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803 Geoff Kors 2022-04-10 Kay and Bill GurtinBehested Payment Report A Public Document Type or Print In Ink. Check box if an Amendment on i, ay, ear APR 12 2022 # on rmaUonum er I office of the City Cle) ��u�u ■ ���wmunn�i�n, i.n 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 CODE/PHONE NUMBER: E-MAIL: (760) 323-8299 geoff.kors@paimspringsca.gov 2. Payor Information (For additional payors, include an attachment with the names, addresses, and proceeding information) NAME: UuKtAJ: T: FAIr: ItY I,V Ut: ❑ Donor Advised Fund (DAF)I (see Instructions) ❑ Payor Is a named party or the subject of a proceeding before my agency. 3. Payee Information (Foradditional 4. Include an attachment with the names, addresses and ennocce• Planned Parenthood of the Pacific Southwet 11075 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 capacity board member or executive officer) or position on an honorary or advisory board. NAME AND TITLE: ROLE WITH THE NONPROFIT ORGANIZATION: James Williamson, President Board of Directors President, Board of Directors Al DA Information (Complete all information. For estimated payment information check the box below.) YEAR) AMOUNT PAYMENT TYPE BRIEF DESCRIPTION OF IN -KIND PAYMENT MONETARY DONATION L01 i IN -KIND GOODS OR SERVICES In MONETARY DONATION 13 IN -KIND GOODS OR SERVICES „- is an estimate and reflects my best efforts at obtaining the accurate I REASON FOR ESTIMATE: CITY: STATE: ZIP CODE San Diego CA 92108 3 role of founder, salaried employee, decision -making Spouse PURPOSE DESCRIBE RITABLEGPURPOSE,GOR GOVERNMENTAL, LEGISLATIVE Sponsorship of 2022 Stand Now! Event GOVERNMENTAL CHARITABLE LEGISLATIVE GOVERNMENTAL CHARITABLE S. Amendment Description and/or Comments (Provide date of original filing or confirmation number in Part 1.) 6. Verification I certify, under penalty of perjury under the laws of the State of California, that to the est of my k gwledge, the Information contained herein Is true a Executed on By DATE t "I 'i"""'U" FPPC Form 803 (February/2022) advice@fppc.ca.gov