HomeMy WebLinkAboutLa Tourette, KennethGift to Agency Report A Public Document GIFT TO AGENCY REPORT
1. Agency Name
City of Tustin
: i
MAY 15 2012
For Official Use Only
Division, Department, or Region (if applicable)
Parks and Recreation
FFICE- TUSTIN CITY CLERK
Street Address
300 Centennial Way, Tustin, CA 92780
Area Code /Phone Number E -mail
❑ Amendment (explain in comment section)
714 - 573 -3326 Dwilson @tustinca.org
Date of Original Filing:
(month. day, year)
Agency Contact (name and title)
David Wilson, Director Parks and Recreation
2. Donor Name and Address
0 Individual La Tourette Kenneth
❑ Other
Last Name First Name Name
Tustin CA 92780
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:
Name $ Amount Name $ Amount
3. Payment Information
Date and Amount of Payment (otherthan travel) 04/07/2012 $ 438.00
(month, day year) (Round to whole dollars)
Travel Payment Information (Round to whole 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:
2012 Concerts in the Park Sponsorship
Identify the officials for whom the payment was used:
Last Name
First Name
Last Name First Name
4. Verification
Title
Department/Division
Title Department/Division
I have dete/�med that it is in the interests of the agency to accept this gift and use it for the official agency business described above.
v Sarah King Recreation Coordinator 5/14/12
nature of Agency ead or esignee Print Name Title (month, day. year)
Comment: (Use this space or an attachment for any additional information.)
FPPC Form 801 (Junell
FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275 -37721