803 Christy Gilbert Holstege 2020-01-02 Aftab DadaBehested Payment Report A Public D�t]UfrtBp��,� �y `S!)
PRiNr
1. Elected Officer or CPUC Member (Last name, First name) Date Stamp
Christy Gilbert Holstege 2020 J N -2 PM 3: 40
City of Palm Springs
3200 E Tahquitz Canyon Way
OFFICE PF THE CITY CL -.-
aehested Payment Report
For Official use Only
Designated Contact Person (Name and title, (/dirrerem)
Christy Gilbert Holstage
[3 Amendment (See Pa s)
krea CodelPhone Number E-mail (Optional) Dale of Original Filing:
(month. day. yes)
(760) 323-8299 christy.hoWege@palmspringsca.gov
Payor Information (For additional payors, include an attachment with the names and addresses.)
Aftab Dada
400 East Tahquitz Canyon Way Palm Springs CA 92262
Address city State Zc Code
3. Payee Information (For additional payees, include an attachment with the names and addresses.)
Equality California
3701 Wilshire Blvd, Suite 725 Los Angeles CA 90010
Address City stale Zip Code
4. Payment Information (Complete Anfonnabon.)
Date of Payment: 10/1512019 Amount of Payment: (in-IandFmio $ 5,000
(month, day, yead (Round to whole dollars.)
Payment Type: ® Monetary Donation or ❑ In -Kind Goods or Services (Provide description below.)
Brief Description of In -Kind Payment:
Purpose: (Chechone and oowdedesorption helow) ❑Legislative ❑Governmental ®Charitable
Describe the legislative, governmental, charitable purpose, or event: Equality California Palm Springs Awards
2019
5. Amendment Description and/or Comments
I am not aware of the actual date the payment was received.
6. Verification
I certify, under penalty of perjury under the laws of the State of California, that to the best of my knowledge, the information contained
herein is true and complete.
Executed on 1/2/2020 By
DATE