Rob Allen - Annual 2017101500115 -NFH -0115
Date Initial Filing
Received
CALIFORNIA • - 1 1 STATEMENT OF ECONOMIC INTERESTS
Official Use Only
POLITICAL FAIR • •
E -Filed
A PUBLIC D. CUMENT
COVER PAGE
015:55:027$
Filing ID:
Please type or print in ink.
168434000
NAME OF FILER (LAST)
(FIRST)
(MIDDLE)
Allen, Robin Mark
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
City of Gilroy
Division, Board, Department, District, if applicable
Your Position
Community Development
Building Official
► If filing for multiple positions, list below or on an attachment.
(Do not use acronyms)
Agency:
Position:
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ Judge or Court Commissioner (Statewide Jurisdiction)
❑ Multi- County
❑ County of
x City of Gilroy
❑
❑ Other
3. Type of Statement (Check at least one box)
x❑ Annual: The period covered is January 1, 2017, through ❑ Leaving Office: Date Left
December 31, 2017 (Check one)
-or-
The period covered Is // through O The period covered is January 1, 2017, through the date of
December 31, 2017 leaving office.
❑ Assuming Office: Date assumed / O The period covered is // through the date
of leaving office.
❑ Candidate:Date of Election and office sought, if different than Part 1:
14. Schedule Summary (must complete) ► Total number of pages including this cover page: 1
Schedules attached
❑ 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-
0 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 Street Gilroy CA 95020
DAYTIME TELEPHONE NUMBER E -MAIL ADDRESS
( 408 ) 846 -0258 rob.allen @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 02/01/2018
(month, day, year)
Signature Robin Mark Allen
(File the originally signed statement with your filing official.)
FPPC Form 700 (2017/2018)
FPPC Advice Email: advice @fppc.ca.gov
FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov