803 Geoff Kors 2022-02-17 Leslie H CollBehested Payment Report A Public Document r Behested Payment Report
1- Elected Officer or CPUC Member (cast name, First name)
Kors, Geoffrey
Agency Name
City of Palm Springs
Agency Street Address
3200 E. Tahquitz Canyon Way
Designated Contact Person (Name and title, if different)
Area Code/Phone Number I E-mail (Optional)
760-323-8299
Date Stamp
202''E8 i i F
❑ Amendment (See Part 5)
official Use Only
Date of Original Filing:
(month, day, year)
2. Payor Information (For additional payors, include an attachment with the names and addresses.)
r
naaress • _ City State Zip Code
3. Payee Information (For additional payees, include an attachment with the names and addresses.)
Planned Parenthood of the Pacific Southwest
1075 Camino del Rio South San Diego CA 92108
Address City State ZIP Code
4. Payment Information (Complete all information.)
Date of Payment: Amount of Payment: (In -rand FMt0 $ _ G [/
Way, fir) (Round to wh domars.)
Payment Type: ® 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 leglslative, governmental, charitable purpose, or event:
Donation to PPPSW Anniversary Celbration
S. Amendment Description and/or Comments
6. Verification
I certify, under penalty of perl'ury under the laws of the State of California, that to the hest of my knowledge, the information contained
herein is true and complete.
Executed on 411 %)� By
DATE
FPPC Form 803 (January/2018)
FPPC Toll -Free Helpline: 666/ASK-FPPC (866/27S-3772)