HomeMy WebLinkAboutTISON, KAREN & JOSEPHGift to Agency Report
1. Agency Name
City of Tustin
Division, Department, or Region (;f appiirat
Street Address
300 Centennial Way, Tustin, CA 92780
Area CodeJPhone Number E-mail
A Public Document
(714) 573-3010 ~ cshingleton@tustinca.org
lgency Contact (name and title}
Christine Shingleton, Assistant City Manager
2. Donor Name and Address
Q Individual Tison Karen & Joseph ~ Other
Last Name First Name Name
Santa Ana CA 92705
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{sj solicited or received by the donor for this gift:
Name ~ Amount Name ~ Amount
3. Payment Information
Date and Amount of Payment (other than travel) 5/5/09 ~ 400.00
(month, day year) (Round to whole dollars)
Travel Payment information (Round to whom dollars! 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:
Library Donation
Identify the officials far whom the payment was used:
Last Name First Name
Last Name First Nama
bl 1 ~aV~t 1 t!S t 1
P7AY -5 P ~' ~0
GIFT TO AGENCY REPORT
For Official Use Only
Amendment (explain in comment section)
Date of Original Filing:
(month, day, year)
Title
Title
DepartmenUDivision
DepartmenUDivision
4. Verification
1 have determined that it is in the interests of the agency to accepf this gift and use it for the official agency business described above.
Christine Shingleton Assistant City Manager 5/5/09
...........
S na e o Agency r Designee Print Name Title (month, day, year)
Comment: (Use this space or an attachment for airy additional information.)
FPPC Form 801 (June/0$)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866!275-3772)