HomeMy WebLinkAboutKarl TipreGift to Agency Report A Public Document GIFT TO AGENCY REPORT
City of Tustin
or
Police Department
NOV 12 2014
For Offidal Use Only
street Address TUSTIN
CITY CLERK'S OFFICE
300 Centennial Way, Tustin, CA 92780
rea Cadet/Phone Number E-mail Amendment fexplain in comment section)
(714) 572 1 saltken @tus6nca.org
Date of Original Filing:
(month, day, year)
Shannon Aitken Executive Secretary
and Address
® Individual Tipre Kart ❑ Other
Last Name First Name Name
Tustin CA 92780
Address city state Lp Code
Association
If -Other' Is marked, describe the entilys 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:
Amount Name Anwurrt
3. Payment Information
Date and Amount of Payment (other than travel) 11/06/2014 $ 150.00
(month, day, year) (Round to whole da7am)
Travel Payment Information (Roundtownoisdona ) Location of Travel
Data(s) of Travel Transpatatbn Expenses Lotl9ing Expenses $ Meal- xi: penses $ 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 Cop Program
Identify the officials for whom the payment was used:
Last Name
First Name
Title
Department/Division
Last Name
DeparmrenUDwIs on
First Name
Title
4. Verification
ermined th
it is in the interests of the agency to accept this gift end use it for the official agency business described above.
raven
Acting Chief of Police
11/06/2014
I9n
or Designee Pnnt Name
TMe
(month, day. year)
Comment: (Use this space a an attachment tar any additional information.)
FPPC Form 801 (June/08)
FPPC Toll -Free Helpllne: 8661ASK -FPPC (88612753772)