803 Geoff Kors 2019-11-04 Jeffrey TownsBehested Payment Report A Public Document Behested Payment Report
1. Elected Officer or CPUC Member (Last name, First name) XtPLCITY OF A I V F f �i5 � • ll •
Kors, Geoff
Palm Springs City Council
3200 E. Tahquitz Canyon Way
(Optional)
7605370061
2019 NOV 14 PM 4. 47
HE CITY CLEM.
❑ Amendment (see Part 5)
For Official Use Only
Date of Original Filing:
(month, day, year)
2. Payor Information (For additional payors, include an attachment with the names and addresses.)
Jeffrey Towns
Name
15823 S. Western Ave
Gardena
city
3. Payee Information (For additional payees, include an attachment with the names and addresses.)
Equality California
CA 90247
State Zip Code
3701 Wilshire Blvd #725 Los Angeles CA 90010
Address City State Zip Code
4. Payment Information (Complam all information.)
Date of Payment: � �✓ - " Amount of Payment: (m-l<mdPMvt $
5,000
(month, day, year) (Round to whole dot/am.)
Payment Type: ❑x Monetary Donation or ❑ In -Kind Goods or Services (Provide description batow)
Brief Description of In -Kind Payment
Purpose: (Check one andprovide description below.) ❑Legislative ❑Governmental ❑x 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 We and complete.
Executed on By
DATE \ SIGNATURE OF ELECTED OFFICER OR CPUC MEMBER
FPPC Form 803(January/2018)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)