803 Geoffrey Kors 2022-04-26 Madeline butler and Arthur LevinBehested 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, GeoffreyDESIGNATED CONTACT PERSON (NAME AND TITLE):
!AGENCY NAME:
Amendment ofFlllng fi Date stamp (Agency) O Check box if an Amendment f< E C E i V E 0
'ontfi, Day, Lr} CIT Y F P A L H SP R IN OS
2022 PR 2 6 AM II : I 0tJ-.#--cP""onil.,.rma"""""'ff"'uo�n N�um�s�er--CLEf r GENCY STREET ADDRESS:
City of Palm Springs 3200 E Tahqultz Canyon Way !AREA CODE/PHONE NUMBER:
(760)323-8299
;E-MAIL: I geoff.kors@palmspringsca.gov 2.Payor Information (For additional payors, Include an attachment with the names, addresses, and proceeding Information)NAME: IADDRESS:
_OAF □ Donor Advised Fund (OAF)(see lnstNctlons)
�1,-. 1 J-1'-/ S
iBRIEF DESCRIPTION OF PROCEEDINGS: □ Payor Is a named party or the subject of a proceeding before my agency.
3.Payee Information (For additions/ payees, Include en attachment with the names, addresses and relationship lnfonnatlon)NAME: ADDRESS:
Planned Parenthood of the Pacific Southwet 1075 Camino del Rio South
CITY:
San Diego
CALIFORNIA 803 FORM
STATE: ZIP CODE:
CA 92108 For a non_proflt organization payee, provide a brief description of any relationship to the official, offlclal'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 adytsory board. NAME AND TITLE: IR,OLE WITH THE NONPROFIT ORGANIZATION: ---l9RIEF DESCRIPTION:
James WIiiiamson, President Board ofOlrectors IPresldent, Board of Directors ISpouse
4.Payment Information (Complete all lnfonnstlon. Forest/mated payment Jnfonnatlon check the box below.)DATE AMOUNT PAYMENT TYPE BRIEF DESCRIPTION OF IN-KIND PAYMENT PURPOSE DESc�nIFli�lt&�Wb�.'l>'ittQU��NTAL,CMONTHIDAY/VEAR>
s}JJ)Jrl
□ The 15AfflAL15CRrJ Information.
�,ouv �ONETARY DONATION□-KIND GOODS OR SERVICES□ MONETARY DONATION□ IN-KIND GOODS OR SERVICESIs an estimate and reflects my best efforts at obtaining the accurate
-LEGISLATIVE: GOVERNMENTAL .,, CHARITABLE -LEGISLATIVE: GOVERNMENTALCHARITABLE REASON FOR ESTIMATE:
5.Amendment Description and/or Comments (Provide date of original filing or conflnnstion number In Part 1.J
8.Verification•ee l& .L_
Executed on , , , <r x «
Sponsorship of 2022 Stand No�I Event
FPPC Form 803 (February/2022) advlce@fppc.ca.gov