HomeMy WebLinkAboutTustin Host Lions ClubGift to Agency Report A Public Document GIFT TO AGENCY REPORT
City of Tustin
Uivlslon, Department, or Region (if applicable)
Tustin Police Department
300 Centennial Way, Tustin, CA 92780
(714) 573 -3300 1 sakken @tusfinca.org
Shannon H. Aitken, Executive Secretary
Name and Address
❑ Individual
Last Name First Name
SEP 2 5 2014
TUSTIN
CITY CLERK'S OFFICE
For Official Use Only
❑ Amendment (exptain m comment section)
Date of Original Filing:
(month, day, yew)
® Other Tustin Host Lions Club
Name
P.O. Box 66 Tustin CA 92781
Address city State Zip Code
Club /Non -Profit Organization
If -Other Is marked, describe the entity's business activity (ff business) or its "wTs 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 (olherthan travel) 09 -24 -2014 $ 100.00
(month, day, year) (Round to whole dollars)
Travel Payment Information (Round to wholedatars) Location of Travel
Date(s) of Travel Transportatbn Expenses $ —Lodging $ Meal Expanses $ Other Expenses $ Total Expenses
Provide a specific description of the nature and use of the payment for official agency business:
Donation to the Tustin Police Department Santa Sleigh program.
Identify the officials for whom the payment was used:
Last Name First Name
Last Nam Rrst Name
4. Verification
Title DepanmwIlDivlslon
Title Deparimr VMlvislon
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.
Charles F. Celano, Jr. Chief of Police 09/24/2014
C—ZWZ;�ncy Head or Designee Print N'mre Title (month, day, year)
Comment: (Use this space wan attachment for any additional information.)
FPPC Form 801 (June/08)
FPPC Toll -Free Helpline: 86WASK -FPPC (86612753772)