HomeMy WebLinkAboutTHE TUTORING CENTERGift to Agency Report A Public Document GIFT TO AGENCY REPORT
agency Name
City of Tustin
)ivision, Department, or
Parks and Recreation
n (if applicable)
ss
300 Centennial Way
area Code/Phone Num
(714) 573-3326 I SKing@tustinca.org
\gency Contact (name and title)
Sarah King, Recreation Coordinator
2. Donor Name and Address
(rnonth, day,
^ Individual ~ Other The Tutoring Center
Last Name First Name Name
14041 Prospect Avenue 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) solicited or received by the donor for this gift:
Name $ Amount Name $ Amount
3. Payment Information
Date and Amount of Payment (ornerrhan travel) 6!8/2010 ~
(month, day, year)
For Offaal Use Only
Amendment (explain In comment section)
Date of Original Filing:
75.00
(Round to whole dollars)
Travel Payment Information (Rounaro wnoledonars) 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:
Sponsorship for 2010 Movies in the Park
Identify the officials for whom the payment was used:
Last Name First Name
Last Name First Name
Title
Title
DepartmenUDivision
DepartmenUDivision
4. Verification
l 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.
l
- ~ Sarah King Recreation Coordinator 8/27/10
Signature of Agency Head or e ignee Print Name Title (month, day, year)
Comment: (Use this space or an attachment for any additional informafion.)
Date Stamp
FPPC Form 801 (June/08)
FPPC ToII-Free Helpline: 866/ASK-FPPC (866/275-3772)