HomeMy WebLinkAboutDUNN, LAURIEGift to Agency Report A Public Document
1. Agency Name
City of Tustin ~~
Division, Department, or Region (if applicable)
Street Address ',
300 Centennial Way, Tustin, CA 92780
Area Code/Phone Number E-mail
(714) 573-3010 cshingleton@tustinca.org
Agency Contact (name and title) ',
Christine Shingleton, Assistant City Manager
2. Donor Name and Address
GIFT TO AGENCY REPORT
V~~mp
_5 P 4: 03
For Official Use Only
^ Amendment (explain in comment section)
Date of Original Filing:
(month, day, year)
^x Individual Dunn Laurie ^ Other
Last Name First Name Name
Santa CA 92705
Address City State Zip Code
!f "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 of Payment (ether than travel) 5/5/09 ~ $400.00
(month, day year) {Round to whole dollars)
Travel Payment Information (Round to whore aonarsl Location of Travel
Date{s1 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:
Library Donation
Identify the officials for whom the payment was used:
Last Name First Name Title DepartmentlDivisian
Last Name First Name Title DepartmenUDivision
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.
_ Christine Shingleton Assistant City Manager 5/5/09
S na ure at ncy Head or Designee Print Name Title (month, day, year)
COmmen . (Use this space or an attachment for any additional information.)
FPPC Form 801 IJunet08)
FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772)