HomeMy WebLinkAbout803 Geoffrey Kors 2022-05-05 Catherine and Phillip BlairBehested Payment Report
A Public Document
Type or Print In Ink.
Amendmentof-Flllng D Check box if an Amendment
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Date Stamp (Agency}
RECEIVED
MAY 5 2022
1.Elected Officer or CPUC Member (Last name, First name)ELECTED OFFICER OR CPUC MEMBER: rGENCY NAME: r GENCY STREET ADDRESS:
Kors, Geoffrey City of Palm Springs 3200 E Tahquitz Canyon Way DESIGNATED CONTACT PERSON (NAME AND TITLE}: rREA CODE/PHONE NUMBER:
(760)323-8299 IE-MAIL:
geoff.kors@palmspringsca.gov
2.Payor Information (For additional psyors, include an attachment with the names, addresses, and proceeding information)NAME: -I v\SE�t I stz. -sr-□ Donor Advised Fund (OAF)(see Instructions}
DON0R(S)AN
IBRIEF DESCRIPTION OF PROCEEDINGS: □ 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, addresses and relationship Information)NAME: ADDRESS:
Planned Parenthood of the Pacific Southwet 1075 Camino del Rio South
CITY:
San Diego
CALIFORNIA 803 FORM
STATE: ZIP CODE:
CA 92108
For a nonprofit organization payee, provide a brief description of any relatlonshlp to the official, offlclal's Immediate family member or staff member In the role of founder, salaried employee, decision-making capacity (ooard member or executive officer) or position on ar, 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: 1//J/J.1 /(} 1JS �ONETARY DONATION B LEGISLATIVE GOVERNMENTAL 0 IN-KIND GOODS OR SERVICES � CHARITABLE
I 0 MONETARY DONATION -LEGISLATIVE : GOVERNMENTAL 0 IN-KIND GOODS OR SERVICES CHARITABLE REASON FOR ESTIMATE: □ The <oXreJAUoONri 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
Sponsorship of 2022 Stand Now! Event
, ces,2 ____ s __ ereln 1s true and complete.
Executed on c: 1-<1 r_L_FPPC Form 803 (February/2022)
advice@fppc.ca.gov