803 Geoffrey Kors 2022-03-24 Richard and Crnda Forsha BlanchardBehested Payment Report
A Public Document
Type or Print In Ink.
1. Elected Officer or CPUC Member (Last name, First name)
ELECTED OFFICER OR CPUC MEMBER:
Kors, Geoffrey
DESIGNATED CONTACT PERSON (NAME AND TITLE):
2. Payor Information (For additional payors, include an attachment with the
RECEIVED
Amendment of Filing Date Stamp (Agency)
❑ Check box if an Amendment MAR 2 4 2022
(month, Day, ear Office of the City C
Con nnatlon um er
IENCY NAME: GENCY STREET ADDRESS:
ity of Palm Springs 3200 E Tahquitz Canyon Way
760) 323-8299
and
eoff.kors@palmspringsca.gov
V 5-6
NAME: DONOR(S)AND DONOR'S VISOR: (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:
Planned Parenthood of the Pacific Southwel 1075 Camino del Rio South
For a nonprofit organization payee, provide a brief description of any relationship to the official, official's Immediate family member or staff member
capacity (board member or executive officer) or position on an honorary or advisory board.
NAME AND TITLE: ROLE WITH THE NONPROFIT ORGANIZATION: B
James Williamson, President Board of Directors President, Board of Directors
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 C
/ 6� ❑ IN -KIND GOODS OR SERVICES ❑ GOVERNMENTAL
r CHARITABLE
❑ MONETARY DONATION 1771 LEGISLATIVE
❑
IN -KIND GOODS OR SERVICES GOVERNMENTAL CHARITABLE
REASON FOR ESTIMATE:
❑ The maTeT 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.)
CITY: STATE: ZIP CODI
San Diego CA 92108
3 role of founder, salaried employee, decision -making
DESCRIPTION:
ise
DESCRIBE RITABLE PURPOSt,GOR GOVERNMENTAL,
isorship of 2022 Stand Now! Event
6. Verification
cart . under Dena tv of Deriury under the laws of the State of California, that tote beat o&fnv knowledoe, the information contains ere n s true and compete.
Executed on 12 y I a III By T �s,> FPPC Form 803 (February/2022)
DATE
advice@fppc.ca.gov