Loading...
Tom Haglund - Annual 2009 CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION Please type or print in ink. A Public Document COVER PAGE I). tj; QA\e Received \'Q t'\)\'IJci.~..ly.!.Se Only ~\\\\ p.~~ \.)~; \;' ~1"",^'t1 " r.., , .~\ \' "~.,.,,)~'t.1 ~ '\i:' .. 'V ~~:.;t;;J>;.'i.! lI'~ STATEMENT OF ECONOMIC INTERESTS NAME (LAST) (FIRST) (MIDDLE) DAYTIME TELEPHONE NUMBER HAGLUND Thomas John ( 408 ) 846-0202 MAILING ADDRESS STREET CITY STATE liP CODE OPTIONAL: E-MAIL ADDRESS (Business Address Acceptable) 7351 Rosanna Street Gilroy CA 95020 tom.haglund@cLgilroy.ca.us 1. Office, Agency, or Court Name of Office, Agency, or Court: City of Gilroy Division, Board, District, if applicable: Your Position: City Administrator ~ If filing for multiple positions, list additional agency(ies)/ position(s): (Attach a separate sheet if necessary.) Agency: South County Regional Wastewater Auth. Position: SCRWA Manager 2. Jurisdiction of Office (Check at least one box) D State D County of IZJ City of Gilroy D Multi-County D Other 3. Type of Statement (Check at least one box) [] Assuming Office/lnitial Date: __J___-1___ ~ Annual: The period covered is January 1, 2009, through December 31,2009. -or- a The period covered is ---1_----1_, through December 31, 2009. D Leaving Office Date Left: _.1---1__ (Check one) o The period covered is January 1, 2009, through the date of leaving office. -or- o The perioe] covered is _____L______L____., througll the date of leaving office. [J Candidate Election Year: 4. Schedule Summary ~ Total number of pages including this cover page: ~ Check applicable schedules or "No reportable interests." I have disclosed interests on one or more of the attached schedules: Schedule A-l DYes - schedule attached Investments (Less tllan 70% OwnerS/lip) Schedule A-2 DYes - schedule attached Investments (70% or Greater Ownersllip) Schedule B DYes - schedule attached Real Property Schedule C DYes - schedule attached Income, Loans, & Business Positions (Income Otller than Gifts and Travel Payments) Schedule D DYes - schedule attached Income - Gifts Schedule E DYes - schedule attached Income - Gifts - Travel Payments -or- IZI No reportable interests on any schedule 5. Verification 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 certify under penalty of peljury under the laws of the State of California that the foregoing is true and correct. 3/15/2010 (mont/J. day, year) Signature FPPC Form 700 (2009/2010) FPPC Toll-Free Helpline: 866/ASI<-FPPC www.fppc.ca.gov