803 Geoff Kors 2019-11-04 Donna MacMillanBehested Payment Report A Public Document
1. Elected Officer or CPUC Member (Last name, First name) K tl;
Kors, Geoff CITY F Ph S INGS
Agency Name 1019 1 IN 64 PM 4% 47
Palm Springs City Council
Agency Street Address OF THE CITY CLERI'
3200 E. Tahquitz Canyon Way
Area Code/Phone Number
7605370061
(Name and title, i1 different)
E-mail (Optional)
❑ Amendment (See Part 5)
Behested Payment Report
For Dflimal Use Only
Date of Original Filing:
(month. day. year/
2. Payor Information (For additional payors, include an attachment with the names and addresses.)
Donna MadMillan
74695 Wren Dr.
Indian Wells
$. Payee Information (For additional payees, include an attachment with the names and addresses.)
Equality California
CA 92210
State ZJp Code
3701 Wilshire Blvd #725 Los Angeles CA 90010
Address City State Zip Code
4. Payment Information (Complete all information.)
Date of Payment: 10/21/19 Amount of Payment: (in-KindFM) $ 5,000
(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 andpmvae description below) ❑ Legislative ❑ Governmental I@ Charitable
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.
Executed on$ By
DATE SIGNATURE OF ELECTED OFFICER OR CPUC MEMBER
FPPC Form 803 (January/2018)
FPPC Tall -Free Helpline: 8G6/ASK-FPPC (866/27S-3772)