HomeMy WebLinkAboutBRANNON, JEFFGift to Agency Report A Public Document GIFT TO AGENCY REPORT
agency Name
City of Tustin
or
300 Centennial Way, Tustin, CA 92780
-rea Gode/Phone Number E-mail
(714) 573-3000 cshingleton@tustinca.org
~g®nCy Contact (name and title)
Christine Shingleton, Assistant City Manager
2. Donor Name and Address
Date Stamp
For Official Use Only
^ Amendment (explain in comment section)
Date of Original Filing:
(month, day, year)
~ Individual Brannon Jeff ^ Other
Last Name First Name Name
P.O. Box 1635 Tustin CA 92781
Address City State Zip Code
If "Other" is marked, describe the entity's business activity ('rf 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 (ornerrnan travel) 12/1/2010 $ $400.00
(month, day, year) (Round to whole dollars)
Travel Payment Information (Round to wnole 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:
Identify the officials for whom the payment was used:
Last Name First Name Title Department/Division
Last Name First Name Title DepartmenUDivision
4. Verification
/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 12/1/2010
Print Name Title (month, day, year)
Comment: (Use thi~pace or an attachment for any additional information.)
FPPC Forrn 801 (June/08)
FPPC Toll-Free Helpllne: 866/ASK-FPPC (866/275-3772)