803 Geoffrey Kors 2022-05-05 Kay and Bill GurtinBehested Payment Report A Public Document
Type or Print In Ink.
Amendment of Flllng O Check box If an Amendment
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MAY 5 2022
CALIFORNIA 803 FORM
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1.Elected Officer or CPUC Member (Last nsme, First name)ELECTED OFFICER OR CPUC MEMBER:Kors, GeoffreyDESIGNATED CONTACT PERSON (NAME ANO TITLE):
AGENCY NAME: City of Palm Springs AREA CODE/PHONE NUMBER: (760)323-8299
f GEN CY STREET ADDRESS:3200 E Tahqultz Canyon Way E•MAIL: geoff.kors@palmsprlngsca.gov
2.Pa or Information (For additional payors, Include an attachment with the names, addresses, end proceeding Information)NAME: , . ,. DORESS:
RIEF DESCRIPTION OF PROCEEDINGS: □ Payor is a named party or the subject of a proceeding before my agency.
3.Payee Information (For additional payees, Include en attachment with the names, addresses and relationship Information)NAME: ADDRESS: Planned Parenthood of the Pacific Southwet 1075 Camino del Rio South CITY: San Diego STATE: ZIP CODE: CA 92108
For a nonprofit organization payee, provide a brief description of any relatlonshlp to the offlclel, offlclal'a Immediate family member or staff member In the role of founder, salaried employee, decision-making capacity (t;oard member or executive officer) or pasltlon on an honorary or advisory board, NAME AND TITLE: IROLE WITH THE NONPROFIT ORGANIZATION: l9RIEF DESCRIPTION: James WIiiiamson, President Board of Directors President, Board of Directors ISpouse
4.Pa ment Information (Complete all Information. For estimated payment Information check the bo" below.)(MONT��I�IYEAR) AMOUNT PAYMENT TYPE BRIEF DESCRIPTION OF IN-KIND PAVMENTI PURPOSE I oesc�nl.rrllrh.i?�Wb�.iiv��NTAL,
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'1 1 '\ . JI, /II, ,I !/1/ □ IN-KIND GOODS OR SERVICES GOVERNMENTAL Sponsorship of 2022 Stand Now! Event @ CHARITABLE □ MONETARY DONATION GOVERNMENTAL r ,,�_.,__. '" , 1 I I� LEGISLATIVE□ IN•KIND GOODS OR SERVICES CHARITABLE
C The tBXWAUoDNfJInformation. Is an estimate and reflects my best efforts at obtaining the accurate REASON FOR ESTI MATE:
5.Amendment Description and/or Comments (Provide dste of origins/ fl/Ing or oonnrmatlon number In Pert 1.)
8.
FPPC Fonn 803 (February/2022) advice@fppc.ca.gov