803 Geoff Kors 2019-11-04 John MonahanBehested Payment Report A Public Document Behested Payment Report
1. Elected Officer or CPUC Member (Last name. First name) CITY OF
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Kors, Geoff
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For Official Use Only
Agency Name 2019 NU
Palm Springs City Council
THE CITY CLER:
Agency Street Address
3200 E. Tahquitz Canyon Way
Designated Contact Person (Name and title, if different)
❑ Amendment Pan
(See 5)
Date of Original Filing:
monM, day, year)
Area Code/Phone Number
E-mail (Optional)
7605370061
2. Payor Information (For additional payors, include an attachment with the names and addresses.)
John Monahan
500 S. Palm Canyon Drive Palm Springs CA 92264
Address City state Zip Cotle
$. Payee Information (For additional payees, include an attachment with the names and addresses.)
Equality California
Name
3701 Wilshire Blvd 4725 Los Angeles CA 90010
Address Crty State Zip Code
4. Payment Information (Complete all information)
Date of Payment: '^ 9 '✓ Amount of Payment: (In-KmdFMV) $ 5,000
(month, day. year) - (Round to whole dollars.)
Payment Type: I@ Monetary Donation or ❑ In -Kind Goods or Services (Provide description below)
Brief Description of In -Kind Payment:
Purpose: (Check one and provide 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 true and complete.
I
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Executed on W f1/19 By _ ✓—
DATE SIGNATURE OF ELECTED OFFICER OR CPUC MEMBER
FPPC Form 803 (January/2019)
FPPC Toll -Free Helpline: 866/ASK•FPPC (866/275-3772)