HomeMy WebLinkAboutO'TOOLE, NANCYGift to Agency Report
1. Agency Name
City of Tustin
Division, Department, or Region (ifapptirab/e)
Street Address
300 Centennial Way, Tustin, CA 92780
Area Cade/Phone Number E-mail
A Public Document
(714) 573-3010 `cshingleton@tustinca.org
tgency Contact (name and title)
Christine Shingleton, Assistant City Manager
2. Donor Name and Address
~ Individual O'Toole Nancy ^ Other
Last Name First Name Name
Tustin CA 92780
Address City State Zip Code
1f "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 (ether than travel} 5/5/09 $ $400.00
(month, day year} {Round to whole dollars)
Travel Payment Information (Round to whore dollars} Location of Travel
Date(s) of Travel T~ransporfation 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 Donation
Identify the officials for whom the payment was used:
Last Name First Name
Last Name First Name Title DepartmenUDivision
4. Verification
f have determined that it is in the interesfs of fhe agency to accept this gift and ttse if for the official agency business described above.
Christine Shingleton Assistant City Manager 5/5/09
Signature ofA cy ead or esignee Print Name Title (month, day, year)
Comment se this space or an attachment for arty additional information.)
GIFT TO AGENCY REPORT
Dater, `r~~~~ •' • ,
TY ~~ 1 U ~
For Official Use Only
I MA`( -5 'P 4' ~
^ Amendment (explain in comment section)
Date of Original Filing:
(month, day, year)
Title
DepartmentlDivision
FPPC Form 801 {Junef08j
FPPC Toll-Free Helpline: 866fASK-FPPC (866!275-3772)