HomeMy WebLinkAboutLILA DOG PRODUCTIONS DBA:CURTAIN CALLGift to Agency Report A Public Document GIFT TO AGENCY REPORT
agency Name
City Of Tustin
)ivision, Department, or
Parks and Recreation
300 Centennial Way
714/573-3326
tgenCy Contact (name and title)
Sarah King
Sking@tustinca.org
2. Donor Name and Address
^ Individual
Last Name First Name
C t i t ~ i`
~~~~ ~~P ~ Q /~ g: ~ v
(month, day, year)
^x Other t_ila Dog Productions DBA: Curtain Call
Name
690 EI Camino Real 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 (other Than traveq 09/10/2010 $ 100.00
(month, day, year) (Round to whole dollars)
Travel Payment Information (Round to whore dollars) 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:
Donation for Tustin Tiller Days
Identify the officials for whom the payment was used:
Last Name First Name
Last Name First Name
Title DepartmenUDivision
Title DepartmenUDivislon
4. Verification
I have determined th t it istin the interests of the agency to accept this gift and use it for the official agency business described above.
r~
J
ure of Agency ead or a nee Print Name Trfle (mon h, da ,year)
t
Comment: (Use this space or an attachment for any additional information.)
For Official Use Only
^ Amendment (explain in comment section)
Date of Original Filing:
FPPC Form 801 (June/OS)
FPPC Toll-Free Helpllne: 8661ASK-FPPC (8661275-3772)