803 Geoffrey Kors 2022-05-13 Jamie CarrBehested Payment Report
A Public Document
Type or Print In Ink.
Amendment of FIiing D Check box If an Amendment
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#. eontlnnailon Number
Date Stamp (Agency)
RECEIVED
MAY 16 2022
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:
(760)323-8299 f•MAIL:
geoff.kors@palmspringsca.gov
2.Pa or Information (For additional payors, Include an attachment with the names, addresses, end proceeding Information)NA --/\.'\ f-l r /I..'{, 10 S
;Go )(□Donor Advised Fund (OAF) (see Instructions) RIEF DESCRIPTION OF PROCEEDINGS: □ Payor Is a named party or the subject of a proceeding before my agency.
3. Paree Information (For additions/ payees, Include an attachment with_ the names, addresses and relationship Information)
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 nonDrOflt organization paye, provide a brief desorlptlon of any relatlonshlp to the offlclal, official's Immediate family member or staff member In the role of founder, salaried employee, decision-making capacity (f>oard member or executive officer) or posJtion on an honorary or advisory board. NAME AND TITLE: IROLE WITH THE NONPROFIT ORGANIZATION: ffRIEF DESCRIPTION:
James Williamson, President Board of Directors President, Board of Directors ISpouse
4.Payment Information (Complete all Information. For estimated paymen!_lnformstlon check the box below.)DATE AMOUNT PAYMENT TYPE BRIEF DESCRIPTION OF l�INO PAYMENT PURPOSE OESCRl�E J�EtiEG�™TI� G�VERN�ENTAL, (MONTH/DAY/YEAR> C A I A LE PO , 0 EVEN :
5/f J(Tl f O) I (J
ifuoNETARY DONATION □ IN-KIND GOODS OR SERVICES
□ The lo7'ff1A£iouA'f, Information.
0 MONETARY DONATION 0 IN-KIND GOODS OR SERVICES
Is an estimate and reflects my best efforts at obtaining the accurate
B LEGISLATIVE GOVERNMENTAL, CHARITABLE : LEGISLATIVE 111 GOVERNMENTAL. CHARITABLE REASON FOR ESTIMATE:
5. Amendment Description and/or Comments (Provide date of origins/ filing or confirmation number in Part 1.)
6.
CBI
Executed on -_ _ __ -p:;:t:::::::::Ji,fofia"; I ICC By
Sponsorship of 2022 Stand No�! Event
FPPC Fonn 803 (February/2022) advlce@fppc.ca.gov