803 Christy Gilbert Holstege 2020-01-02 Gregory HellerBehested Payment Report A Publi I Y ED eenasietl Pay rent Report
1. Elected Officer or CPUC Member (Last name, First name) Date Stamp • '
Christy Gilbert Holstege 2020 JAN -2 PM 3 40
City of Palm Springs
3200 E Tahquitz Canyon Way
Christy Gilbert Holstege
Area Code/Phone Number
(760)323-8299
For Official Use Only
OFFICE OFITHE CITY CAE;
❑ Amendment (See Part 5)
Email (Optionato Date of Original Filing:
(month. day, Jeer)
christy.holstege @palmspdngsca.gov
2. Payor Information (For additional payors, include an attachment with the names and addresses.)
Greoory Heller
243 S McCarty Dr
Beverly Hills
3. Payee Information (For additional payees, include an attachment with the names and addresses.)
Equality California
CA 90212
state ➢p Code
3701 Wilshire Blvd, Suite 725 Los Angeles CA 90010
Address Clry state ZJp Code
4. Payment Information (Campieteallintammahon.)
Date of Payment: 10/8/2019 Amount of Payment: ier-IendFMw) $ 5,000
(month, day, year) (Round to whole dollars.)
Payment Type: ® Monetary Donation or ❑ In -Kind Goods or Services (Provide desclititfon ta,a )
Brief Description of In -Kind Payment:
Purpose:(Checlr one and provide description below) ❑Legislative ❑Governmental IN 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 1/2/22020 By
r FPPC Farm 803 (January/2018)
FPPCToll-Free llelpline: 866/ASK-FPPC (866/275-3772j