HomeMy WebLinkAbout2019-07-01 Form 410 - WoodsREC EIVE D JUL 1 5 2019
Statement of Organization Date Stamp
Recipient Comr=m:-itt_e_e _____ ----,-=::---------r=-----~~l;IVED AND f .lLE
Statement Type O Initial 0 Amendment office o1 the Secretary of Sta
O Not yet qualified of the State of California
or e Date qualification threshold met Date qualification threshold met
06 / 20 / 20 19 ---------
1.0. Number
{if opplicoble) \ 4 I et. :;>. 0 0
NAME OF CO MMITTEE
Dennis Woods for Palm Springs City Council District 2, 20 19
ST REH AO ORE.55 (NO P.O. BOXI
(ITV STATE ZIP CODE
Palm Springs Ca 92262
FULL MAILING ADOR[S!i (If OtfF[R[NT)
E·MAIL AOORESS IREQUIRED)/ FAX (OPTIONAll
COU NTY OF OOMICtlE
Riverside
JUl:USOICTtON WH ERE COMM!TTCE IS ACT IVE
Palm Springs
ARE.A CODE/PHONE
Attach additional information on appropriately labeled co ntinuation sheets.
3. Verification
Date of termination JUL 01 2019
-1--1--
2. Treasurer and Other Principal Officers
NAME OF TREASURER
Robert Rotman
STREET AOORESS (NO PO BOXJ
CITY STAT£
Palm Springs CA
NAME OF ASSISTANT TREASURER, 1F ANY
STREET AOOR£SS (NO PO BOX)
CITY STATE
NAME OF PIU NCIPAl OfFICER(S)
Dennis Woods
STREET ADDRESS INO P.O. BOX)
(ITV STATE
Palm Springs CA
CALIFORNIA 41 Q
FORM
For Offfclal Use Only
ZIP CODE AREA. CODE/PHONE
92262
ZIP COO[ AREA CODE/PHONE
ZIP CODE AREA CODE/PHONE
92262
I have used all reasonable diligence in P::.r,,__.....,..:.
penalty of perju ry under the laws
STAT£ MEASURE PROPONENT
Execu t ed on By
DATE SIGNAiURE OF CONTROLUNG OfFICEt-40LOER CANOIOAH, OR STAT£ MEA SU RE PROPONENT
Executed on By
DATE SIG NATURE Of CONTROlUNG OfF1C(HOL0£R, CANDIDATE, OR STATE MEASURE PROPONENr
~;ti F=
Q l> I ,, ::0 U)
::oo --,,
~< ~
::00 (/)-, .. ofti o
FPPC Form 4ffi!(QQGust~8)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
.:u n,
n m -< rr,
0
•
Statement of Organization
Recipient Committee
CALIFORNIA 41 0 .
FORM. . ,
INSTRUCTIONS ON REVERSE
COMMITTEE NAME I 1.0, NUMBER
Dennis Woods for Palm Springs City Council District 2, 2019 141'1 ;i.oo
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAt INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
Bank of America 760.864.8611 325116976114
ADDRESS CITY STATE ZtP CODE
588 S. Palm Canyon Drive Palm Springs Ca 92264
'
Controlled Committee ..
list the name of each controlling officeholder, candidate, or state measure proponent. If candidate or officeholder controlled, also list the elective office sought or held, and
district number, if any, and the year of the election.
list the political party with which each officeholder or candidate is affiliated or check "nonpartisan." Stating "No party preferepce" is acceptable.
If this committee acts jointly with another controlled committee, list the name and identification number of the other controll~d committee.
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT
ELECTIVE OFFICE SOUGHT OR HELD
(INCLUDE DISTRICT NUMBER IF APPLICABLE)
VEAR OF
ELECTION I
PARTY
CHECK ONE
Dennis Woods
Primarily F9rmed Committee •
Nonpartisan
Palm Springs City Council District 2 2019 0
Nonpartisan •
I
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER)
IF A RECALL, STATE "RECALL~ IN FRONT OF THE OFFICEHO~OER'S NAME.
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASlJRE{S) JURISDICTION
(INCLUDE DISTRICT NO., CITV OR COUNTY. AS APPLICABLE)
Partisan • Partisan •
(list political party below)
(list political party below)
CHECK ONE
°[j
FPPC Form 410 (August/2018)
FPPC 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, 2019
I
CALIFORNIA_ 41 Q ..
FORM -~ -.
1,0, NUMBER
p·:,.;1)1iiE!iof (:ofurili~ee·-\f-,:;;:-,:.csoritj6Ued1;:~~;,ys:\'S~,:V·fi;• ~~-~J /". {1;,,_¾b" 47; ,j ,~')~~~ -~. ·~ -J~)'~ -~~,.;-;_;. ·:-,~ :: -, . .-~ _, : .. '-:.~-~,:;:~ .· -· -: ; ·:~-7-i,_; -~.: ,t:>; w "'-·-",·~· -""=~=:-_'_•c__•_· -·c.,_·•~-~--· ... f_".~-~i_,I
i
• §el!_e!af Purpose._ Commi~ee " Not formed to supp'ort or oppose specific candidates or measures in a single election. Check only one box:
0 CITY Committee' 0 COUNTY Committee O STATE Commi'ttee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
Spon"sored Committee • list additional sponsors on an attachment.
NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREET ADDRESS NO. ANO STREH CITY STATE ZIP CODE AAEA CODE/PHONE
, · Small Contributor Committee •-1--'/ __
Date qualified
snTetmin·atiOl'l"·R"e~qliii"E!JTien:tS~-,:tziBy:;Tg~ingtt\~veiiflcitio~o,ia'·fil:i''s"oferfass1rumf'tre1islf,i!7a~d/Or'eandiaatl5':6ffl&'h61i:re'r::or;proP9n"ent-~rti'"'f~1hatli11:itthe10f16\Vi~i'cO~d1tiCln's'h'a~i/b'eeiimtt~:? .. ~~-t,;:~ .,_,,.,_.._' . __,..,...~~--="'~-•"""-'-"-'-----...-~-. ......... ~--~~-=-'~--·='---!•~----··~..-... .4 .. -.,...,..--.;c.~~--•-S--,.,-.-...,.,._,-.,,_ .. ]L.~-lX:.~-
' 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; 1
I
I • This committee has no surplus funds; and
• This committee has filed all campaign statementsirequired by the Political Reform Act disclosing all reportable transactions.
--There are restrictions on the disposition of sur.plus campaign funds held by elected officers who are leaving office and b~ 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