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HomeMy WebLinkAbout803 Christy Gilbert Holstege 2020-01-02 PS ResortsBehested Payment Report A Publ' d -p Behested Payment Report 1. Elected Officer or CPUC Member (Last name, First name) Date Stamp ' Christy Gilbert Holstege 2020 JAN - 2 PM 3: 4 0 Agency Name For 011kial use only City of Palm Springs OFFICE OF I iE CITY CLERi 3200 E Tahquitz Canyon Way ❑ Amendment (See Part 5) Christy Gilbert Holstege Area CodelPhone Number E-mail (Optional) Date of original Filing: (760) 323-8299 christy.holstege@palmspdngsca.gov 2. Payor Information (For additional payers, include an attachment with the names and addresses.) PS Resorts P.O. BOX 4607 Palm Springs CA 92263 Address City State Zip Code 3. Payee Information (For additional payees, include an attachment with the names and addresses.) Equality California Name 3701 Wilshire Blvd, Suite 725 Los Angeles CA 90010 Address city State zip Code 4. Payment Information (camplaaaamromaee ) Date of Payment: 11/25/2019 Amount of Payment: (in-rcndFidv) $ 5,000 (month, day, year) (Round to whole dollers.) Payment Type: ® Monetary Donation or ❑ In -Kind Goods or Services (Provide desrnptlenbelow) Brief Description of In -Kind Payment: Purpose: (Cheer one and pmNdo desarptlen below) ❑ Legislative ❑ Governmental ® Charitable Describe the legislative, governmental, charitable purpose, or event: Equality California Palm Springs Awards 2019 5. Amendment Description and/or Comments I was notified on 12/12/2019 that this was received by the payee. 6. Verification I certify, under penalty of perjury under the laws of the State of California, that to the best of my knowledge, the information contained herein is true and complete. Executed on 1/212OW By. DATE SIG NA GF ERECTED OFFICER M CPUC MEMBER FPPC Form 803 (January/2018) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)