803 Geoffrey Kors 2022-03-24 Doris & Charles KouBehested Payment Report
A Public Document
Type or Print in Ink.
1. Elected Officer or CPUC Member (Last name, First name)
Kors, Geoffrey
(NAME AND TITLE):
Anlenament of rmng Date)mgjum(b l)
Check box if an Amendment
on , ay, ear
MAR 2 4 2022
# confirmation Nume_r I Office of the City Cl
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 proceeding information)
NAM DDRESS:
❑ Donor Advised Fund (DAF) DAF NAME: DONOR(S)AND DONOR'S
(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)
F�
NAME: ADDRESS: CITY: STATE: ZIP CODE:
Planned Parenthood of the Pacific Southwet fi 1 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.)
DATE AMOUNT PAYMENT TYPE BRIEF DESCRIPTION OF IN -KIND PAYMENT PURPOSE DESCRIBE CHARITABLE PURPOSE OR EVENTENTAL,
MONTH/DAY/YEAR
/ MONETARY DONATION ® LEGISLATIVE Sponsorship of 2022 Stand Now! Event
//02/G CG GOVERNMENTAL
/ V IN -KIND GOODS OR SERVICES v CHARITABLE
❑ MONETARY DONATION ❑ LEGISLATIVE
❑ IN -KIND GOODS OR SERVICES GOVERNMENTAL
CHARITABLE
REASON FOR ESTIMATE:
❑ The ICAr Ti 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 numberin Part 1.)
6. Verification
I wruty, unuer PUMMLY U1 perjury unuer me taws oT me wa[e or Gawomia, tnat to the Desr or my Knowiea a the
Executed on ',r , �, By C_�
DATE t
FPPC Form 803 (February/2022)
advice@fppc.ca.gov