803 Geoffrey Kors 2022-03-24 Arlene & Ronald PBehested Payment Report Amendment of Filing Date Stamp (Agency)
APublic Document ❑ Chec�oxifan Amendment RECEIVED
Type or Print In Ink. (Month, Day. ear>
MAR 2 4 2022
on rmatlan um er
1. Elected Officer or CPUC Member (Last name, First name) 1
ELECTED OFFICER OR CPUC MEMBER: AGENCY NAME: AGENCY STREET ADDRESS:
Kors, Geoffrey City of Palm Springs 3200 E Tahquitz Canyon Way
DESIGNATED CONTACT PERSON (NAME AND TITLE): AREA CODE/PHONE NUMBER: E-MAIL:
(760) 323-8299 geoff.kors@paimspringsca.gov
2. Payor Information (For additional payors, include an attachment with the names, addresses, and proceeding information)
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DAF NAME:
DONOR(S)AN DONOR'S VISOR: ( INSTRUCTIONS,)
❑ Donor Advised Fund (DAF)
(see Instructions)
BRIEF DESCRIPTION OF PROCEEDINGS:
❑ 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:
CITY:
STATE:
ZIP CODE:
Planned Parenthood of the Pacific Southwefl-
1075 Camino del Rio South
San Diego
CA
192108
For a nonprofit organization payee, provide a brief description of any relationship to the official, official's Immediate family member or staff member In the role of founder, salaried employee, decision -making
capacity (board member or executive officer) or position on an honorary or advisory board.
NAME AND TITLE:
ROLE WITH THE NONPROFIT ORGANIZATION:
BRIEF 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
(MONTHMAYNEAR
AMOUNT
PAYMENT TYPE
BRIEF DESCRIPTION OF IN -KIND PAYMENT
PURPOSE
DESCRIBE THE LEGISLATIVE GOVERNMENTAL,
CHARITABLE PURPOSt, OR EVENT:
MONETARY DONATION
❑ LEGISLATIVE
❑ GOVERNMENTAL
Sponsorship of 2022 Stand Nowl Event
Gi'
❑ IN -KIND GOODS OR SERVICES
b
✓ CHARITABLE
❑ MONETARY DONATION
LEGISLATIVE
❑ IN -KIND GOODS OR SERVICES
GOVERNMENTAL
CHARITABLE
REASON FOR ESTIMATE:
❑ The IonrFJ�ouNrl is an estimate and reflects my best efforts at obtaining the accurate
Information.
5. Amendment Description and/or Comments (Provide date of original filing or confirmation number in Part 1.)
6. Verification
I ceniry, unaer penalty or per)ury unaer the laws
Executed on 7��y f �)_
DATE
By
my
FPPC Form 803 (February/2022)
advice@fppc.ca.gov