HomeMy WebLinkAboutENDERLE CENTER MERCHANTS ASSOCIATIONGift to Agency Report
'!.Agency Name
City of Tustin
Division, Department, or Region (if applicable)
Police Department
300 Centennial Way
Brea Cade/Phone Nun
714-573-3306 ~ pfoley@tustinca.org
(name and tit/e)
Penni Foley
2. Danar Name and Address
A Public Document
GIFT TO AGENCY REPORT
Date stamp
Far Official Use Only
^ Amendment (explain in comment section)
Date of original Filing:
(month, day, year)
^ Individual ~ Other Enderle Center Merchants Assoc
Last Name First Name Name
14081 S. Yorba St.; Ste 107 Tustin CA 92780
Address City State Zip Code
Merchants Association
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 (arharthan rraver) 1117-2011 ~ 200.00
(month, day, year) (Round to whole dollars)
Travel Payment Information (Round to whole aouars) Location Of Travel
$ $ $
Dates} 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 to the Tustin Police Department Santa Sleigh Program.
identify the officials for whom the payment was used:
last Name First Name Title
DepartmenttDivision
Last Name First Name Title Department/Division
4. Verification
!have determined that it is in the interests of the agency fo accept fhis gift and use it for fhe official agency business described above.
Scott M. Jordan Chief of Police 12-01-2011
5~ynature of Agency Fi~ad o Designee Print Name Title (month, day, year)
Comment: (Use this space or an attachment for any additional intonnation )
FPPC Form 801 (June/08)
FPPC ToII-Free Helpline: 866/ASK-FPPC (866!275-3772)