HomeMy WebLinkAboutESPARZA, RONGift to Agency Report A 1'ubIIC DOCUment GIFT TO AGENCY REPORT
1. Agency Name
City of Tustin -Parks and Recreation
Division, Department, or Region (if applicable)
300 Centennial Way Tustin, CA 92780
itreet Address
{714) 573-3326
area ~oaelrnone tvumper t-malt
Sarah King sking@tustinca.org
agency Contact (name and title)
Recreation Coordinator
2. Donor Name and Address
~ Individual Esparza Ron ^ Other
Last Name First Name Name
Tustin CA 92780
Address City State Zip Code
Sponsorship for Summer Concerts in the Park
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 (orherthan travel) 06 _ 011 ~ 438.00
(mon€h; .,ay, year) (Roand to whole doltars)
Travel Payment Information (Round ro wrote dollars) t_ocation 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
Last Name First Name
Date Stamp • •
® •
ror Official Use Only
.. f
^ Amendment (explain in comment section)
Date a# original Filing:
(month, day year)
Title
Title
DepartmenUDivision
4. Verification
1 have determined that it is in the interests of the agency to accept t/~is gilt and use it for the affrcial agency business described above.
,
p ~ ~r ~ t ~
~~ , ~ture of,,gency ;' or Designee Pnnt Na,~,e E I itle (month. day ear)
'1
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Comment: (Use this space or an attachment #or any additional informatr"on.)
DepartmenUDivision
FPPC Form 801 (June/08}
FPPC ToII-Free Helpline: 866/ASK-FPPC (8661275-3772}