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Mercy Mollinedo-Goold - Annual 2017101500115 -NFH -0115 Date Initial Filing Received CALIFORNIA • - 700 STATEMENT OF ECONOMIC INTERESTS Official Use Only POLITICAL FAIR • • E -Filed A PUBLIC D. CUMENT COVER PAGE 01441:018 Filing ID: Please type or print in ink. 170297348 NAME OF FILER (LAST) (FIRST) (MIDDLE) Mollinedo - Goold, Mercy 1. Office, Agency, or Court Agency Name (Do not use acronyms) City of Gilroy Division, Board, Department, District, if applicable Your Position Physically Challenged Board Boardmember ► 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 /east one box) ❑ x Annual: The period covered is January 1, 2017, through December 31, 2017 -or- The period covered is / 1 through December 31, 2017 ❑ Assuming Office: Date assumed I I ❑ Leaving Office: Date Left I I (Check one) O The period covered is January 1, 2017, through the date of leaving office. p The period covered is I through the date of leaving office. ❑ Candidate:Date of Election and office sought, if different than Part 1: 4. Schedule Summary (must complete) P. 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) Gilroy CA 95020 DAYTIME TELEPHONE NUMBER E -MAIL ADDRESS ( 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 03/27/2018 (month, day, year) Signature Mercy Mollinedo - Goold (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