HomeMy WebLinkAbout803 Lisa Middleton 2019-11-13 Donn MacMillanRECEIVED
Behested Payment Report A PubftTDo@GIPIAlbt9 SPRINGS Behested Payment Report
1. Elected Officer or CPUC Member (Last name, First name) 2019 NOV ! pMDf SrCp
Middleton, Lisa
%U'l—y ,. '.J� 7 l ;: 0C 11NL- rC11 Y CLF. .
City of Palm Springs
Canyon Way, Palm Springs CA 92262
❑ Amendment (see Fart 5)
For Offival Use Only
Area Code/Phone Number E-mail (Optional) Date of Original Filing:
760-5Lisa.middleton@palmspringsca.gov monn.dayJead
07-7851
payors, include anattachment mth namles and addresses.)
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Address City State Zip code
3. Payee Information (For additional payees. Include an attachment with the names and addresses)
Equality California
3701 Wilshire Blvd. # 725 Los Angeles CA 90010
Address City State Zip Code
4. Payment Information (Complete alhnhormaeonJ s�
10/19/2019
Date of Payment: Amount of Payment: (In-FindFMv) $ $ate
(month. day, year) (Round to whole dollars.)
Payment Type: ® Monetary Donation or ❑ In -Kind Goods or Services rproWde description below)
Brief Description of In -Kind Payment:
Purpose: (Check one and prowde description below) ❑Legislative ❑Governmental ❑x Charitable
Describe the legislative, governmental, charitable purpose, or event:
Donation to Equality California 2019 Palm Springs Awards Gala
5. Amendment Description and/or Comments
` a
6. Verification
I certify, under penalty of perjury under the laws of the State of Califomi at to the best of my knowledge, the information contained
herein is true and complete.
November 13, 2019 ' Y
Executed on By
DATE SIGNATURE OF ELECTED OFFICER OR CPUC MEMBER
FPPC Form 803 (January/2018)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)