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HomeMy WebLinkAboutENDERLE ASSOC FOR SHOPPING CENTERGift to Agency Report A PubIIC DOCUnlent GIFT TO AGENCY REPORT . Agency Name TUSTIN POLICE DEPARTMENT Division, Department, or Region (if applicable) ADMINISTRATIVE SERVICES 300 CENTENNIAL WAY, TUSTIN, CA 92780 lrea Code/Phone Number E-mail 714-573-3300 I SFRAZIER@TUSTINCA.ORG Agency Contact (name and title) SCOTTIE FRAZIER, ACCREDITATION MANAGER 2. Donor Name and Address Date of Original Filing: (month, day, year) ^ Individual ^x Other ENDERLE CENTER MERCHANTS ASSOC Last Name First Name Name 17300 E. 17TH ST, #J-131 TUSTIN CA 92780 Address City State Zip Code - MERCHANTS ASSOCIATION FOR SHOPPING CENTER 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: OFFICER GEORGE VALLEVIENI ~ $200.00 $ Name Amount Name Amount 3. Payment Information Date and Amount of Payment (other than travel) 11/20/08 $ $200.00 (month, day, year) (Round to whole dollars) Travel Payment Information (Round ro wnore 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: FUNDS TO BE USED BY TUSTIN POLICE DEPARTMENT "SANTA COP" PROGRAM Identify the officials for whom the payment was used: Last Name First Name Title DepartmenUDivision Last Name First Name Title Department/Division 4. Verification I have determined that it is in the interests of the agency to accept this gift and use it for the official agency business described above. ~~ SCOTT M. JORDAN CHIEF OF POLICE 11/24/08 Signature of Agency ad or Designee Print Name Title (month, day, year) CDmment: (Use this space or an attachment for any additional information.) Date Stamp ITY OF TUSTII'`~~ 8 DEC - u P 5~ For Official Use Only ^ Amendment (explain in comment section) FPPC Form 801 (June/08) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) . EN~EC~LE CENTER MERCHANTS ASSOC. 17300 E. 17TH ST. STE J-131 TUSTIN, CA 92780 ,, ~~ _^ ,-~ P~ 2340 '~ 90-4284/1222 I ~~' ~' ~~' __._- '~:; ~-~~°C/'ti`C/ ~- O 1.13 J'GZ-f~~G~t / Y~ 1!JC:.HG~'G/~ ~+E. /i'" F~' /~ ~~' ~ ~ , Tustin O[fice 701 E. FIRST ST. TUSTIN, CA 92780 - ~~~~,S~e 1-8003884265 ,_ .~ - .n,,, 11'00234011^ ~:L22242843~: 65603957511 r~~ ~ C~-~~~~~kJ+.-~--C .~.~:..J-:9