office. ❑ Assuming Office: Date assumed 1 O The period covered is —J 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: ❑ 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- W1 None - No reportable interests on any schedule 5. Verification MAILING ADDRESS STREET CITY STATE ZIP CODE (Business or Agency Address Recommended - Public Document) 5055 Santa Teresa Blvd Gilroy CA 95020 DAYTIME TELEPHONE NUMBER E -MAIL ADDRESS (OPTIONAL) ( 408 ) 848 -4813 ssweeney @gavilan.edu 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 that the for true and corre Date Signed 02/13/2013 Signature (month, day, year) (Filet or gin sign stat ent with yrour filing official) 4/ FPPC Form 700 (20 2/2p`13) FPPC Advice Email: adviceOfppc. gov FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov