HomeMy WebLinkAbout801 Payment to Agency Report (Wafu School of Ikebana)Payment to Agen
1. Agency Name
City of Cupertino
Division, Department,
City Manager
Re
or Region (if applicable)
A Public Document
10300 Torre Ave Cupertino Ca, 95014
krea Code/Phone Number Email
408-777-3225 LaurenS@cupertino.gov
Agency Contact (name and title)
Lauren Sapudar, City Clerk
2. Donor Name and Address
Date Stamp
RECEIVED
MAR 10 2026
CUPERTINO CITY CI
PAYMENT TO AGENCY REPORT
For Official Use Only
❑ Amendment (explain in comment section)
Date of Original Filing: 03/10/26
(month, day, year)
❑ Individual ® Other
Wafu School of Ikebana, California Chapter
Last Name First Name Name
22576 Poppy Drive Cupertino Ca 95014
Address City State Zip Code
School for Japanese art of floral arranging
If "Other" is marked, describe the entity's business activity (if business) or its nature and interests
0 If applicable, identify the name of each source and the amount(s) received by the donor for this payment:
Fusako Hoyrup $ 400.00 $
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)
❑ Rail ❑ Air ❑ Bus ❑ Auto ❑ Other
Transportation Provider Check Applicable Boxes 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) Total Expenses
3.2. Payment Description. Provide a specific description of the payment and its agency purpose and use.
Flower arrangement donation for display at City of Cupertino State of the City event on 2/26/26
3.3. Identify the officials who used the payment in Section 3.1 (See instructions)
Last Name First Name Position/Title Department/Division
Last Name First Name Position/Title Department/Division
4. Verification
I authorize C tI'e of the reported payment(s) as in compliance with FPPC regulations.
Tina Kapoor City Manager 03/10/26
Signature Print Name Title (month, day, year)
Comment:
(Use this space or an attachment for any additional information)
FPPC Form 801 (Jan/18)
advice@fppc.ca.gov