803 Geoffrey Kors 2022-03-24 Dee Ann TraitelBehested Payment Report
A Public Document
Type or Print In Ink.
1. Elected Officer or CPUC Member (Last name, First
ELECTED OFFICER OR CPUC MEMBER:
Kors, Geoffrey
DESIGNATED CONTACT PERSON (NAME AND TITLE):
Amendment of Filing Date Stam {�q�
Check box if an Amendment R,Et"
/ LIAR 2 4 2022
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CY NAME: AGENCY STREET ADDRESS:
of Palm Springs 3200 E Tahquitz Canyon Way
CODE/PHONE NUMBER: E-MAIL:
) 323-8299 geoff.kors@palmspringsca.gov
2. Payor Information (For additional payors, include an attachment with the names, addresses, and proceeding
Nq DDRESS:
,;e� A frol 7Yr-,
DAF NAME: DONOR(.
❑ Donor Advised Fund (DAF)
(see Instructions)
BRIEF DESCRIPTION OF PROCEED
❑ 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)
;/o
NAME: ADDRESS: CITY: STATE: ZIP CODE:
Planned Parenthood of the Pacific Southwefl— 1075 Camino del Rio South San Diego CA 92108
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: RIEF 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
MONTH/DAY/YEAR
MONETARY DONATION ❑ LEGISLATIVE
b" ❑ IN -KIND GOODS OR SERVICES ❑ GOVERNMENTAL
r CHARITABLE
❑ MONETARY DONATION LEGISLATIVE
❑
IN -KIND GOODS OR S GOVERNMENTAL
SERVICECHARITABLE
REASON FOR ESTIMATE:
❑ The �pAT— O�NT, 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
my
of 2022 Stand Nowl Event
AL,
�!� /��li FPPC Form 803 (February/2022)
Executed on 4 DAT By '-
5
advice@fppc.ca.gov