803 Geoffrey Kors 2022-05-05 David LeeBehested Payment Report
A Public Document
Type or Print In Ink.
Amendmenf offlllngD Check box if an Amendment
fuontfi, Day, Lr)
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MAY 5 2022
CALIFORNIA 803 FORM
# -----""!Co-n"l!fi""'rm-a""!ti""o-n .. N"'u-m-.b_e_r __ _ Office of the City Clek-k
1.Elected Officer or CPUC Member (Last name, First name)ELECTED OFFICER OR CPUC MEMBER: rGENCY NAME: rGENCY STREET ADDRESS:
Kors, Geoffrey City of Palm Springs 3200 E Tahquitz Canyon Way, Palm Springs, CA 92262 DESIGNATED CONTACT PERSON (NAME ANO TITLE): AREA CODE/PHONE NUMBER:
760-323-8299
f•MAIL:
geoff.kors@palmpringsca.gov
2.Payor Information (For additional payors, include an attachment with the names, addresses, and proceeding information)NAM� 1 J(DDRESS: / r:· ' '
; f Cvr �
D Donor Advised Fund (DAF)(see instructions) RIEF DESCRIPTION OF PROCEEDINGS: D 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:
Boys & Girls Club of Palm Springs 450 S. Sunrise Way
ITY:
� �t;e}S
CITY:
Palm Springs
STATE: ZIP CODE:
CA 92262
For a nonprofit 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 (Doard member or executive officer) or position on an honorary or advisory board. NAME AND TITLE: IROLE WITH THE NONPROFIT ORGANIZATION: l9RIEF DESCRIPTION:
Geoffrey Kors, President Board of Directors President Board of Directors lself
4.Payment Information_ (9_omplete all inrormatlon. For estlma_ted payment info,matlon check �he box below.)DATE AMOUNT PAYMENT TYPE BRIEF DESCRIPTION OF IN-KIND PAYMENT PURPOSE DESCRIBE THE LEGISLATIVEE GOVERNMENTAL, (MONTH/DAY/YEAR) CHARITABLE PURPOS , OR EVENT: ca(_MONETARY DONATION B LEGISLATIVE f/!/1<!� � � //)(/
GOVERNMENTAL 0 IN-KIND GOODS OR SERVICES I� CHARITABLE 0 MONETARY DONATION □LEGISLATIVE
0 IN-KIND GOODS OR SERVICES R GOVERNMENTAL CHARITABLE REASON FOR ESTIMATE: □The (DATE/AMOUNT) 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.VerificationI __ ...... ;2 _____ 3 __
Executed on �s/�/iJ-2 By � < -- ,< ,<� < @A"!ia 111ue
Sponsorship of 2022 Fundraising Event
FPPC Form 803 (February/2022)
advice@fppc.ca.gov