HomeMy WebLinkAbout803 Geoffrey Kors 2022-03-24 Kurt G. and Mick W.Behested Payment Report
A Public Document
Amendment of FIiing D Check box if an Amendment CALIFORNIA 803 FORM
Type or Print In Ink. I I (Month, Day, Year)
# ___ .,C.,o-n""fl""rm-a""il,.o -n"'N""u-m"'6'"'e_r __ _
MAR 2 4 2022
Office of the City Cle�k
1.Elected Officer or CPUC Member (Last name, First name) ELECTED OFFICER OR CPUC MEMBER:f GEN CY NAME:�GENCY STREET ADDRESS:
Kors, Geoffrey City of Palm Springs 3200 E Tahquitz Canyon Way DESIGNATED CONTACT PERSON (NAME AND TITLE): E-MAIL:AREA CODE/PHONE NUMBER:
(760)323-8299 geoff .kors@palmspringsca.gov
2.Payor Information (For additional payors, include an attachment with the names, addresses, and proceeding information) NAME: !ADDRESS:
'1
BRIEF DESCRIPTION OF PROCEEDINGS: D Payor Is a named party or the subject of a proceeding before my agency.
3.Payee Information (For additions/ payees, Include an attachment with the names, addresse� and relationship lnformatlo'!lNAME: ADDRESS:
Planned Parenthood of the Pacific Southwef ( 1075 Camino del Rio South
CITY:
San Diego
STATE: ZIP CODE:
CA 92108 For a nonprofit organization payee, provide a brief description of any relationship to the official, offlclal's Immediate famlly member or staff member In the role of founder, safaried employee, decision-making capacity (f>oard member or executive officer) or position on an honorary or advisory board. NAME AND TITLE: IROLE WITH THE NONPROFIT ORGANIZATION: IBRIEF 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 THE LEGISLATIVEE GOVERNMENTAL, (MONTH/DAY/YEAR) . CHARITABLE PURPOS , OR EVENT:
J /Jt/J;J <::: /l/J(J
Bl.MONETARY DONATION B LEGISLATIVE GOVERNMENTAL Sponsorship of 2022 Stand Nowl Event 0 IN-KIND GOODS OR SERVICES @ CHARITABLE
0 MONETARY DONATION □LEGISLATIVE
0 IN-KIND GOODS OR SERVICES Fl GOVERNMENTALCHARITABLE REASON FOR ESTIMATE: D The <DATEIAMOUNT) 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.VerificationI certify, under penalty of perjury under the laws of the State of California, that to the be
Executed on ?, [)? {8 BY-----:��71""-nn:mm�------FPPC Form 803 (February/2022) advice@fppc.ca.gov