803 Geoffrey Kors 2022-03-24 Drs. Jasmine Lai & Justin JanBehested Payment Report
A Public Document
Type or Print in Ink.
1. Elected Officer or CPUC Member (Last name, First
Kors, Geoffrey
DESIGNATED CONTACT PE
2. Payor Information (F
NA
L. �Sn,li
❑ Donor Advised Fund (C
(see Instructions)
3.
4.
Amendment of ruing Date Stamp (Agency)
Check box if an Amendment RECEIVED
(month, Day, ear MAR 2 4 2022
Confirmation Number h rn of trip City Ciprk
CY NAME: AGENCY STREET ADDRESS:
of Palm Springs 3200 E Tahquitz Canyon Way
CODE/PHONE NUMBER: E-MAIL:
) 323-8299 geoff.kors@palmspringsca.gov
additional payors, include an attachment with the names, addresses, and
❑ Payor is a named party or the subject of a proceeding before my agency.
Sl ee'v✓f
Information (For additional payees, Include an attachment with the names, addresses and relationship Information)
511, /%la e 6 1 rll� 1 %3v
Planned Parenthood of the Pacific Southwef r 11075 Camino del Rio South Isan Diego ICA 192108
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
Payment Information (Complete all information. For estimated payment information check the box below.)
MON7�/DAY/YEAR
AMOUNT
PAYMENT TYPE
BRIEF DESCRIPTION OF IN KIND PAYMENT
PURPOSE
DESCRIBE RITABLEGPURPOSE,GORVER NMENTAL,
MONETARY DONATION
❑LEGISLATIVE
❑ GOVERNMENTAL
Sponsorship of 2022 Stand Now! Event
IN -KIND GOODS OR SERVICES
r CHARITABLE
❑ MONETARY DONATION
LEGISLATIVE
❑ IN -KIND GOODS OR SERVICES
GOVERNMENTALCHARITABLE
❑ The IoATErT is an estimate and reflects my best efforts at obtaining the accurate
5. Amendment Description and/or Comments (Provide date of original riling or confirmation number in Part 1.)
6. Verification
certify, under penalty of perjury un er the laws of the State of California, that tote best of my knowledge, the information contained ere n Is true and compete.
Executed on 2 L I DATE I—.[__ By ti BRAT FPPC Form 803 (February/2022)
advice@fppc.ca.gov