HomeMy WebLinkAboutSENIOR CENTER FUND INCGift to Agency Report
1. Agency Name
City of Tustin
Division, Department, or Region (if al
Parks and Recreation Department
Street Address
300 Centennial Way, Tustin, CA 92780
Area Code/Phone Number E-mail
A Public Document
714-573-3326 I dwilson@tustinca.org
Agency Contact (name and title)
David Wilson - Director of Parks and Recreation Services
2. Donor Name and Address
Date Stamp
CITY OF TU
~~^~ SFP I l
GIFT TO AGENCY REPORT
For Official Use Only
I~~ ~ I
^ Amendment (explain in comment section)
Date of Original Filing: 9-17-08
(month, day, year)
^ Individual ^x Other Senior Center Fund, Inc.
Last Name First Name Name
200 South C Street Tustin CA 92780
Address City State Zip Code
Fund established to raise funds for the Tustin Area Senior Center
If "Other" is marked, describe the entity's business activity (if business) or its nature and interests.
If applicable, identify the name of each source and the amount(s) solicited or received by the donor for this gift:
Name Amount
Name
Amount
3. Payment Information
Date and Amount of Payment (other than traveq ~ ~ ~ Q~ $ ~ ~ ~ ~ S Q(~
(month, day, year) (Round to whole dollars)
Travel Payment Information (Round to whole aouars) Location of Travel
Date(s) of Travel $ ansportation Expenses $ Lodging Expenses $ Meal Expenses $ Other Expenses $ Total Expenses
Provide a specific description of the nature and use of the payment for official agency business:
The Senior Center Fund donated a 2008 EI Dorado National Aerotech 16 Passenger Bus to be utilized for the TASC
Transportation Program. Value of bus is $61,500.
Identify the officials for whom the payment was used:
Last Name First Name
First Name
ification
Title
Department/Division
DepartmenUDivision
I ha~e determined that~it~is in the interests of the agency to accept this gift and use it for the official agency business described above.
`tJ~~' b A - ,,Q~ t t-Sa PJ ~ t r~~ Ptu'~S Gkf~1^~, t„~ ~ ~ ` ~~
of Agency ad or esignee Print ame Title (month, day, year)
Comment: (Use this space or an attachment for any additional information.)
Bus for transportation program.
Title
FPPC Form 801 (June108)
FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772)