HomeMy WebLinkAbout803 Geoffrey Kors 2022-04-26 Jackie Bridge and Nathan S. McMCoyBehested Payment Report
A Public Document
Type or Print In Ink.
Amendment of Flllng I Date Stamp (Agency) D Check box If an Amend�ent , R f C E i V £ D ' / vi T OF P �� Ui SPRING, ...onifi, bay, Year) CALIFORNIA 803 FORM
1.Elected Officer or CPUC Member (Last name, First name) ELECTED OFFICER OR CPUC MEMBER:GENCYNAME: #, Conilrmailon Number 202 APR 2 6 AM I I : I o
-THE CiTY Cl nGENCY STREET ADDRESS:
Kors, Geoffrey City of Palm Springs 3200 E Tahqultz Canyon Way DESIGNATED CONTACT PERSON (NAME AND TITLE):REA 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: A aADDRESS:� (} �h,t
RIEF DESCRIPTION OF PROCEEDINGS: □ Payor la a named party or the subject of a proceeding before my agency.
3.Payee Information (For additions/ payees, Include an attachment with the names, addresses and relationship Information) NAME: �DDRESS:
Planned Parenthood of the Pacific Southwet 1075 Camino del Rio South
CITY:
San Diego
STATE: ZIP CODE:
CA 92108 For a non_proflt organization payee, provide a brief description of any relatlonshlp to the offlclal, offlclal's Immediate famlly member or staff member In the role of founder, salaried employee, decision-making ca�aclty (l>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 DESCRl�E T�l LEG�Wb� G�V,RN�ENTAL,(MONTH/DAY/VEAR) C ARI BLE ;,0 VEN:
�/1fl11 ,�MONETARY DONATION B LEGISLATIVE
/01 I) 0 ()GOVERNMENTAL □ IN-KIND GOODS OR SERVICES � CHARITABLE
/ -1 □ MONETARY DONATION -LEGISL ATIVE : GOVERNMENTAL□ IN-KIND GOODS OR SERVICES CHARITABLE REASON FOR ESTIMATE: □ The toXffJAUolliJf> Is an estimate and reflects my best efforts at obtaining the accuratelnformaUon.
5.Amendment Description and/or Comments (Provide date of original filing or conflrmat;on number In Part 1.)
6. Executed on , , rr:::::, •; -4 ,411 JKY 1':.sna I IIUC g { \ • I By , u:
Sponsorship of 2022 Stand No�I Event
FPPC Form 803 (February/2022) advlce@fppc.ca.gov