HomeMy WebLinkAboutCORTESE, MARCI & JIMGift to Agency Report
1. Agency Name
City of Tustin
Department, or Region (if applicable)
itreet Address
300 Centennial Way, Tustin, CA 92780
lrea Code/Phone Number E-mail
A Public Document
Date Stamp
CiiY OF iUS~I
2009 FED 2 ~ A
(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 Cortese Marci & Jim ^ Other
Last Name First Name Name
Tustin CA 92780
Address City State Zip Code
If "Other" is marked, describe the entity's business activity (if business) ar its nature and interests.
(f applicable, identify the name of each source and the amounts} solicited or received by the donor for this gift:
Name Amount
Name
GIFT TO AGENCY REPORT
For Official Use Only
2Q
Amount
3. Payment Information
Date and AmOUnt Of Payment {other than travel)
2/26/2009
{month, day year)
~ 400.00
{Round to whole dollars)
Travel Payment Information {Round to wnae dotrars) Location of Travel
Date(s) of Travel Transportation Expenses ~ Lodging Expenses ~ Meal Expenses ~ Other Expenses $ Total Expenses
Pravide a specific description of the nature and use of the payment far official agency business:
Library Building Fund
Identify the officials for whom the payment was used:
Last Name First Name
Last Name First Name
Title
Title
DepartmenUDivision
4. Verification
t 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.
Christine Shingleton Assistant City Manager
Signature of Agency d or ~esignee Print Name Title
COt7lment: (U e this space or an attachment for any additional irtformafion.)
2/26/09
(month; day, year)
^ Amendment {explain in comment section)
DepartmentlDivision
FPPC Form 801 (June/08)
FPPC ToII-Free Heipiine: 866/ASK-FPPC ($66!275-3772)