803 Geoff Kors 2019-10-14 Ann ShefferBehested Payment Report
A Public Document 9ehested Payment Report
1. Elected Officer or CPUC Member (Last name, First name) CITY
�'lf'wu 1 SPR
Kors, Geoff
019 OCT 14 PM 12.
07 For Official Use Only
Agency Name
Palm Springs City Council
FICE OF THE CITY
E;;
Agency street Address
3200 E. Tahquitz Canyon Way
Designated Contact Person (Name and title, if different)
❑ Amendment (See Part 5)
Date of original Filing:
Area Code/Phone Number
E-mail (Optional)
7605370061
month, day. year)
2. Payor Information (For additional payors, include an attachment with the names and addresses.)
Ann Sheffer
Name
3200 Avenida Sevilla ~ CA 92264
Address City state Zip Code
3. Payee Information (For additional payees, include an attachment with the names and addresses.)
Equality California
Name
3701 Wilshire Blvd #725 Los Angeles CA 90010
Address City State Zip Code
4. Payment Information (Complete all information.)
Date of Payment: 09/13/19 Amount of Payment: (In-KindFMV) $ 5,000
(month, day, year) (Round to whole dollars.)
Payment Type: ❑X Monetary Donation or ❑ In -Kind Goods or Services (Provide deserip ion below.)
Brief Description of In -Kind Payment:
Purpose: (Check me and provide description below) ❑Legislative ❑Governmental 0Charitable
Describe the legislative, governmental, charitable purpose, or event:
Sponsorship of 2019 Equality Awards
5. Amendment Description and/or Comments
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.
n
Executed on 10/11/19 By
FPPC Form 803 (January/2018)
FPPC Toll -Free Nelpline: 866/ASK-FPPC (866/275-3772)