HomeMy WebLinkAboutSports ClipsGift to
City of Tustin
uwtslon, ueparlment, or Keglon (if appticaole)
Parks & Recreation Dept.
300 Centennial Way, Tustin, Ca. 92760
A Public
714-573-3326 1 cwoodward@tusdnra.org
Carrie Woodward
2. Donor Name and Address
[I Individual Last Niime
First Nemo
MAR 2 7 2015 For offi"" u" Orly
TUSTIN
CITY CLERK'S OFFICE
❑ Amendment (explain In crormnenf section)
Date of Original Filing:
(nth, ay, Year)
® Other Sports Clips
Name
22 Eclipse Irvine Ca 92620
Address City state Zip Code
Business
ff'Other is marked, desaibe the entitys bueWess ad0ty (if dulness) or he nature and interests.
If applicable, identify the name of each source and the amount(s) solicited or received by the donor for this gift:
Sports Clips $ 1,150.00 $
Name Amount Name Amount
3. Payment Information
Date and Amount of Payment (otherthnn travel) $
(month, day, year) (Round W whole dollars)
Travel Payment Information(Roundtowhaedallen;) Location of Travel
Dates)of Travel 'freneponWWn Expenses $ Lodpirp Expenses $ McWExpenses $ OmerExpenses $ RAW Fxpeni
Provide a specific description of the nature and use of the payment for official agency business:
ISVDIDWMTN�oyS\Vv�aFSvsh�F 'rh,��,S ee's`�aa�, l�t�CeY�S 4th o� �u��
Identify the officials for whom the payment was used:
Leat Nance First Name Title Depenmenl/DMslon
Lest Nuns Flat Name
4. Verification
DeputmenWivsion
I have determined that it Is in interests of the agency to accept this gift and use it for the official agency business described above.
f av ri e 1�Ooc�wavd ), c imV 3 s
nature or 11.1 Head or Designee Print Name Title (monM, Y year)
Comment: (Use this space or an attachment for any additional Information.)
FPPC Form 801 (June108)
FPPC Toll -Free Helpline: 86$/ASK-FPPC (8661276-3772)