HomeMy WebLinkAboutELIDO JR., ROMEOGift to
rt
. Agency Name
City of Tustin
or
n {if appficable)
itreet ~aaress
300 Centennial Way, Tustin, CA 92780
A Public Document
(714) 573-3010 ~ cshingleton@tustinca.org
tgency Contact (name and title)
Christine Shingleton, Assistant City Manager
2. Donor Name and Address
Date Stam
I i ~ OF TU~ai~IN
FEP~ -3 P t~.:
Q Individual Elido, Jr. Romeo ^ Other
Last Name First Name Name
Tustin CA 92782
Address City State Zip Coda
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 (otnertnan travarl
(month, day year)
Travel Payment Information {Round to whole dorrars)
Location of Travel
Date{s) of Travel Transportation 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:
Identify the officials for whom the payment was used:
Last Name First Name Title
Last Name First Name
^ Amendment (explain in comment section)
Date of Original Filing:
(month, day, year)
(Round to whole dollars)
Title
DepartmenUDivision
4. Verification
!have determined that it is in the interests of the agency to accepf fhis gifr and use it for the official agency business described above.
` Christine Shingleton Assistant City Manager 2/2/09
ignat (Agency Head or Designee Print Name Title (month. day, year)
COmment: {Use this space or an attachment for any additional information.)
GIFT TO AGENCY REPORT
For Official Use Only
Department/Division
FPPC Form 807 (June/08)
FPPC Toll-Free Helpline: 8fi6tASK-FPPC {8661275-3772}