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HomeMy WebLinkAbout803 Lisa Middleton 2019-11-13 Harold MatznerBehested Payment Report 1. Elected Officer or CPUC Men Middleton, Lisa City of Palm Springs 760-507-7851 RECEIVEDAopb- INGS (Last name, First nartq,►9 NOV 13 OFF Canyon Way, Palm Springs CA 92262 2. Payor Information (Foradditionalpay+rs, include an Stamp C L ER, ❑ Amendment (See Pan 5) Ballasted Payment Report For Offical Use Only Date of Original Filing: (month, day. year) the names and addresses.) Name ) (� —( "c 1�p� 1—I l % Et.-_wJ�t>_.XSo(� r�.2�.C_ t�i� �i�4� 1 Address City stale 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 4. Payment Information (Compkk all information i Date of Payment: 10/19/2019 Amount of Payment: (In-xindFmv) $ (mood., day, year) (Round M whole dollars) Payment Type: p Monetary Donation or ❑ in -Kind Goods or Services (Provide dewnpeon beaw) Brief Description of In -Kind Payment: Purpose:(checkone andpmwde desanpdcnhe/nw) ❑Legislative ❑Governmental ©Charitable Describe the legislative, governmental, charitable purpose, or event: Donation to Equality California 2019 Palm Springs Awards Gala 5. Amendment Description and/or Comments 6. Verification I certify, under penalty of perjury under the laws of the State of California, th t the best of my knowledge, the information contained herein is true and complete. November 13, 2019 Executed on DATE By gIGNATURE OF ELECTEO OFFICER OR CPUC MEMBER FPPC Form 803 (January/2018) FPPCToll-Free Helpline: 866/ASK-FPPC (866/275-3772)