HomeMy WebLinkAbout2019-08-19 Form 410 - Woods'\. I -:,.--...
Statement of Organization Date Stamp
Recipient Com_m_i_tt_e_e _____________________ ,-1RECEI 'v'ED .
Statement Type • Initial 1£1 Amendment • Termination -See'r,li"ft'i; F 'P:h LH SPRINGS
CALIFORNIA 41 Q
FORM
For Official Use Only
0 Not yet qualified
or
Date of termination 0 Date qualification threshold met Date qualification threshold met
6 1 20 1 2019 ,OFFlc· OF THE CITY CLER!i
~;{tli,~11.J;-;:~.
NAME OF COMMITTEE
''Y 1.D. Number
(If applicable} 1419200
Dennis Woods for Palm Springs City Council District 2, 2019 Peter F East
STREET ADDRESS (NO P.O. BOX)
CITT STATE
Palm Springs CA
FULL MAILING ADDRESS {IF DIFFERENT)
E·MA.IL ADDRESS (REQUIRED)/ FAX (OPTIONAU
ZIP CODE
92262
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE
Riverside City of Palm Springs
AREA CODE/PHONE
(
STREET ADDRESS {NO P.O. BOX)
CITT
Palm Springs
NA.ME Of ASSISTANT TREASURER, IF ANY
Robert Rotman
STREET ADDRESS (NO P.O. BOX)
CITT
Palm Springs
NAME OF PAINOPAL OFFICER(S)
Dennis Woods
STREET ADDRESS (NO P.O. BOX)
CITT
Attach additional information on appropriately labeled continuation sheets. Palm Springs
DATE
Executed on 8f14/2019 By
DATE PROPONENT
Executed on By
DATE SIGNATURE Of CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
STATE ZIP CODE AREA CODE/PHONE
CA 92262 (
STATE ZIP CODE AREA CODE/PHONE
CA 92262 (
STATE ZIP CODE AREA CODE/PHONE
CA 92262 (
FPPC Form 410 (August/2018)
FPPC Advice: advlce@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
CALIFORNIA 41 Q
FORM
INSTRUCTIONS ON REVERSE
COMMITTEE NAME I.D.NUMBER
Dennis Woods for Palm Springs City Council District 2, 2019 1419200
• All committees must list the financial institution where t_he campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
Bank of America (760) 864-8811 325116976114
ADDRESS CITY STATE ZIP CODE
588 S Palm Canyon Dr Palm Springs CA 92264
~-Type of-Committee Complete the applicable sections.
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 preference" is acceptable.
• If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee.
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT
ELECTIVE OFFICE SOUGHT OR HELO
{INCLUDE DISTRICT NUMBER JF APPLICABLE)
YEAR OF
ELECTION
PARTY
CHECK ONE
Nonpartisan
Dennis Woods Palm Springs City Council District 2 2019 0
Nonpartisan •
Primarily Formed Committee 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 OFFICEHOLDER'S NAME.
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
Partisan • Partisan •
(list political party below)
(list political party below)
FPPC Form 410 (August/20181
FPPC Advice: advlce@fppc.ca.gov (866/275-37721
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Dennis Woods for Palm Springs City Council District 2, 2019
4. Type of Committee (Continued)
CALIFORNIA 41 Q
FORM
1.0, NUMBER
1419200
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 att_~chment.
NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE AREA CODE/PHONE
Smalf Contributor Committee o _ __,. __ , __
Date qualified
5. Termination Requirements !3y signing the verification, the treasu_rer, a~sistant treasurer and/or can~i~ate, qfficeholder, or proponent certify that all of the following conditions have been me_t:
• 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: advlce@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov