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803 Geoffrey Kors 2022-03-24 Catherine Stiefel and Keith BehnerBehested Payment Report A Public Document Type or Print in Ink. 1. Elected Officer or CPUC Member (Last name, First Kors, Geoffrey DESIGNATED CONTACT PERSON (NAME AND TITLE): Amenamem oT ruing Date fthW,0.IJ Check box if an Amendment MAR 2 4 2022 (Monin, usy, ear # I Office of the City C on rma on um er CY NAME: AGENCY STREET ADDRESS: of Palm Springs 3200 E Tahquitz Canyon Way CODEIPHONE NUMBER: E-MAIL: ) 323-8299 geoff.kors@palmspringsca.gov 2. Payor Information (For additional payors, include an attachment with the names, addresses, and NAME: DDRESS: u S► i°fP� a �� Ke, �re✓ �� 9 C., DAF NAME: ❑ Donor Advised Fund (DAF) (see instructions) (BRIEF DESCRIPTION Of ❑ Payor is a named party or the subject of a proceeding before my agency. I< 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 Southwe5:r 1075 Camino del Rio South San Diego CA 92108 For a nonprofit organization payee, provide a brief descilption 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.) MONTHD/DAY/YEAR AMOUNT PAYMENT TYPE BRIEF DESCRIPTION OF IN -KIND PAYMENT PURPOSE DESCRIBETHE LE P LATIVE GOVERNMENTAL, MONETARY DONATION ❑ LEGISLATIVE GOVERNMENTAL Sponsorship of 2022 Stand Nowl Event IN -KIND GOODS OR SERVICES rsol CHARITABLE ❑ MONETARY DONATION LEGISLATIVE ❑ IN -KIND GOODS OR SERVICES GOVERNMENTAL CHARITABLE REASON FOR ESTIMATE: The is an estimate and reflects my best efforts at obtaining the accurate (DATEJA ou� Information. 5. Amendment Description and/or Comments (Provide date of original filing or confirmation number in Pert 1.) 6. Verification Executed on I I �DA E fay '� �4 /sILIN FPPC Form advice@fppc.ca.gov