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Adam Henig - Assuming Office 2017 Date Left // (Check one) The period covered is //, through the date STATEMENT OF ECONOMIC INTERESTS COVER PAGE FPPC Form 700 (2016/2017) FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov (month, day, year) (Check at least one box) State Multi-County County of City of Other (Check at least one box) Election Year and o // 700 FAIR POLITICAL PRACTICES COMMISSION CALIFORNIA FORM Agency Name Division, B () NAME OF FILER (LAST) (FIRST) (MIDDLE) Investments – schedule attached Investments – schedule attached Real Property – schedule attached ( ) (Business or Agency Address Recommended - Public Document) Income, Loans, & Business Positions – schedule attached – schedule attached – schedule attached No reportable interests on any schedule A PUBLIC DOCUMENT CourtCommissioner The period covered is January 1, 2016, through The period covered is //, through December 31, 2016 -ILDDRESS Date assumed FPPC Advice Email: advice fppc.ca.gov@ Dnotuseacronyms Dnotuseacronyms December 31, 2016 the date of The period covered is January 1, 2016, through lntiallng Received 101500115-NFH-0115 Henig, Adam City of Gilroy Recreation Recreation Manager X Gilroy X 02 01 2017 2 X 7351 Rosanna Street Gilroy CA 95020 408 846-0577 adam.henig@cityofgilroy.org 02/16/2017 Adam Henig E-Filed 02/16/2017 12:02:16 Filing ID: 163356897 IF APPLICABLE, LIST DATE: // // ACQUIRED DISPOSED IF APPLICABLE, LIST DATE: // // ACQUIRED DISPOSED SCHEDULE A-2 of Business Entities/Trusts Comments: Name Address (Business Address Acceptable) Name Address (Business Address Acceptable) INVESTMENT REAL PROPERTY Description of Business Activity or City or Other Precise Location of Real Property Check one Trust, go to 2 Business Entity, complete the box, then go to 2 Check one Trust, go to 2 Business Entity, complete the box, then go to 2 3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF (Attach a separate sheet if necessary.) 2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA SHARE OF THE GROSS INCOME TO THE ENTITY/TRUST) Name 700 Check one box: FPPC Form 700 (2016/2017) Sch. A-2 FPPC Toll-Free Helpline: 866/275-3772 www.fppc.ca.gov FAIR MARKET VALUE $2,000 - $10,000 $10,001 - $100,000 $100,001 - $1,000,000 Over $1,000,000 $0 - $499 $500 - $1,000 $1,001 - $10,000 $10,001 - $100,000 OVER $100,000 INVESTMENT REAL PROPERTY Description of Business Activity or City or Other Precise Location of Real Property 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR LEASED BY THE BUSINESS ENTITY OR TRUST 3. LIST THE NAME OF EACH REPORTABLE SINGLE SOURCE OF (Attach a separate sheet if necessary.) 2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA SHARE OF THE GROSS INCOME TO THE ENTITY/TRUST) Check one box: FAIR MARKET VALUE $2,000 - $10,000 $10,001 - $100,000 $100,001 - $1,000,000 Over $1,000,000 $0 - $499 $500 - $1,000 $1,001 - $10,000 $10,001 - $100,000 OVER $100,000 FAIR POLITICAL PRACTICES COMMISSION CALIFORNIA FORM 1. BUSINESS ENTITY OR TRUST 1. BUSINESS ENTITY OR TRUST NATURE OF INTEREST Stock Partnership Leasehold Other Check box if additional schedules reporting investments or real property are attached NATURE OF INTEREST Stock Partnership Leasehold Other Check box if additional schedules reporting investments or real property are attached IF APPLICABLE, LIST DATE: // // ACQUIRED DISPOSED FAIR MARKET VALUE $2,000 - $10,000 $10,001 - $100,000 $100,001 - $1,000,000 Over $1,000,000 GENERAL DESCRIPTION OF THIS BUSINESS YOUR BUSINESS POSITION NATURE OF INVESTMENT Partnership Sole Proprietorship Other $0 - $1,999 IF APPLICABLE, LIST DATE: // // ACQUIRED DISPOSED FAIR MARKET VALUE GENERAL DESCRIPTION OF THIS BUSINESS $2,000 - $10,000 $10,001 - $100,000 $100,001 - $1,000,000 Over $1,000,000 YOUR BUSINESS POSITION NATURE OF INVESTMENT Partnership Sole Proprietorship Other $0 - $1,999 Assessor’s Parcel Number or Street Address of Real Property Name of Business Entity, if Investment, or Assessor’s Parcel Number or Street Address of Real Property Name of Business Entity, if Investment, or None None FPPC Advice Email: advice fppc.ca.gov@ 4. INVESTMENTS AND INTERESTS IN REAL PROPERTY HELD OR LEASED BY THE BUSINESS ENTITY OR TRUST or Names listed below or Names listed below Henig, Adam 101500115-NFH-0115 Adam Henig (author/speaker) P.O. Box 1544 San Martin, CA 95046 X Author of two nonfiction books. Earn monthly royalties. Paid speaker too. X X X X