HomeMy WebLinkAbout803 Robert Moon 2019-11-04 Harold MatznerBehested Payment Report
RECEIVED
A Public C76(YuOfepl,ALM SPRINGS Behested Payment Report
1. Elected Officer or CPUC Member (lastname, First name)
2019 NM
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. 1
Robert Moon, Mayor
THE CITY CL
For Official Use Only
Agency Name -
!C� Or
City of Palm prings
Agency Street Address
3200 E. Tahquitz Canyon Way, Palm Springs, CA
Designated Contact Person (Name andtifle, ifdi8erent)
❑ Amendment (see Part 5)
Anthony Melia, City Clerk, City of Palm Springs
Date of Original Filing:
Area Code/Phone Number
E-mail (Optional)
(760) 323-8206
Anthony.mejia@paimspringsca.gov
(month, day, year)
2. Payor Informatl On (For additional payors, include an attachment with the names and addresses)
Harold Matzner
181 S. Civic Drive Suite 1
Palm Springs
CA 92262
Address City State Zip Code
3. Payee Information (For additional payees, include an attachment with the names and addresses.)
City of Palm Springs Walk of Stars
3200 E. Tahquitz Canyon Way Palm Springs CA 92262
Address City State Zip Code
4. Payment Information (comptateaninfonnaaon)
10/14/2019 $15,000
Date of Payment: Amount of Payment: (tnandFMv $
(month, tlay. year) (Routs to whole dollars)
Payment Type: ❑x Monetary Donation or ❑ In -Kind Goods or Services(Prowde description below)
Brief Description of In -Kind Payment:
Purpose: (Check one adprowdedescription below) El Legislative El Governmental 0Charitable
Describe the legislative, governmental, charitable purpose, or event: Donation toward Walk of Star
Dedication for local Radio Host Bill Feingold and following reception at LULU California Bistro.
5. Amendment Description and/or Comments
6. Verification
I certify, under penalty of perjury under the laws of the�Sta a o to the best of my knowledge, the information contained
herein is true and complete.
Executed on Oct 31, 2019 By
y
FPPC Form 803 (January/2018)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)