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Behested Payment Report A Public Document_ _ BehestedPayment Report <br />1. Elected Officer or CPUC Member (Last name, First name) #. RE@aF_�rYp D <br />Giselle Hale i� <br />Agency Name r Official Use Only <br />g Y <br />Redwood City Council <br />Agency Street Address <br />Cie, _....,.... <br />1017 Middlefield Rd, Redwood City L'ity Clerk <br />Designated Contact Person (Name and title, if different) ❑ Amendment (See Part 5) <br />Area Code/Phone Number E-mail (Optional) Date of Original Filing: <br />650-521-2134 giselle@gisellehale.com (month, day, year) <br />2. Payor Information (For additional payors, include an attachment with the names and addresses.) <br />Facebook <br />Name <br />12 Hacker Way <br />Address <br />Menlo Park <br />City <br />3. Payee Information (For additional payees, include an attachment with the names and addresses.) <br />SMCU Community Fund (ATTN: Support Services) <br />Name <br />350 Convention Way <br />Address <br />Redwood City <br />City <br />CA <br />State <br />CA <br />State <br />94025 <br />Zip Code <br />94063 <br />Zip Code <br />4. Payment Information (Complete all information.) <br />Date of Payment: 1/12/21 Amount of Payment: (Fn-KindFMV) $ 49,500 <br />(month, day, year) (Round to whole dollars.) <br />Payment Type: ❑x Monetary Donation or ❑ In -Kind Goods or Services (Provide description below) <br />Brief Description of In -Kind Payment: <br />Purpose: (Check one and provide description below.) ❑ Legislative ❑ Governmental ❑x Charitable <br />Describe the legislative, governmental, charitable purpose, or event: Donation in support of childare providers <br />impacted by Covidl9 <br />5. Amendment Description and/or Comments <br />6. Verification <br />I certify, under penalty of perjury under the laws of the State of California, that to the best of my knowledge, the information contained <br />herein is true and complete. <br />Executed on <br />1/16/21 <br />DATE <br />By <br />G OF ELECTED OFFICER OR CPUC MEMBER <br />FPPC Form 803 (January/201k) <br />FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-377x) <br />