HomeMy WebLinkAbout2019-12-04 Form 410 - WoodsStatement of Organization
Recipient Committee RECEIVE D
OTennination -SeePart5 y OF Pt,LH SPR/N S
CALIFORNIA 41 0
FORM
Statement Type 0 Initial
Nol ye1 quahfied Dor
0 Dale quatll,ed as committee
Date qualified as comm,ttee
1. Committee information 1.0.Number
(If applic8ble)
NAME OF COMMITTEE
~Amendment
Date qua~fied as committee
{If amending to provide this date)
1419200
Dennis Woods For Palm S prings C ity Council District 2. 2019
STRHT ADDRESS (NOP O eox
CITY
Palm Springs, CA 92262
MAILING ADDRESS (If DIFFERENT]
STAIE ZJPCOOE AREA CODE/PHONE
(
Palm Spnngs, CA 92262
Riverside
JUAISOICTION WHEA[ (X)MMTTEE IS AC TIVE
Palm Springs
Attach add1t1onal information on appropriately labeled continuation sheets
3 . Veriflcatlon
2 19 DEC -4 PM '4: 3
Oa1eof1erm1nalion OF IC£ OF TH[ CITY CL E, f,
2. Treasurer and Other Principal Officers
NAME OF TREASURER
Peter F . East
STREET ADDRESS (NO P O BOX)
CITY STATE ZIP CODE ARE A CODE/PHONE
Palm Springs, CA 92262 (
NAME OF ASSISTANT TREASURER IF ANY
Robert Rotman
STREET ADDRESS (NO PO BOX)
CITY STATE ZIP CODE AAl:A COOEJP>tONE
Palm Springs, CA 92262 (
NAME Of PHINCIPAt OH'ICt:A!SI
STREET ADDRESS INO PO BOX)
CIT'< STATE ZlPCOOE AREA COOE/PI IONE
I have used all reasonable diligence in preparing this s tatement and to th e best of my knowledge the information contained herein is true and complete . I certify under
penalty ot pel')ury under the laws of the State of C ·t om,a that the foregoing Is true and correct.
Executed on __ I 1_/_3_0_/2_0_1_9 ___ By --~.&..
TREASURFR OR ASSISTANT TREASURER
Executed on __ 11_/_3-'0/_2_0_1_9 __ By
Executed on _______ _ By
SIGNATUl~C OF CONTROL! ING OFFICEHOI DER CANOIDIITE OR STATF MEASURE PROPONENT
Executed on ________ By -------------------------------------
SIGNAnJRE OF CONTAOWNG OFFICEHOLDER CANDIDATE OR STATE MEASURE PROPONENT
FPPC Form 410 (May/2017)
FPPC Advice: advlceO fppc.ca.gov (8661275-3772)
www.fppc .ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
C OMMITTEE NAM€
Dennis Woods For Palm Sp nngs City Council District 2, 201 9
• An com mittees must list the flnenclal institution where the campaig n bank account is located.
N-'IME or FINANCIAL INSTITUTION AREA CODE/PHONE
Bank Of A merica, N.A. (760) 8 64-8 584
ADDRESS CITY
1801 East P a lm Canyon Dnve Palm Springs, CA 92264
4. Type of Committee Complete the appficable sections.
Controlled Comm,ttee
BANK ACCOUNl NUMBfR
3251 16976114
STATE 71PCODE
CALIFORNIA 41 0
FOR M
··1•:
I O N U MBCR
1419200
• List th e name of each cont rolling o ffi1ceh old er, candid ate . o r state measure proponent. If candidate or offi ceholder controlled, alsoltst the elective office sought or held. and
d ist ric t number. If any, and th e year of the electr on
• List the political party w ith which each 0 1t1ceholder or candidate Is a ff ilia ted or check "nonpartisan •
• II this committee acts j ointly w ith anothe r controlled commIt1 ee, list the name and 1dentifrcat1on number o f the o ther controlled commI11ee.
NAME: OF CANDIDA fE/OfflCHlOI..DEA/S r A rE MEASURE PROPONENT
Den n is L W oods
ELECTIVE OrFICE SOUGKT OR r1ELD
(INCLUDE DISTRICT NUMBER If APPLICABLE)
City Council M ember
DISTRICT NO .. 2
<EAR OF ELECTION
2019
P'111Ja111y Fo11ne d Cornrmttee Pnmanty trmed to s upport or oppose specific candida tes or measures in a s ingle ele tron List below:
CANOIDATE(S) l~AME OR MEASUREISI FULL I ITLE (INCLUDE BAU.OT NO OR LETTER )
CANOIDATE(S) OFFlCE SOUGHT OR HELD OR MEASUREISI JURISDIC"TION
(l"ICLUDE DISTRICT NO CITY 0A COUNTY AS APPLLICABLE)
PART\
(Zl Nonparbsan
D Nonpartisan
CHECK ONE
OPPOSt
•
OPPOSf •
FPPC Form 410 (M ey/2017)
FPPC Advice: edvloe@tppc.ca.gov (8661275-3772)
WWW fppc.ca.gov
Statement of Organization
Recip ient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Den nis W oods For Pal m Sp nngs City Council O1stnc t 2 , 201 9
4 . Type of Committee (Contin ued)
CALIFORN IA 410
FOR M
ID NUMBER
141 9200
Genera, Pu~ ose Comm,ttee N ot formed to support o r o ppse specific candida tes or measures in a smgle elect ion C h eck only one box.
0 C ITY Committee O COUNTY Committee O STATE Committee
PAOVIOF BRIEF Of$CRIPTION Qr ACTIVITY
Sponsored Committee List add1 t1onal sponsors on an attachment.
NAME Of' SPONSOR INOUSTRV G ROUP or AFAUAT!ON OF SPONSOR
S TREFT AOORESS NO ANO STREET cnv STATF ZI P COOE
Small Contnbl,IOr Committee •-------
Date Ooallfle<f
5. Tennination Requirements B y signing th& 11erilication. 1he ti:easurer. asslst11111 treasurer end/or candidate, officeholder, or proponem certify that all of lh& following conditions have beea met;
• This committee has ceased to r eceive contnbutions and make expenditures;
• This committee does not anuc1pa te rece1v1ng contnbutt ons or making expenditures in the future,
• This committee has elimin at ed or has no in tention or ability to discharge all debts loans received. and o th er o bligations.
• This committee h as no su rplus fund s ; a n d
• T his committee has filed all campaign statements req ui red by the Political Reform Act d1sclos1ng all rep ortable transactions.
There are resl nchons on the d1spos1lion o f surplus campaig n funds held by elect ed officers who are leaving office and by defeate d candidates Rei er to Govern ment
Code Section 8951 9
Leftov er fun d s of ba llot measure committees may b e used fo r poht1cal , legislative or governmental purposes under Government Code Secti ons 8951 1 • 89518, an d are
subject to Ele ctions Code Sect10n 18680 and FPPC Regula tio n 18521.5
FPPC Form 410 (May/201 7)
FPPC Advice advk:e Ofppc.ca.gov (8661'275-3n2)
www.fppc .ca .. gov