HomeMy WebLinkAboutBounce UGift to
A Public
and
OCT 21 2014 I I Fcr 0111c41 the
TUSTIN
CITY CLERK'S OFFICE
❑ Arnendment (expWnfncommentsecdon)
Date of Original FIBng:
(month, day, Y*ed
6'Odm' is merksd, describe the w0y's buekress acbWty (ff bwkress) w Ib MWm and Wftrests.
If applicable, identify the name of each source and the amounts) solicited or received by the donor for this gift
Oo
Nam AmouM Nana AmDunt
3. Payment Information
Date and Amount of Payment (oMeruw ""o $
(month, Choi: ysar) (ROwW to whop doers)
Travel Payment Information (aowwto whom dausm) Location of Travel
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Dah(s) otTmN fraruporbstlon Expsnws LOtlpkp Fxpenses Meal Expenses Other F_xpensas Twat 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:
lsM Name FM None Title D"Mrw*DMalcn
Last Name Fest Name Me
DspsMrwM/Dlvlabn
4. Verification
I have determined that it is in Interests of the agency to accept this gift and use it for the official agency business described above.
Ck V ' m n . Fr-&. Oooydinc��D� 1b1
IpnaWre of Apwwy Head w Dealpnse ° M Name Tile
(marts, tley deed
Comment: (use this space or an attachment for any additional information.)
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