Adam Henig - Annual 2020101500115-NFH-0115
CALIFORNIA FORM 700
FAIR POLITICAL PRACTICES COMMISSION
1393050
Please type or print in ink.
NAME OF FILER
Henig, Adam
1. Office, Agency, or Court
Agency Name (Do not use acronyms)
City of Gilroy
Division, Board, Department, District, if applicable
Recreation
(LAST)
STATEMENT OF ECONOMIC INTERESTS
COVER PAGE
A Public Document
(FIRST)
Your Position
Recreation Manager
► 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
❑ Multi -County
0 City of Gilroy
3. Type of Statement (Check at least one box)
x❑ Annual:The period covered is January 1, 2021 through
December 31, 2021.
-or-
The period covered through
December 31, 2021.
❑ Assuming Office: Date assumed—J
ate Initial Filing .Re , ' d
Frl%ng Of(icrar Use CmiY
❑ Judge, Retired Judge, Pro Tem Judge, or Court Commissioner
(Statewide Jurisdiction)
❑ County of
❑ Other
❑ Leaving Office: Date Left _J—J
(Check one circle)
O The period covered is January 1, 2021 through the date of
leaving office.
Q The period covered is through the date
of leaving office.
❑ Candidate:Date of Electior and office sought, if different than Part 1:
4. Schedule Summary (must complete) ► Total number of pages including this cover page:
Schedules attached
❑ Schedule A-1 - Investments — schedule attached
❑ Schedule A-2 - Investments — schedule attached
❑ Schedule B • Real Property — schedule attached
-or-
® None - No reportable interests on any schedule
5. Verification
MAILING ADDRESS STREET
(Business or Agency Address Recommended - Public Document)
CITY
❑ Schedule C - Income, Loans, & Business Positions — schedule attached
❑ Schedule D - Income — Gifts — schedule attached
❑ Schedule E - Income — Gifts — Travel Payments — schedule attached
7351 Rosanna Street Gilroy
DAYTIME TELEPHONE NUMBER
( 408 ) 846-0577
STATE
CA
E-MAIL ADDRESS
adam.henig@cityofgilroy.org
ZIP CODE
95020
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.
certify under penalty of perjury under the laws of the State of Califomia that the foregoing is true
)
FPPC Form 700 - Cover Page (2021/2022)
advice@fppc.ca.gov • 866-275-3772 • www.fppc.ca.gov