HomeMy WebLinkAboutEnderle Center Merchants AssociationGift to Agency Report A Public Document GIFT TO AGENCY REPORT
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 Address
❑ Individual
Last Name First Name
For OMdal Use Only
Nov 2 6 2014
TUSTIN
m n FRWS OFFICE
❑ Amendment (explain In comment section)
Date of Original Filing:
(month. day, year)
® Other Enderle Center Merchants Association
New
14081 S. Yorba Street, Suite 107 Tustin CA 92780 -2050
Address City State Zip Code
Shopping Center
I( "Other' Is marked, desa" the entity's business actNity (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 (Ofharlhan travel) 11/26/2014 $ 200.00
(mOMh, day, year) (Round to whole dollars)
Travel Payment Information rpmrotowholedallars) Location of Travel
Date(s) of Travel 'frensp rt.Wn 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 Sleigh Program
Identify the officials for whom the payment was used:
Last Name First Name Title Department/Divisim
Last Name First Name Titla Department/Division
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.
�y��—^�\�
' Stephen D.
Lewis
Acting Chief of Police
11/26/2014
—Signature
tune ofAg r Head or D"nee
Pdnt Name
Title
(month, day. year)
Comment' (Use this space or an attachment for any additional information.)
FPPC Form 801 (JUne108)
FPPC Toll -Free Helpline: 866/ASK-FPPC (868!275 -3772)