Teresa Mack - Leaving Office 2014Please type or print in ink.
NAME OF FILER
Mack
1., Office, Agency, or Court
(LAST)
STATEMENT OF ECONOMIC INTERESTS
COVER PAGE
Teresa
(FIRST)
Agency Name (Do not use acronyms)
City of Gilroy, Public Works Department
Division, Board, Department, District, if applicable Your Position
Senior Engineer
► If filing for `multiple positions, lisgelow or on an attachment. (Do not use acronyms)
Agency:
2. Jurisdiction Of Office (Check at least one box)
Position:
ate Received
tidal use Only ,
C' (MIDDLE)
�.?..
❑ State ❑Judge or Court Commissioner (Statewide Jurisdiction)
❑ Multi- County
m City of Gilroy
❑ County of
❑ Other
3. Type of Statement (Check at least one box)
❑ Annual: The period covered is January 1, 2013, through m Leaving Office: Date Left 01 i 17 i 2014
December 31, 2013. (Check one)
-or- The period covered is January 1, 2013, through the date of
The period covered is �� ,through ® P ry 9
December 31, 2013. leaving office.
❑ Assuming Office: Date assumed I 1 O The period covered is _J I 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: 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)
7351 Rosanna St Gilroy CA 95020
( 408 ) 846 -0255
teresa.mack@cityofgilroy.org
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 foregoing is true and correct.
Date Signed 01/15/2014 Signature
(month, day, year) (file the originally signed stat nt with your fi' g official)
FPPC Form 700 (2013/2014)
FPPC Advice Email: advice @fppc.ca,gov
FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov