803 Geoffrey Kors 2022-03-24 Dr. Patricia ZBehested Payment Report
A Public Document
Type or Print In Ink.
Amendment ofFlling D Check box if an Amendment
/ / (Month, Day, Year)
Date�
MAR 2 4 2022
CALIFORNIA 803 FORM
# ___ ""!Cro-n"llfl�rm-a""!t'l"'lo-n-rN'l"u-m"'l'b_e_r __ _ Office of the City Cl4lrk
1.Elected Officer or CPUC Member (Last name, First name) ELECTED OFFICER OR CPUC MEMBER:
2.
Kors, GeoffreyDESIGNATED CONTACT PERSON (NAME AND TITLE):
�, f V'-tvllr ff OAF NAM D Donor Advised Fund (OAF)_ (see Instructions)
' ,, 0( -""J
D Payor is a named party or the subject of a proceeding before my agency.
�GENCY NAME:
City of Palm Springs
�REA CODE/PHONE NUMBER:
(760)323-8299
,,s Ave
BRIEF DESCRIPTION OF PROCEEDINGS:
�GENCY STREET ADDRESS:
3200 E Tahquitz Canyon Way
jE-MAIL:
geoff.kors@palmspringsca.gov
3.Payee Information (For additional payees, Include an attachment with the names, addresses and relationship Information)NAME: rDDRESS: CITY:
Planned Parenthood of the Pacific Southweff" 1075 Camino del Rio South San Diego
TATE: ZIP CODE: Clf f2e,
STATE: ZIP CODE:
CA 92108 For a non_proflt 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: IROLE WITH THE NONPROFIT ORGANIZATION: IBRIEF 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 THE LEGISLATIV\ GOVERNMENTAL, (MONTH/DAY/YEAR) CHARITABLE PURPOS , OR EVENT:
2//{/1) 5,101 Bf MONETARY DONATION B LEGISLATIVE GOVERNMENTAL 0 IN-KIND GOODS OR SERVICES � CHARITABLE
f V 0 MONETARY DONATION � LEGISLATIVE : GOVERNMENTAL 0 IN-KIND GOODS OR SERVICES CHARITABLE REASON FOR ESTIMATE: D The <DATEJAMouNT> Information. 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
Sponsorship of 2022 Stand Now! Event
I __ _._JI _____ 3 __ ereln Is true and complete.
FPPC Form 803 (February/2022) advice@fppc.ca.gov