803 Geoffrey Kors 2022-01-13 Stacy JacobsBehested Payment Report A Public Doci
1. Elected Officer or CPUC Member (cast name, First name) C
Kors, Geoffrey
City of Palm Springs -
Agency Street Address
3200 E. Tahquitz Canyon Way
E-mail (Optional)
760-323-8299
Behesw Payment Report
e'. 18 1: 43 r For Official Use only
Amendment (See Part 5)
Date of Original Filing:
(month, day, year)
2. Payor Information (For additional payors, include an attachment with the names and addresses.)
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6� J 'd
PAC"as — 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 MY State Zip Code
4. Payment Information (Complete all intom,awn.)
Date of Payment: ZL2i Amount of Payment: (ln-K(nd FW $ _
(m th, de , a (Round whole do ers.)
Payment Type: p Monetary Donation or ❑ In -Kind Goods or Services (Pmvlde 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 pedury under the laws of the State of California, that to the best of my knowledge, the information contained
herein is true and complete.
Executeda� on OWBy
DATE
FPPC Form 803 (January/2018)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)