HomeMy WebLinkAboutMAO, STELLAGift to Agency Report
1. Agency Name
City of Tustin
)ivision, Department, or Region (if applicable)
Library Fund
300 Centennial Way
lrea Code/Phone Number E-ma
Cl~~e ~Jr
rrtt ct For Official Use Only
^ Amendment {explain in comment section)
(714)573-3010
Agency Contact (name and title) Date of Original Filing:
(month, day, year)
Christine Shingleton, Assistant City Manager
2. Donor Name and Address
p Individual Mao Stella ^ Other
Last Name First Name Name
Tustin CA 92780
Address City State Zip Code
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) solinited or received by the donor for this gift:
Stella Mao
Name
~ 400.00
Amount
Name
Amount
3. Payment Information
Date and Amount of Payment {otnertnan travel)
A Public Document GIFT TO AGENCY REPORT
{month, day year)
{Round to whole dollars)
Travel Payment Information (Round ro whale dollars) Location of Travel
Dates) of Travel Transportation Expenses ~ Lodging Expenses ~ Meal Expenses ~ Other Expenses ~ Tota! Expenses
Provide a specific description of the nature and use of the payment for official agency business:
Identify the officials for whom the payment was used:
Last Name First Name Title Department!Division
Last Name First Name Title Department/Division
4. Verification
! have determined that it is in the interests of the agency to accept this gift and use it for the official agency business described above.
c~~~~~~ Christine Shingleton Assistant City Manager 11/14/08
Signature of Agency He Designee Print Name Title (month, day, year)
Comment: {Use this space or an attachment far any additional information.)
Donation -Library Fund
FPPC Form 801 (June108)
FPPC Tall-Free Helpline: 866/ASK-FPPC (8661275-3772)