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HomeMy WebLinkAboutEileen Jacobs - Annual 2012STATEMENT OF ECONOMIC INTERESTS r' DOCUMENT A PUBLIC COVER PAGE F( ran Please type or print in ink. �" 2013 NAME OF FILER (LAST) (FIRST) �(MIDDLEY Jacobs Eileen Julie 1. Office, Agency, or Court Agency Name City of Gilroy Division, Board, Department, District, if applicable Your Position Finance Budget Analyst P. If filing for multiple positions, list below or on an attachment. Agency: 2. Jurisdiction of Office (Check at least one box) ❑ State ❑ Multi- County © City of Gilroy Position: ❑ Judge or Court Commissioner (Statewide Jurisdiction) ❑ County of ❑ Other 3. Type of Statement (Check at least one box) 0 Annual: The period covered is January 1, 2012, through ❑ Leaving Office: Date Left I December 31, 2012. (Check one) -or- The period covered is through December 31, 2012. ❑ Assuming Office: Date assumed _J I ❑ Candidate: Election year 4. Schedule Summary Check applicable schedules or "None." ❑ Schedule A -1 - Investments — schedule attached ❑ Schedule A -2 - Investments — schedule attached ❑ Schedule B - Real Property — schedule attached Q The period covered is January 1, 2012, through the date of leaving office. Q The period covered is I I through the date of leaving office. and office sought, if different than Part 1: ► Total number of pages including this cover page: 1 ❑ Schedule C - Income, Loans, & Business Positions — schedule attached ❑ Schedule D - Income — Gifts — schedule attached ❑ Schedule E - Income — Gifts — Travel Payments — schedule attached -or. El 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 ( 408 ) 846 -0206 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 i jrue and correct. Date Signed 02/04/2013 Signature C_ ' c (month, day, year) (File the originally signed statement with your (ling official.) FPPC Form 700 (2012/2013) FPPC Advice Email: advicegfppc.ca.gov FPPC Toll -Free Helpline: 866/275 -3772 www.fppc.ca.gov