Loading...
HomeMy WebLinkAbout803 Geoffrey Kors 2022-03-24 RobinsonBehested Payment Report A Public Document Type or Print in Ink. Amendment oT mung Check box if an Amendment on ay, ear Date,Stam," MAR 2 4 2022 # Confirmation Number Office of the City C14rk 1. Elected Officer or CPUC Member (Last 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 proceeding information) ke �s � 1I � -*X ❑ Donor Advised Fund (see Instructions) ❑ 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 SouthweS 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.) MDNTHDAAE/YEAR AMOUNT PAYMENT TYPE BRIEF DESCRIPTION OF IN -KIND PAYMENT PURPOSE DESCRIBE CHATHE LEGISLATIVE EGP LATIVE GOVERNMENTAL, 2 MONETARY DONATION ❑ LEGISLATIVE ❑ GOVERNMENTAL Sponsorship of 2022 Stand Nowl Event 1 �� G ❑ N-KIND GOODS OR SERVICES t% r CHARITABLE ❑ MONETARY DONATION ❑ LEGISLATIVE ❑ IN -KIND GOODS OR SERVICES GOVERNMENTAL CHARITABLE REASON FOR ESTIMATE: ❑ The is an estimate and reflects my best efforts at obtaining the accurate (OAT AMOUNT) Information. 5. Amendment Description and/or Comments (Provide date of original filing or confirmation number in Part 1.) 6. Verification my a Executed on } V 22 By z2z� FPPC Form 803 (February/2022) DATE advice@fppc.ca.gov