HomeMy WebLinkAbout2021-07-22 Form 460 - PettitCOVER PAGE
Recipient Committee
Campaign Statement
Cover Page
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from January 1, 2021
through June 30, 2021
1. Type of Recipient Committee: All Committees —complete Parts 1, 2, 3, and 4.
W1 Officeholder, Candidate Controlled Committee
O State Candidate Election Committee
Q Recall
.,,Also Complete Part 5)
❑ General Purpose Committee
O Sponsored
O Small Contributor Committee
O Political Party/Central Committee
3. Committee Information
4.
Alfie Pettit for City Council, District 3, 2019
❑ Primarily Formed Ballot Measure
Committee
O Controlled
O Sponsored
{Also Complete Part 6)
❑ Primarily Formed Candidate/
Officeholder Committee
(Also Complete Part 11
I.D. NUMBER
141924,
STREET ADDRESS tNO P.O. BOX)
(
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL FAX ? E-MAILADDRESS
Date Stamp
REc t
�109j't9
Date of election if applicable: SDI
/ JU
(Month, Day, Year) L L 27 pH ^ , O
November 5, 2019 Fl CF OF THE C1 t Y CL f i l
2. Type of Statement:
❑ Preelection Statement
Semi-annual Statement
❑ Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
1 of 5
For Official Use Only
❑ Quarterly Statement
❑ Special Odd -Year Report
Treasurer(s)
NAME OF TREASURER
Michael R. McCulloch
CITY STATE ZIP CODE AREA CODE/PHONE
Palm Springs CA 92262 (
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL. FAX / E-MAIL ADDRESS
Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete. I
certify under penalty of perju under th laws of the State of California that the foregoing is true and correct.
Executed on._ �0 2-1
-z Z ✓ ,/
Executed on By
011ete Signature of Controlling utilcenoider Candidate, State Measare TTrbponent or Responsible Officer of Sponsor
Executed on
Date
Executed on
Date
By
Signature of Controlling Officeholder Candidate State Measure Proponent
By
Signature of Controlling Officeholder Candidate, State Measure Proponent
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Recipient Committee
Campaign Statement
Cover Page — Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Alan P. Pettit
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
Palm Springs City Council, District 3, 2019
RESIDENTIAL/BUSINESS ADDRESS (NO.AND STREET) CITY STATE ZIP
Related Committees Not Included in this Statement: List any committees
not included in this statement that are controlled by you or are primarily formed to receive
contributions or make expenditures on behalf of your candidacy.
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREET ADDRESS (NO PO. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREACODE/PHONE
COVER PAGE - PART 2
Page 2 of 5
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER JURISDICTION
❑ SUPPORT
❑ OPPOSE
Identify the controlling officeholder, candidate, or state measure proponent, if any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY
7. Primarily Formed Candidate/Officeholder Committee List names of
officeholder(s) or candidate(s) for which this committee is primarily formed.
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
Attach continuation sheets if necessary
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
Amounts may be rounded
to whole dollars.
SUMMARY PAGE
Statement covers period
from January 1, 2021
through June 30, 2021 Page 3 of 5
NAME OF FILER
I.D. NUMBER
Alfie Pettitt for City Council, District 3, 2019
1419242
Column A
Column B
Calendar Year Summary for Candidates
Contributions Received
TOTAL THIS PERIOD
CALENDAR YEAR
Running in Both the State Primary and
(FROM ATTACHED SCHEDULES)
TOTAL TO DATE
General Elections
0
0
1. Monetary Contributions...................................................
Schedule A, Line 3
$ $
1/1 through 6/30 711 to Date
0
0
2. Loans Received................................................................
Schedule B. Line 3
0
0
20. Contributions
3. SUBTOTAL CASH CONTRIBUTIONS ..............................
Add Lines 1 +2
$ $
Received $ $
0
0
4. Nonmonetary Contributions ............................................
Schedule C, Line 3
21. Expenditures
0
0
Made $ $
5. TOTAL CONTRIBUTIONS RECEIVED. ...................................
Add Lines 3 + 4
$ $
Expenditures Made
6. Payments Made................................................................
Schedule E, Line 4 $
0 $
0
7. Loans Made.......................................................................
Schedule H, Line 3
0
0
8. SUBTOTAL CASH PAYMENTS ..........................................
Add Lines 6 +7 $
0 $
0
9. Accrued Expenses (Unpaid Bills) ..........................................
Schedule F Line 3
0
0
10. Nonmonetary Adjustment.........................................................
Schedule C, Line 3
0
0
11. TOTAL EXPENDITURES MADE ........................................
Add Lines 8 + 9 + 10 $
0 $
0
Current Cash Statement
12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $
13. Cash Receipts........................................................... Column A, Line 3 above
14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4
15. Cash Payments......................................................... Column A, Line 8 above
16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $
If this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ................................ Schedule s, Part $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ................................................ See instructions on reverse $
19. Outstanding Debts .............................. Add Line 2 +Line 9 in Column 8 above $
0
To calculate Column B,
0
add amounts in Column
Ato the corresponding
amounts from Column B
0
0
of your last report. Some
amounts in Column A may
0.00
be negative figures that
should be subtracted from
previous period amounts. If
this is the first report being
0,00
filed for this calendar year,
only carry over the amounts
from Lines 2, 7, and 9 (if
0.00
any).
0.00
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made'
(if Subject to Voluntary Expenditure Limit)
Date of Election Total to Date
(mm/dd/yy)
Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
SCHEDULE B - PART 1
Schedule B — Part 1 vto whole dollars.
Statement covers period
CALIFORNIA
Loans Received
January 1, 2021
FORM 460
from
through June 30, 2021
page 4 of 5
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
Alfie Pettitt for City Council, District 3, 2019
1419242
FULL NAME, STREETADDRESS AND ZIP CODE
IF AN INDIVIDUAL. ENTER
a
OUTSTANDING
AMOUNT
(c)
AMOUNT PAID
OUTSTANDING
e
INTEREST
ORIGINAL
g
CUMULATIVE
OF LENDER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED. ENTER
BALANCE
BEGINNING THIS
RECEIVED THIS
OR FORGIVEN
BALANCE AT
CLOSE OF THIS
PAID THIS
AMOUNT OF
CONTRIBUTIONS
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
NAME OF BUSINESS)
PERIOD
PERIOD
THIS PERIOD'
PERIOD
PERIOD
LOAN
TO DATE
❑ PAID
CALENDAR YEAR
Alan P. Pettit
Self-employed
RATE
28843.09
$ 0
$
DEMAND
$ 0
$
t iZ IND ❑ COM ❑ OTH [-I PTY ❑ SCC
$
DATE DUE
DATE INCURRED
❑ PAID
CALENDAR YEAR
$ 0
$ 0
0%
$ 0
$ 0
FORGIVEN
E] FORGIVEN
PER ELECTION**
$ 0
$ 0
$ 0
$ 0
$
DATE DUE
DATE INCURRED
T❑ IND ❑ COM ❑ OTH ❑ PTY [_1 SCC
❑ PAID
CALENDAR YEAR
$ 0
$ 0
0 oro
$
S 0
E] FORGIVEN
PER ELECTION**
RATE
$ 0
S 0$
0
0
$ 0
$
I
I
DATE DUE
DATE INCURRED
T❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
SUBTOTALS $ 0 $ 0 $ 28843.09 $ 0
Schedule B Summary
Loansreceived this period........................................................................
(Total Column (b) plus unitemized loans of less than $100.)
2. Loans paid or forgiven this period...............................................................
(Total Column (c) plus loans under $100 paid or forgiven.)
(Include loans paid by a third party that are also itemized on Schedule A.)
3. Net change this period. (Subtract Line 2 from Line 1.) .............................
Enter the net here and on the Summary Page, Column A, Line 2.
*Amounts forgiven or paid by another party also must be reported on Schedule A.
** If required.
...............$ n nn
................... NET $ n no
(May be a negative number)
(Enter (e) on
Schedule E, Line 3)
tContributor Codes
IND— Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Party
SCC — Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
SCHEDULEF
Schedule F Amounts may be rounded Statement covers period CALIFORNIA
Accrued Expenses (Unpaid Bills) to whole dollars. from January 1, 2021 FORM 460
through June 30, 2021 Pa e 5 of 5
9
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER I.D. NUMBER
Alfie Pettitt for City Council, District 3, 2019 1419242
CODES: If one of the following codes accurately describes the payment, you may enter the code.
Otherwise, describe the payment.
CMP
campaign paraphernalia/misc.
MBR
member communications
RAD
radio airtime and production costs
CNS
campaign consultants
MTG
meetings and appearances
RFD
returned contributions
CTB
contribution (explain nonmonetary)*
OFC
office expenses
SAL
campaign workers' salaries
CVC
civic donations
PET
petition circulating
TEL
t.v. or cable airtime and production costs
FIL
candidate filing/ballot fees
PHO
phone banks
TRC
candidate travel, lodging, and meals
FND
fundraising events
POL
polling and survey research
TRS
staff/spouse travel, lodging, and meals
IND
independent expenditure supporting/opposing others (explain)*
POS
postage, delivery and messenger services
TSF
transfer between committees of the same candidate/sponsor
LEG
legal defense
PRO
professional services (legal, accounting)
VOT
voter registration
LIT
campaign literature and mailings
PRT
print ads
WEB
information technology costs (internet, e-mail)
(a)
(b)
(c)
(d)
NAME AND ADDRESS OF CREDITOR
CODE OR
OUTSTANDING
AMOUNT INCURRED
AMOUNT PAID
OUTSTANDING
(IF COMMITTEE, ALSO ENTER I.O. NUMBER)
DESCRIPTION OF PAYMENT
BALANCE BEGINNING
THIS PERIOD
THIS PERIOD
BALANCE AT CLOSE
OF THIS PERIOD
(ALSO REPORT ON E)
OF THIS PERIOD
Honey Printing
1801 E Tahquitz Canyon Way, STE 101
LIT
1,738.65
0
0
1,738.65
Palm Springs, CA 92262
McCulloch & Company, CPA
801 E Tahquitz Canyon Way, STE 102
PRO
5,205.00
0
0
5,205.00
Palm Springs, CA 92262
* Payments that are contributions or independent expenditures must also be SUBTOTALS $ 6,943.65 $ 0 $ 0 $ 6,943.65
summarized on Schedule D.
Schedule F Summary
1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for
accrued expenses of $100 or more, plus total unitemized accrued expenses under $100. ...............INCURRED TOTALS $ 0.00
2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on
accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under$100.)................................... PAID TOTALS $ 0.00
3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and
Page, Column A, Line 9.......................................... NET $ 0.00
on the Summary g ).......................................................................................................................................... May be a negative number
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov