HomeMy WebLinkAbout803 Lisa Middleton 2019-12-30 Frederick NobleBehested Payment Report A Public Document Behested Payment Report
1. Elected Officer or I
Lisa Middleton
Agency Name
City of Palm Springs
(Last name, First name)
3200 Tahquitz Canyon Way, Palm Springs CA 92262
tEC:EIVEQ
F PALM SPRINGS
2019 DEC 30 PM 4: 55
?FFICE pF THE CITY CLU.
❑ Amendment (See Part 5)
Area Code/Phone Number E-mail (Optional) Date of original Filing:
760-507-7851 lisa.middleton@palmspringsca.gov
2. Payor Information (For additional payors. include an attachment with the names and addresses.)
For Official Use Only
(month, day,
..e` �2- r C:-L:.
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 all lniormetlon.)
Date of Payment: l cD — 2--3 — t et Amount of Payment: (in -KW FMO $ ZS , cxx,)
(month, day, year) (Round to whole dollars.)
Payment Type: ❑x Monetary Donation or ❑ In -Kind Goods or Services (Providedescrlption below)
Brief Description of In -Kind Payment:
Purpose: (Check one and pmNde description below) ❑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
I was not made aware of this contribution until December 19, 2019.
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. /
December 30, 2019
Executed on
DATE
FPPC Form 803 (January/2019)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)