HomeMy WebLinkAboutD.C. EichingerGift to Agency
1. Agency Name
City of Tustin
Police Department
300 Centennial Way, Tustin, CA 92780
A Public Document
(714) 573 -3300 I sailkenOlustinca.org
Agency Contact (nnmo 41d kilo)
Shannon Aitken Executive Secretary
2. Donor Name and Address
�O PFT VACENCy REPORT
Far Official Use Only
JAN 72 1 2?I5
TUSfIN
CITY CLERK'S OFFICE
❑ Amendment a q:bnn m r onunnnl aechon)
Oath of Original Flling�
(monllr, dny, ymlr)
[] Individual Eichinger D.C.
Ln.I Mine rn IN .mo ❑Other
Nome
Tustin
Addro CA 92780
city Slate Zip Code
11.Olhor ,. marked do robe Ihr r. r.g4. business,Xln -Jr el hu ne s w a ,,wn nd iow,. I
If applicable, identify the name of each source and the amount(s) so8cltod or received by the donor for this gift
Namr' $ Amount $
Name Amuunl
3. Payment Information
Date and Amount of Payment l flier ft. lrrrrr: V; 01/15/2015 $ 100.00
Inlonllr, d,ry y,,.') (RNmdln whole dollars)
Travel Payment Information 1R0Umr10 wholedoll;,rs) Location of Travel
A $ $ $
04, t - I Travel Transponalion Expenses Lodytng Eepun $ M. 11 , ,
a, Omer Expenses Tolnl Expense
Provide a specific description of the nature and use of the payment for official agency business:
Donation to the Tustin Police Department Santa Cop Program
Identify the officials for whom the payment was used:
N u"e First Name
L � N..,: a Firs] Name
Oepworsenvontaem
OeparlmenVDrvrla,
4. Verification
thaw determined that it is in the Interests of the agency to accept this gill and use 1' for the offlciat agency business described above
Charles F. Celano, Jr. Chief of Police 01 -15 -2015
�eney Head or Designee Prim Name
Comment: (Use lths space or an attachment for any additional information.)
FPPC Form 801 (June108)
FPPC Toll-Free Helpllne: 8661ASK -FPPC (8661275.3772)