803 Geoffrey Kors 2022-03-24 Dorian & Jeffrey PattersonBehested Payment Report
A Public Document
Type or Print In Ink.
❑ Check box if an Amendment
(Month, Day, Year)
Confirmation um er
Date Stamp (Agency)
RECENED
MAR 2 4 2022
1. Elected Officer or CPUC Member (Last name, First name)
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 CODEIPHONE NUMBER: E-MAIL:
(760) 323-8299 geoff.kors@palmspringsca.gov
2. Payor Information (For additional payors, include an attachment with the names, addresses, and proceeding information)
NA�E: (� DDRESS: IT TATE: ZIP DE: C
La I L. I ")V- ro-1 *V'- r r (.4 1 L2,-,
DAF NA DON (S) D DONOR'SADVISOR: (SEE 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 Southwe� r 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: 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)
MONTHH/DAYNEAR AMOUNT PAYMENT TYPE BRIEF DESCRIPTION OF IN KIND PAYMENT PURPOSE DESCRIBE RITABLE PURPOSE GOVERNMENTAL,
R EVENTENTAL,
` MONETARY DONATION ❑ LEGISLATIVE Sponsorship of 2022 Stand Nowl Event
/ [ - ❑ GOVERNMENTAL
�/ �� S /b ❑ IN -KIND GOODS OR SERVICES r CHARITABLE
❑ MONETARY DONATION ❑ LEGISLATIVE
I IN -KIND GOODS OR SERVICES GOVERNMENTAL
❑ CHARITABLE
❑ The (DATEIAMOUNT) is an estimate and reflects my best efforts at obtaining the accurate
Information. REASON FOR ESTIMATE:
5. Amendment Description and/or Comments (Provide date of original filing or confirmation number in Part 1.)
6. Verification
, that to the best of my
Executed on 3��y%� By
FPPC Form 803 (February/2022)
advice@fppc.ca.gov