HomeMy WebLinkAbout803 Geoffrey Kors 2022-03-24 Jennifer and David CBehested Payment Report
A Public Document
Type or Print In Ink.
Check box if an Amendment _
/ MAR 2 4 2022
(month, 5ay, ear
# Office of the City C.
onfirmatlon um er
1. Elected Officer or CPUC Member (cast name, First name)
ELECTED OFFICER OR CPUC MEMBER: AGENCY NAME: AGENCY STREET ADDRESS:
Kors, Geoffrey City of Palm Springs 3200 E Tahquitz Canyon Way
DESIGNATED CONTACT PERSON (NAME AND TITLE): AREA CODE/PHONE NUMBER: E-MAIL:
(760) 323-8299 geoff.kors@palmspringsca.gov
2. Payor Information (For additional payors, include an attachment with the names, addresses, and Proceedinq information)
/f e _F Lz�_, F
❑ Donor Advised Fund (DAF) DAF NAME: DONOR(S)AND DONOR'SADVISOR: (SEE INSTRU TI
(see instructions)
BRIEF DESCRIPTION OF PROCEEDINGS:
❑ Payor is a named party or the subject of a proceeding before my agency.
3. Payee Information (For additional payees, include an attachment with the names, addresses and relationship information)
NAME: ADDRESS: CITY: STATE: ZIP CODE:
Planned Parenthood of the Pacific Southw4 1075 Camino del Rio South San Diego ICA __]92108
For a nonprofit organization payee, provide a brief description of any relationship to the official, official's immediate family member or staff member In the role of founder, salarled employee, decision -making
capacity (board member or executive officer) or position on an honorary or advisory board.
NAME AND TITLE: ROLE WITH THE NONPROFIT ORGANIZATION: BRIEF DESCRIPTION:
James Williamson, President Board of Directors President, Board of Directors Spouse
4. Payment Information (Complete all information. For estimated payment information check the box below.)
DATE AMOUNT PAYMENT TYPE BRIEF DESCRIPTION OF IN -KIND PAYMENT PURPOSE DESCRIBE RITABLE PURPOSE GORVEVENTENTAL,
MONTH/DAY/YEAR
1 MONETARY DONATION ❑ LEGISLATIVE Sponsorship of 2022 Stand Nowl Event
/6GOVE" �� ❑ IN -KIND GOODS OR SERVICES ❑r CHARTABLE TAL
❑ MONETARY DONATION ❑ LEGISLATIVE
❑ IN -KIND GOODS OR SERVICES GOVERNMEN® CHARITABLETAL
❑ The (DATElAMOUNT) is an estimate and reflects my best efforts at obtaining the accurate
Information,
5. Amendment Description and/or Comments (Provide date of original filing or confirmation number in Part 1.)
6. Verification Z
i uaniTy, unaer penaity oT pepuryunaer the (aws oT me state oT Uanrorrna, tnat to to est oT my
Executed on — By
AT-
FPPC Form 803 (February/2022)
advice@fppc.ca.gov