HomeMy WebLinkAboutHILL, MARKGift to Agency Report
1. Agency Name
City of Tustin -Parks and Recreation
ion, Department, or Region (itappticabte)
300 Centennial Way Tustin, CA 92780
(714) 573-3326
area CodelPhone Number E-mail
Sarah King sking@tustinca.org
(name and title}
Recreation Coordinator
2. ®onor Name and Address
^ Amendment (explain rn comment section}
Date of Original Filing:
(month, day, year)
Q Individual Hill Mark ^ ether
Last Name First Name Name
Tustin CA 92780
Address City State Zip Code
Sponsorship for Summer Concerts in the Park
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:
Name ~ Amount Name ~ Amount
3. Payment Information
Date and Amount of Payment {other than traveq 06/03/2011 ~ 438.00
(month, day, year) (Round to whole dollars)
Travel Payment Information (Round to Whole donors) Location of Travel
Dates} 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
DepartmentlDivision
Last Name First Name Title Department'Division
4. Verification
have determinedat it is in the interests of the agency to accept this gift and use it for the officio( agency business described above.
~~ ~ ~-~ ~ ~. i ~_
~' ~ ~ ~~ ~ f - ~ . ' ~ s'~_i .. ~
~:~nature of Agency H d~r Designee Pn t Name Tine (month, a year)
Comment: (Use ttn~ space or an attachment for any additional intormation.)
FPPG Form 84'1 {June/08)
FPPG Toll-Free Helpline: 866/ASK-FPPG (8661275-3772}