HomeMy WebLinkAboutTUSTIN MEM FUND/TUSTIN POLICE RESERVE PROGRAMGift to Agency Report
1. Agency Name
City of Tustin
A Public Document
Division, Department, or Region (rfapplicable)
POlice Department
300 Centennial way
rea c;oae/rnone
714-573-3252 I sfrazier@tustinca.org
-gency Contact (name and title)
Scottie Frazier, Accreditation Manager
2. Donor Name and Address
CI 1 1 eVfm~UJ 1
T049 APR I U P
GIFT TO AGENCY REPORT
For Official Use Only
51
Amendment (explain in comment section)
Date of Original Filing:
(month, day, year)
^x Individual Saunders Bradley ~ Other
Last Name First Name Name
4013 Hoosier Lawn Way Yorba Linda CA 92886
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:
Tustin MEm Fund -Baker to Vegas $ 250.00 Tustin Police Reserve Program $ 1,000.00
Name Amount Name Amount
3. Payment Information
Date and Amount of Payment (other than travel) 3-18-09 $
(month, day, year)
Travel Payment Information (Round to whole dollars) Location of Travel
(Round to whole dollars)
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
Title
Department/Division
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.
r~~, J~ Scott M.Jordan Chief of POlice 4-9-09
Signature of/Agen f ead or Designee Print Name Title (month, day, year)
Comment: (Use this space or an attachment for any additional information.)
$1,250.00
FPPC Form 801 (June/08)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)