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HomeMy WebLinkAbout803 Geoffrey Kors 2022-03-24 Mary & Ernest PennellBehested Payment Report A Public Document Type or Print In Ink. 1. Elected Officer or CPUC Member (Last name, First name) ELECTED OFFICER OR CPUC MEMBER: Kors, Geoffrey DESIGNATED CONTACT PERSON (NAME AND TITLE): 2. Payor Information (For additional payors, include an attachment with the ✓� � ,, ne l DAF NAME: ❑ Donor Advised Fund (DAF) (see instructions) ❑ Payor is a named party or the subject of a proceeding before my agency. Check box if an Amendment (Month, Day, ear) confirmation M- er CY NAME: of Palm Springs CODE/PHONE NUMBER: ) 323-8299 dresses, and proceeding informab Al,-,"h Tevv EF DESCRIPTION OF P LIAR 2 4 ZOZZ ice of the City C1 E Tahquitz Canyon Way eoff.kors@palmspringsca.gov �T.2/G 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 Southwe$'r 1075 Camino del Rio South San Diego CA 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, salaried 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 THE LEGISLATIVE GOVERNMENTAL, (MONTH/DAYNEAR CHARITABLE PURPOSt, OR EVENT: MONETARY DONATION ❑ LEGISLATIVE Sponsorship of 2022 Stand Nowl Event 0I �Z S 0 ❑ IN -KIND GOODS OR SERVICES ❑ GOVERNMENTAL r CHARITABLE ❑ MONETARY DONATION LEGISLATIVE ❑ IN -KIND GOODS OR SERVICES GOVERNMENTAL VCHARITABLE REASON FOR ESTIMATE: ❑ The IoAT 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 Fart 1.) 6. Verification Ty Executed on By FPPC Form 803 (February/2022) advice@fppc.ca.gov