HomeMy WebLinkAboutTWEEDT, SANDRAGift to Agency Report
1. Agency Name
City of Tustin
Division, Department, or Rep
300 Centennial Way, Tustin, CA 92780
-rea Code/Phone Number E-mail
(714) 573-3010 cshingleton@tustinca.org
-genCy Contact (name and title)
Christine Shingleton, Assistant City Manager
2. Donor Name and Address
(month, day, year}
Q Individual Tweedt Sandra ^ Other
Last Name First Name Name
North Tustin CA 92705
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) solicited or received by the donor for this gift:
Same as above ~ 400.00 ~
Name Amount Name Amount
3. Payment Information
Date and AmOUnt Of Payment (other than travel)
(month, day year) (Round to ~•vhole dollars)
Travel Payment Information (Round to whole aonars) Lacatian of Travel
Date(s) of Travel Transportation Expenses ~ Lodging Expenses ~ Meal Expenses ~ Other Expenses ~ Total Expenses
Pravide 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 DepartmenUDivision
4. Verification
I have defermined that it is in the interests of the agency to accept this gift and use it for the official agency business described above.
~~2~-- Christine Shingleton Assistant City Manager 2/2/09
Sig ature of Agen ead or Designee Print Name Title {month, day, year)
Comment: ( this space or an attachment for any additional information.)
A Public Document
~I~Y ~
zoos ~r_~ ~3 P 4.3~
GIFT TO AGENCY REPORT
For Official Use Only
^ Amendment (explain in comment section)
Date of Original Filing:
FPPC Form 801 (June/OS)
FPPC Toll-Free Heipline: 866/ASK-FPPC (8661275-3772)