801 Payment to Agency Report (KeyPoint Credit Union) 09-18-24Payment to Agency Report A Public Document PAYMENT TO AGENCY REPORT
California
Form
1. Agency Name
Agency Contact (name and title)
Street Address
Amendment
Date Stamp
Email
Division, Department, or Region (if applicable)
801
(month, day, year)
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Area Code/Phone Number
Date of Original Filing:
(explain in comment section)
2. Donor Name and Address
Individual Other NameLast Name First Name
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) received by the donor for this payment:
$ $ Name Amount Name Amount
3. Payment Information (Complete Sections 3.1 (a or b), 3.2, 3.3)
3.1 (a) Travel Payment
Location of Travel Dates (month, day, year)
Transportation Provider
Rail Air Bus
Check Applicable Boxes
Auto Other
Name of Lodging Facility
$ Lodging Expenses $ Meal Expenses $ Transportation Expenses $ Other Expenses
$ Total Expenses
3.1 (b) Payment(s) not related to travel: $
Dates (month, day, year) 7RWDO([SHQVHV
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Last Name First Name Position/Title Department/Division
Last Name First Name Position/Title Department/Division
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I authorized the acceptance of the reported payment(s) as in compliance with FPPC regulations.
Signature Print Name Title (month, day, year)
Comment:
8VHWKLVVSDFHRUDQDWWDFKPHQWIRUDQ\DGGLWLRQDOLQIRUPDWLRQ FPPC Form 801 (Jan/1)
advice@fppc.ca.gov
City of Cupertino
City Manager's Office
10300 Torre Avenue, Cupertino, CA 95014
408-777-320 kirstens@cupertino.gov
Kirsten Squarcia, City Clerk
■KeyPoint Credit Union
10815 N Wolfe Rd #100 Cupertino CA 95014
KeyPoint is a banking institution in Silicon Valley
Persian Kebabs 643.53
KeyPoint sponsorship of food served at a Professional Women's Luncheon. City employees
attended the event in an official capacity for economic development purposes.
Degu Daniel Economic Development Ma City Manager
Pamela Wu City Manager 09/18/24
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