803 Geoff Kors 2019-12-30 Palm Springs Hospitality AssociationBehested Payment Report
1. Elected Officer or CPUC Men
Kors, Geoffrey
City of Palm Springs
A Public DocumerAE
(Last name, First name)
3200 E. Tahquitz Canyon Way, Palm Springs, CA 92262
30 PM 3: 40
OFFIC OF TH- CITY CLE
Behested Payment Report
For Official Use Only
Designated Contact Person (Name and title, if different)
Amendment (See PertS)
Area Code/Phone Number E-mail (Optional) Date of Original Filing:
7603238200 geoff.kors@palmspringsca.gov (month, day, year)
Payor Information (For additional payors, include an attachment with the names and addresses.)
Palm Springs Hospitality Association
PO Box 4507 Palm Springs CA 92263
Address City state Zip Code
3. Payee Information (For additional payees, include an attachment with the names and addresses.)
Equality California Institute
Name
3701 Wilshire Blvd., Ste 725 Los Angeles CA 90010
4. Payment Information (Complete all information.)
Date of Payment: 11/25/19 Amount of Payment: (ir.wndFMv) $ 5.000.00
(month, day, year) (Round to whole dollars)
Payment Type: Qx Monetary Donation or ❑ In -Kind Goods or Services tiorowde description below)
Brief Description of In -Kind Payment:
Equality Awards Sponsorship
Purpose: (Check one andprovide description below) ❑Legislative El Governmental ZCharitable
Describe the legislative, governmental, charitable purpose, or event:
Palm Springs Equality Awards Sponsorship
5. Amendment Description and/or Comments
Organization reported to me on 12/12/19 despite repeated requests
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
FPPC Form 803 (January/2018)
FPPCToll-Free Helpline: 866/ASK-FPPC (866/275-3772)