803 Geoff Kors 2022-02-17 Courtney McovenBehested Payment Report A Public DocuiWent a� , 'f ® Reheated Payment Report
1- Elected Officer or CPUC Member (cast name, First name) ��ate s Pi �p • ,
Kors, Geoffrey Z Z F(7 3:
m4ency name For official Use only
City of Palm Springs TF C'` ca. t 1 CIiY C!_
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3200 E. Tahquitz Canyon Way
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❑ Amendment (see Pert 5)
Area Code/Phone Number E-mail (Optionao Date of Original Filing:
760-323-8299 (month, day, year)
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 Pack Southwest
1075 Camino del Rio South San Diego CA 92108
Address City State Zip Code
4. Payment Information l(complete al►intormation.)
Date of Payment: / a 2 Amount of Payment: (11Klnd FW $ G "
(month, day, year) found to whore doNers.)
Payment Type: ® Monetary Donation or ❑ In -Kind Goods or Services (Provide desc iption 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 SIGNATUR ELECTED OFFICER OR CPUC MEMBER
FPPC Form 803 (January/2018)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)