HomeMy WebLinkAboutMORSE, DAVID & MURIELGift to Agency Report
1. Agency Name
City of Tustin
Division, Department, or Region (if applicable)
A Public Document
GIFT TO AGENCY REPORT
Date Stamp
0~ ~U~~ i~
For Official Use Only
Street Address
300 Centennial Way, Tustin, CA 92780
-rea CodelPhone Number E-mail
(714) 573-3010 ~ cshingleton@tustinca.org
Agency Contact (name and title)
Christine Shingleton, Assistant City Manager
2. Donor Name and Address
Q Individual Morse David & Muriel
^ Amendment (explain in comment section)
Date at Original Filing:
(month, day, year)
^ Other
Last Name First Name Name
Tustin CA 92780
Address Gity 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:
$ ~
Name Amount Name Amount
3. Payment Information
Date and Amount of Payment (other than travel) 2/6/09 ~
(month, day year}
400.00
(Round fo whole dollars)
Travel Payment Information (Round to whole dollars) Location of Travel
Date{sl 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:
Library Building Fund
Identify the officials for whom the payment was used:
Last Name First Name Title Department(Division
Last Name First Name
Title
DepartmenUDivision
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.
Christine Shingleton Assistant City Manager 2/17/2009
Signature of Agency Hea or De i ttee Print Name Title (month; day, year)
Comment: (Use this space or an attachment for any additionat information.)
FPPC Form 801 June/08)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866!275-3772)