HomeMy WebLinkAbout803 Lisa Middleton 2019-11-13 Jeffrey TownsBehested Payment Report
1. Elected Officer or CPUC Men
Middleton, Lisa
Agency Name
City of Palm Springs
A Pu
ber (Last name. First name)
3200 Tahquitz Canyon Way, Palm Springs CA 92262
ENED
TLH SPRINGS Behe:tea
2919NOV q3
!FFICE OF
PRINT
CITY CLE
For Official Use Only
Designated Contact Person (Name and title, if different) ❑ Amendment (See Pan 5)
Area Code/Phone Number E-mail (optional) Date of Original Filing:
760-507-7851 Lisa.middleton@palmspringsca.gov (maam,day year)
2. Payor Information (For additionallpayors, include an attachment with the names and addresses.)
Name (�
(5,Z 3 2.. V, .ems &"X�
Address city state ZIP Code
3. Payee Information (Forsddltional payees, include an attachment with the names and addresses)
Equality California
Name
3701 Wilshire Blvd. # 725 Los Angeles CA 90010
Adorers City State Zip Code
4. Payment Information (Complete all wromrehon.)
Date of Payment: 10/19/2019 Amount of Payment: (In-tdmFn+v) $
(month, day. year) (Round to whole dollars.)
Payment Type: p Monetary Donation or ❑ In -Kind Goods or Services (Provide description oelbw)
Brief Description of In -Kind Payment:
Purpose:(CheaP me and pmwde descdpton oebw) ❑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
6. Verification
I certify, under penalty of perjury under the laws of the State
herein is true and complete.
November 13, 2019
Executed on
DATE
to the best of my knowledge, the information contained
FPPC Form 803 (January/2018)
FPPCToll-Free Helpline: 866/ASK-FPPC (866/Z75-3772)