HomeMy WebLinkAbout2023 - FPPC Form 803 - Elected Officials Behested Payment Re (2) Behested Payment Report Amendment of Filing Date Stamp(Agency) CALIFORNIA 803
❑ Check box 1f an Amendment
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1. Elected Officer or CPUC Member(Last name,Fist name)
ELECTED OFFICER OR CPUC MEMBER: AGENCY NAME AGENCY STREET ADDRESS: 9 2-6 N 8
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DESIGNATED CONTACT PERSON(NAME AND TITLE): AREA CODEIPHONE NUMBER: E-MAIL:
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2. Payor Information (For additional payoffs,include an attachment with the names,addresses,and proceedng information)
NAME: - Viry,ksA.- ADDRESS: CITY: STATE: ZIP CODE:
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DAP NAME: )DONOR(S)AND DONOR'S ADVISOR:(SEE INSTRUCTIONS)
❑Donor Advised Fund(OAF)
(see inehud5one.)
Payor is a named partyor the subject of a proceeding before myagency. BRIEF DESCRIPTION OF PROCEEDINGS: k'
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3. Payee Information(For additional payees,include en attachment with the names,addresses end relationship information)
NAME: ADDRESS: CITY: STATE: ZIP CODE:
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For a nonprofit organ ion payee,provide a brief description of any relationship to the official,offciars Immediate family member or staff member In the role of founder,salaried employee,decision-meldng
capacity(board member or executive officer)or position on an honorary or advisory board.
NAME AND TITLE: ROLE WITH THE NONPROFIT ORGANIZATION: BRIEF DESCRIPTION: �+
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(MONT}AAYIYEAI� AMOUNT PAYMENT TYPE BRIEF DESCRIPTIONOF IN-KIND PAYMENT PURPOSE DESCRIBE CHA THE LEGISLATIVE,
SLAPUR VE,GOVERNMENTAL,
E RNMEMAL, n r�
` S MONETARY DONATION B LEGISLATIVE ArinuLurlL Rory- r0 k.,+''�P, truv orls- nn rl
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IN KIND GOODS OR SERVICES CHARITABLE ti'1- oh k v t s 10 C a.9 yc11...i e S
MONETARY DONATION LEGISLATIVE
GOVERNMENTAL
IN KIND GOODS OR SERVICES CHARITABLE
REASON FOR ESTIMATE:
0 The (DANrl is an estimate end reflects my best efforts at obtaining the accurate
Information.
5. Amendment Description and/or Comments(Provide date of original filing or confirmation numberin Pa it 1.)
6. Verification
I certify,under penalty of perjury under the laws of the State of California,
/that
"tto the be my knowledge,the information oontained herein is true and complete.
Executed on 'a - / it - 4-3 By c FPPC Form tiO3(February/1022)
DATE S1 NAIUKE
adviceigfppc.ca.gov
Estanislau, Robin
From: Tony Strickland <tstrickland@tonystrickland.com>
Sent: Friday, December 15, 2023 4:39 PM
To: Estanislau, Robin; Form803@fppc.ca.gov
Subject: [SUSPICIOUS MESSAGE] Fwd: Behest payment
Attachments: Behest payment 11-17 HB Mayors Ball.pdf
This Message contains suspicious characteristics and has originated outside your organization.
Here is my behested payment report from the HB Mayor's Ball that took place November 17,
2023.
If you have any questions, feel free to contact me.
Thank you,
Tony Strickland
Huntington Beach Councilman
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