803 Christy Gilbert Holstege 2020-01-02 Harold MatznerBehested Payment Report
a'-"CEIYEQ
A POfia QOQUITMt5PRINGS
Elected Officer or CPUC Member (Last name. First name) 2�20 JAN ' 2 I PM `t (lamp
Christy Gilbert Holstege
City of Palm Springs
3200 E Tahquitz Canyon Way
Christy Gilbert Holstege
(760)323-8299
2. Payor Inform.
Harold Matzner
(Name and title, if different)
OFFICE OF THEICITY CLUII..
❑ Amendment �Sse Parr S;
8ehested Payment Report
E-mail (Optional) Dale of Original Filing:
(month_ tlay year
christy.holstege@palmspdngsca.gov
(For additional payors, include an attachment with the names and addresses)
PO Box 1717 Elmwood Park CA 7407
Address Cary stage Zip Code
3. Payee Information (For additional payees. include an attachment with the names and addresses.)
Equality California
Name
3701 Wilshire Blvd, Suite 725 Los Angeles CA 90010
Address City state Zip Code
4. Payment Information (Complete all information.)
Date of Payment: 10/11/2019 Amount of Payment: (in-andF-iuv) $ 65'00()
(month, day, year) (Round to whole dollars-)
Payment Type: ❑x Monetary Donation or ❑ In -Kind Goods or Services (Provide description below.)
Brief Description of In -Kind Payment:
Purpose: (Check one and provide dasuVOon below..) ❑ 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
GATE SIGWI OF Tag OFFICER OR CPtic
M R
I FPPC Form 803 (January/2018)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)