HomeMy WebLinkAboutCHEN, GLENNGift to Agency Repart
1. Agency Name
City of Tustin
uepartment, or
300 Centennial Way, Tustin, CA 92780
lrea Code/Phone Number E-mail
GIFT TO AGENCY REPORT
For Official Use Only
^ Amendment (explain in comment section)
(714) 573-3010 cshingleton@tustinca.org
Agency Contact (name and title) Date of Original Filing:
(month, day, year}
Christine Shingleton, Assistant City Manager
2. Donor Name and Address
~ Individual Chen Glenn ^ Other
Last Name First Name Name
Tustin CA 92782
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:
Name ~ Amount Name ~ Amount
3. Payment Information
Date and Amount ofi Payment (other man travel) 2/11/09 ~
(month, day year}
CITY 0~'~"~~N
2009 ~EB 2 0 Q l0~ { S
400.00
{"Round fo whole dollars}
Travel Payment Information (Round fo whore douars} Location of Travel
Date(s) of Travel transportation Expenses ~ Lodging Expenses ~ Meal Expenses ~ Other Expenses ~ Totai Expenses
Provide a specific description of the nature and use of the payment far official agency business:
Library Building Fund
Identify the officials for wham the payment was used:
Last Name First Name
Title
Department!Division
Last Name First Name Title DepartmenL'Division
4. Verification
1 have determined that it is in the interests of the agency to accept this ,gift and crse it for the official agency business descrihed above.
,ss (,,~~~1t~/.l~-tom Christine Shingleton Assistant City Manager
Signature ofAg~y~Hea or D ig e` e' ` Print Name Title
Comment: (Use this space or an attachment for any additional information.)
2/17/2009
(month, day, year}
A Public Document
FPPC Form 801 (June/08)
FPPC Toll-Free iieipline: 866/ASK-FPPC (866!275-3772)