HomeMy WebLinkAboutTustin Effective Apartment Managers Gift to Agency Report A Public Document GIFT TO AGENCY REPORT
1.Agency Name Date Stamp a 1 ornia 801
City of Tustin - C1 ,%, ID) Form
Division, Department, or Region (if applicable) For Official Use Only
Police Department DEC 2'3 2015
Street Address
TUSTIN
300 Centennial Way, Tustin, CA 92780 CITY CLERK'S OFFICE
Area Code/Phone Number E-mail ❑ Amendment(explain in comment section)
(714) 573-3300 saitken@tustinca.org
Agency Contact (name and title) Date of Original Filing:
(month,day,year)
Shannon Aitken Executive Secretary
2. Donor Name and Address
1:1 Individual Z Other Tustin Effective Apartment Managers
Last Name First Name Name
15701 Tustin Village Way#I-7 Tustin CA 92780
Address City State Zip Code
Association
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 amount(s)solicited or received by the donor for this gift:
$ $--
Name Amount Name Amount
3. Payment Information
Date and Amount of Payment(other than travel) 12/22/2015 $ 100.00
(month,day.year) (Round to whole dollars)
Travel Payment Information(Round to whole dollars) Location of Travel
$ $ $ $ $---
Date(_)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 used:
Last Name First Name Title Department/Division
Last Name First Name Title 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.
CHARLES F. CELANO, JR. Chief of Police 12/22/2015
Signature of Agency Head or Designee 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:866/ASK-FPPC(866/275-3772)