HomeMy WebLinkAbout803 Geoff Kors 2022-02-17 Lynn Gorguze and Scott PetersBehested Payment Report A Public Document cSeh
. Elected Officer or CPUC Member (Last name, First name)
Kors, Geoffrey
City of Palm Springs
3200 E. Tahquitz Canyon Way
Designated Contact Person (Name and title, if different)
Area Code/Phone Number E-mail (optional)
760-323-8299
Date Stamp
� lY/
Official se �.
❑ Amendment (See Pan 5)
Date of Original Filing:
(month, day, year)
2. Payor Information (For additional payors, include an attachment
with the names and addresses.)
/
Name
l .7 ��2 `l �Glr-+tirG l/' f j(GT"�
AddreCity State Zip Code
3. Payee Information (For additional payees, include an attachment with the names and addresses.)
Planned Parenthood of the Pacific Southwest
Name
1075 Camino del Rio South San Diego CA 92108
Address City State Zip Code
4. Payment Information (complete all infor ation.)
Date of Payment: Amount of Payment: (ln-Kind FW $ �, roop
( oA th, d y, 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 and provide description below.) ❑ Legislative ❑ Governmental 0 Charitable
Describe the legislative, governmental, charitable purpose, or event:
Donation to PPPSW Anniversary Celbration
5. Amendment Description and/or Comments
o. venTlcation
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.
Executed on -) /? / a 2 By
DATE
FPPC Form 803 (January/2018)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)