HomeMy WebLinkAbout803 Robert Moon 2019-10-02 Harold MatznerBehested Payment Report
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A Public Doc ►T,p r7dF PALK SPRINGS aehested Payment Report
1. Elected Officer or CPUC Member (cast name, First name)
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Moon, Robert 2��)OCT.
E OF THE CITY CL
For Official use only
R t y
Agency Name
City of Palm Springs 3FFI
Agency Street Address
3200 E Tahquitz Canyon Way, Palm Springs CA 92262
Designated Contact Person (Name and title, if different)
❑ Amendment Part 5)
Anthony Mejia, City Clerk, City of Palm Springs
(see
Date of Original Filing:
Area Code/Phone Number
E-mail (Optional)
7603238200
robert.moon@paimspringsca.gov
(Month, day, year)
z. Payor information (For additional payors, include an attachment with the names and addresses.)
Harold Matzner
rveme c
S. V r� uce 1 Palm Springs CA 92262
Address City State lip Cone
3. Payee Information (For additional payees, include an attachment with the names and addresses.)
City of Palm Springs
3200 E. Tahquitz Canyon Way Palm Springs CA 92262
Address City State Zip Code
4. Payment Information (Complete alllnformation.)
Date of Payment: Sept 24, 2019 Amount of Payment: (tn-wndi mv) $ $5000
(month, day, year) (Round to whole dollars.)
Payment Type: ❑x Monetary Donation or ❑ In -Kind Goods or Services (Provide description below)
Brief Description of In -Kind Payment:
Purpose: (Check one andprovide description below) 0Legislative ❑Governmental ❑x Charitable
Describe the legislative, governmental, charitable purpose, or event: Donation to the City of Palm Springs
fund for the annual Veterans Day Parade and Celebration
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.
Executed on October 2, 2019 By
of my knowledge, the information contained
MEMBER
FPPC Form 803 (January/2018)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)