803 Geoffrey Kors 2022-01-13 Joyce & Rick RossBehested Payment Report A Public Document k_ � � # ,f E p aehested Payment Report
1. Elected Officer or CPUC Member (cast name, First name) C I T ' ' OF ibi4iW111"•
Kors, Geoffrey •
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Agency Name
City of Palm Springs J - THE O IT Y C I_
3200 E. Tahquitz Canyon Way
Designated Contact Person (Name and title, it different)
❑ Amendment (See Part 5)
Area Code/Phone Number E-mail (Options!)
Date of Original Filing:
(month, day, year)
760-323-8299
2. Payor Information (For additional pagors, include an attachment with the names and addresses.)
J o-i ( e 9 'V i C K `e i <<
e
PAQr4= ' city - state Zip Code
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 City State Zip Code
4. Payment Information (complete all information.)
Date of Payment: 2jL&JZ f Amount of Payment: (ln-Kind FW $
month, ay,)bar)(Round 16 whdXddftars.T_
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
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)
FPPC Toll -Free Heipllne: 866/ASK-FPPC (866/275-3772)