803 Geoffrey Kors 2022-03-24 Aline B. and Ruth WBehested Payment Report
A Public Document
Type or Print In Ink.
Amendment of FIiing D Check box If an Amendment
'nth, Day, Lr)
Date
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CALIFORNIA 803 FORM
# Office of the City [JP.JI.JC
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1.Elected Officer or CPUC Member (Last name, First name) ELECTED OFFICER OR CPUC MEMBER: �GENCY NAME: �GENCY STREET ADDRESS:
Kors, Geoffrey City of Palm Springs 3200 E Tahquitz Canyon Way DESIGNATED CONTACT PERSON (NAME AND TITLE): f REA CODE/PHONE NUMBER:
(760)323-8299
E-MAIL:
geoff.kors@palmspringsca.gov
2.Payor Information (For additional payors, include an attachment with the names, addresses, and proceeding information)N�7 _ !ADDRESS: /-t / j Y) e... r-::1/ Ir t:.,,, u,.A D LM f 1-.. \l\.,(Uf.., ,II-Vv
RIEF DESCRIPTION OF PROCEEDINGS: D Payor is a named party or the subject of a proceeding before my agency.
3.Payee Information (For additional payees, Include an attachment with the names, addresses and relationship Information) NAME: ADDRESS: ,
Planned Parenthood of the Pacific Southwef r 1075 Camino del Rio South
CITY:
San Diego
TATE: ZIP CODE:
f )v],
STATE: ZIP CODE:
CA 92108
For a nonprofit organization payee, provide a brief description of any relationship to the official, offlclal's Immediate family member or staff member In the role of founder, salaried employee, decision-making capacity (l:>oard member or executive officer) or position on an honorary or advisory board. NAME AND TITLE: IROLE WITH THE NONPROFIT ORGANIZATION: IBRIEF DESCRIPTION:
James Williamson, President Board of Directors President, Board of Directors Spouse
4.Payment Information (Complete all information. For estimated payment information check the box below.) DATE AMOUNT PAYMENT TYPE BRIEF DESCRIPTION OF IN-KIND PAYMENT PURPOSE DESCRIBE THE LEGISLATIVEE GOVERNMENTAL, (MONTH/DAY/YEAR) CHARITABLE PURPOS , OR EVENT:
-")/)..th) � MONETARY DONATION B LEGISLATIVE
�f/itJf}
GOVERNMENTAL 0 IN-KIND GOODS OR SERVICES � CHARITABLE 0 MONETARY DONATION -LEGISLATIVE : GOVERNMENTAL 0 IN-KIND GOODS OR SERVICES _ CHARITABLE REASON FOR ESTIMATE: □The (DATE/AMOUNT) Information.
is an estimate and reflects my best efforts at obtaining the accurate
5.Amendment Description and/or Comments (Provide date of original filing or confirmation number in Part 1.)
6.Verification
Sponsorship of 2022 Stand Now! Event
I certify, under penal
/
of peijury under the laws of the Stale of Calllomla, that to the be , the information contained herein Is true and complete.
Executed on S, ')_ Y(};;; By c 0!!!§7 - -,r,c r """""'""FPPC Form 803 (February/2022)
advice@fppc.ce.gov