HomeMy WebLinkAboutD.C. EichingerGift to Agency Report A Public Document GIFT TO AGENCY REPORT
City of Tustin i ULA J�U��
)ivision, Department, or Region (if applicable) For ofrcial Use Or
Police Department FEB 9 2016
itreet Address TUSTIN
300 Centennial Way, Tustin, CA 92780 CITY CLERK'S OFFICE
lrea Code/Phone Number E-mail
Amendment (explain in comment section)
(714) 573-2 1 saitken@tustinca.org
\gency Contact (name and title) Date of Original Filing:
(month, day, year)
Shannon Aitken Executive Secretary
2. Donor Name and Address
❑X Individual Eichinger D. C. ❑ Other
Last Name First Name Name
Tustin CA 92780
Address City State Zip Code
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) 02/02/2016 $ 100.00
(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 used:
Last Name First Name
4. Verification
Title
Department/Division
Department/Division
1 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.
oNt==i�
Charles F. Celano, Jr. Chief of Police 02-04-2016
n f Agency Head or Designee Print Name Title (month, day. year)
Comment: (Use this space or an attachment for any additional information.)
FPPC Form 801 (Junel08)
FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772)