HomeMy WebLinkAbout2019-06-03 Form 410 - WoodsStatement of Organization
Recipient Committee
Date St amp CALIFORNIA 41 Q
FORM ,--------------,-------------,,----------------j Statement Type 0 Initial D Amendment D Termination -See Part 5 For Offici al Use Only
e Not yet qualified
or 20 9 JUtl -3 AH II : 4 3
0 Date qualification threshold met Date qualification threshold met Date of term in ation
---,1---,1---___ , ___ , __ _
1. Committee Information 1.0. Number
(if applicable) 2. Treasurer and Other Principal Officers
NAME OF COMMITTEE NAME OF TREASU RER
Dennis Woods fo r Palm Springs City Council District 2 , ? o I '1 Robert Rotman
STREET ADDRE SS (NO P.O. BOX)
STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE
Palm Springs CA 92262
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY
Palm Springs C A 92262
FULL MAILIN G ADDR ESS (IF DIFFERENT) STREET ADDRESS (NO P.O. BOX)
WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S J
Riverside Palm Springs Dennis Woods
STREET AD DRESS (NO P.O. BOX)
Attach additional information on appropriate ly labeled co ntinuation sheets.
CITY STATE ZIP CODE AREA CODE/PHONE
Palm Springs CA 92262
3. Verification
I ha ve used all r easona ble diligence in
MEASURE PROPONENT
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE M EASURE PROPO NENT
FPPC Form 410 (August/2018)
FPPC Advice : advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
CALIFORNIA 41 Q
FORM
INSTRUCTIONS ON REVERSE
COMMITTEE NAME 1.D.NUMBER
Dennis Woods for Palm Springs City Council Dist ri ct 2 , ;) o I 9
• All co mmittees must list t he fin an cia l institution wher e t he ca mpai gn b an k acco unt i s l oca t ed.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
Bank of America (760) 864-8611 ·3 2.51
ADDRESS CITY STATE ZIP CODE
5 88 S Pa lm Canyon Dr. Palm Spri ngs CA 92264
~-Ty~e of Committee Complete the applicable sections. ------~~~~~---~--------~-----...;. _____________________ ...
Controlled Committee
• Li st the nam e of each co ntrolling office holder, candidate, or state m easure propone nt. If ca nd idate or office holder co ntro ll ed, also list th e elective office so ught or h eld, and
distr ict number, if any, and t h e year of the elec tion.
• List t he politica l party with w hich each officeholder o r ca ndidat e is affili at ed o r ch eck "nonparti sa n ." St ating "No party pre ference" is acce pt able.
• If t his co mm ittee acts jointly with an other co ntrolled committee, list the nam e and ide ntification number of th e other controlled committee.
NAME OF CA NOI DATE/OFFICEHO LDER/STATE MEASURE PROPONENT
ELECTIVE OFFICE SOUGHT OR HELD
(I NCLUDE DISTRICT NUMBER IF APPLICABLE)
YEAR OF
ELECTION
PARTY
CHECK ONE
No npartisan
Dennis Wood s Palm Springs C ity Council D istrict 2 0
Nonpartisan •
Primarily Formed Committee Pr im ari ly formed to supp o rt or oppose specific candidates o r measures in a sin gle e lection. Li st below:
CANDIDATE(S) NAME OR MEASURE(S) FU LL TITLE (INCLUDE BALLOT NO. OR LETTER)
IF A RECA LL, STATE "RECALL" IN FRONT OF TH E OFFICEHOLDER'S NAME.
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDI CTION
(IN CLUDE DISTRICT NO., CI TY OR COUNTY, AS APPLICABLE)
Partisan • Partisan •
(list political party below)
(list political party b elow )
CHECK ONE
I
SUPPORT I OD
8"•
FPPC Fo rm 410 (Augu st/2018)
FPP C Advice : advice@ fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
. Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Dennis Woods for Palm Springs City Council District 2 1 ? o I 4
CALIFORNIA 41 0
FORM
l,D,NUMBER
General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
0 CITY Committee O COUNTY Committee O STATE Committee
• PROVIDE BRIEF DESCRIPTION OF ACTIVITY
Sponsored Committee List additional sponsors on an attachment.
NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREET ADDRESS NO, ANO STREET CITY STATE ZIP CODE AREA CODE/PHONE
Small Contributor Committee • ---1---1---
Date qualified
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• This committee has ceased to receive contributions and make expenditures;
• This committee does not anticipate receiving contributions or making expenditures in the future;
• This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations;
• This committee has no surplus funds; and
• This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions.
There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government
Code Section 89519.
Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code Sections 89511-89518, and are
subject to Elections Code Section 18680 and FPPC Regulation 18521.5.
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov