HomeMy WebLinkAboutPerformance Media MarketingGift to Agency Report A Public Document r,If T To A! iFNCY REPORT
1. Agency Nan
City of Tustin
Police Department
300 Centennial Way, Tustin, CA 92780
(714) 573 -3300 1 saitken @tustinca.org
Shannon Aitken Executive Secretary
2. Donor Name and
Date Stamp l'T- 11+1�UI1litJ � '
v
FC F,ffl D
For Official Use Only
Nov 2 6 2014
Tus-nN _
in comment section)
Date of Original Filing:
(month, day, year)
❑ Individual ❑x Other Performance Media Marketing
Last Name First Name Name
150 El Camino Real Tustin CA 92780
Address City State Zip Code
Marketing
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 amounts) solicited or received by the donor for this gift:
$ Amount Name $ Amount
3. Payment Information
Date and Amount of Payment (olharthan travel) 11/26/2014 $ 150.00
(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:
Donation to the Tustin Police Department Santa Cop Program
Identify the officials for whom the payment was uued.
Last Name First Name Title DepartmenttQvislon
Last Name First Name Title DepartmentlDivision
4. Verification
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.
Stephen D.
4e,
Lewis
Acting Chief of Police
11/26/2014
ignat f Agen esignee
Print Name
Title
(month, day. year)
Comment: (Use this space or an attachment for any additional information.)
FPPC Form 801 (June/08)
FPPC Toll -Free Helpline: 866tASK -FPPC (8661275.3772)