HomeMy WebLinkAboutTUSTIN COMMUNITY FOUNDATIONGift to Agency Report
1. Agency Name
City of Tustin
Division, Department, or Region (ifapplicabte)
street Aaaress
300 Centennial Way, Tustin, CA 92780
Brea Code/Phone Number E-mail
A Public Document
(714) 573-3010 ~ cshingleton@tustinca.org
Christine Shingleton, Assistant City Manager
2. Donor Name and Address
{month, day, year)
^ Individual Q Other Tustin Community Foundation
Last Name First Name Name
P.O. Box 362 Tustin CA 92781
Address City State Zip Code
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:
~ 7,700.00 ~
Name Amount Name Amount
3. Payment Information
Gate and Amount Of Payment {ofherthan travel)
(month, day year} {Round to whole dollars)
Travel Payment Information {Round to whore dolars) 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:
Identify the officials for whom the payment was used:
Last Name First Name
Last Name First Name
CI Y O~a`~IN
1U09 FE8 -U P 3~ 05
GIFT TO AGENCY REPORT
For Official Use Only
^ Amendment (explain in comment section)
Date of Original Filing:
Ti11e
Title
Department!Division
DepartmenVDivision
4. Verification
! have determined that it is in the interests of the agency fo accepf fhis gift and use it for the official agency business described above.
Christine Shingleton Assistant City Manager 2/3/09
Sign ure of A en y ad or Designee Print Name Title (month, day, year)
Comment: U this space or an attachment for any addifionai irtformatian. j
FPPC Form 801 (JunelO$)
FPPC Toll-Free Heipline: 866/ASK-FPPC (866!275-3772)