2019-03-22 HRC & Center Movie FundraiserAgency Report of:
Ceremonial Role Events and Ticket/Pass Distributions
A Public Document
City of Palm Springs
Division. Department. or
Christina Chartier, Executive Assistant to Mayor and Council
Date Stamp
For Official Use Only
❑ Amendment (Must Provide Explanation in Part 3.)
760-322-8366 I chdstina.chartier alms rin sca. ov I Date of Original Filing:
@P P 9 9 (month, day, year)
2. Function or Event Information
Does the agency have a ticket policy? Yes ® No ❑
Face Value of Each Ticket/Pass $ 25.00
Event Description: HRC&Center Movie Fundraiser Date(s) 03 ) 22 1 19
Provide Title/Explanation
Ticket(s)/Pass(es) provided by agency? Yes ❑ No ® If no: HRC & The Center
NameofSource
Was ticket distribution made at the behest Yes ❑ No ® If yes:
Official's Name (Last, First)
of agency official?
3. Recipients
• Use Section A to identify the agency's department or unit. • Use Section B to identify an individual. • Use Section C to identify an outside organization.
A. Name of Agency, Department or Unit
Number
of Ticket(s)r
Describe the public purpose made pursuant to the agency's policy
Passes
B. Name of Individual
(Last, First)
Number
of Tlmber )/
Passes
Identity one of the following:
Moon, Robert
Z
Ceremonial Role ❑x Other ❑ Income ❑
Irchacklag'O9remcnial Rae-or'Olherdescnbe below:
Public Purpose as defined by PS Resolution No. 22454,
Section 1 d vii viii ix xi
Ceremonial Role ❑ Other ❑ Income ❑
Itcbecking'Cen;monial Role' or'Other descnbe below:
Name of Outside Organization
C. (include address and description)
Number
of Ticket(s)l
Passes
Describe the public purpose made pursuant to the agency's policy
4. Verification
I have read and understand
with the requirements.
Comment:
Regulations 18944.1 and 18942. I have verified that the distribution set forth above, is in accordance
David Ready City Manager
Print Name Title (month, day, year)
FPPC Form 802 (212016)
FPPC Toll -Free Helpline: 8661ASK-FPPC (866/275-3772)