803 Geoffrey Kors 2022-01-13 Deborah Fritsh & Pat BoyceBehested Payment Report A Public Document RECEIVED
_P..' ,A C1r
1. Elected Officer or CPUC Member (cast name, First name) e ' ` `" bate stamp
Kors, Geoffrey
Agency Name
City of Palm Springs
3200 E. Tahquitz Canyon Way
and title, if different)
Area Code/Phone Number I E-mail (Optional)
760-323-8299
❑ Amendment (See Part 5)
For
Payment Report
Use Only
Date of Original Filing:
(month, day, year)
2. PayOr Information (For additional payors, include an attachment with the names and addresses.)
3. Payee Information (For additional payees, include an attachment with the names and addresses.)
Planned Parenthood of the Pacific Southwest
Name
1075 Camino del Rio South San Diego CA 92108
Address MY State Zip Code
4. Payment Information (Complete all information.)
Date of Payment: IVILAmount of Payment: (In-IQndFW $
(month, 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 and provide description below.) ❑ Legislative ❑ Governmental ® Charitable
Describe the legislative, governmental, charitable purpose, or event:
Donation to PPPSW Anniversary Celbration
5. Amendment Description and/or Comments
6. Verification
1 certify, under penalty of pedury under the laws of the State of California, that to the best of my knowledge, the information contained
herein is true and complete.
.?ZaExecuted on By
DATE
FPPC Form 803 (January/2018)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)