HomeMy WebLinkAbout2017-01-31 Form 460 - KorsCOVER PAGE L.-
Recipient Committee
Campaign Statement
Cover Page
from
Statement oovers period
7/1 /2016
SEE INSTRUCTIONS ON REVERSE through 12/31/2016
9. Type of Recipient: Committee: AN Comastees - Complete Parts 1, 2.3. and 4.
® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure
0 State Candidate Election Committee Committee
Q Recall 0 Controlled
(AW CemOk Aw 5) 0 Sponsored
row Compbb Pert 6)
❑ General Purpose Committee
0 Sponsored
O Small ContribiAor Committee
O Political Party/Centrat Committee
3. Committee inforrnation
Geoff Kors for City Council 2015
❑ Primarily Formed Candidate!
Officeholder Committee
(Eft ComptY Pat 7)
I.D.
STR9FT ADDRESS (NO P.O. BO )
CITY
STATE
ZIPCOOE
AREACODE/PHONE
Palm Springs
CA
92262
MAILING ADDIIESS (IF DI FFERENT) NO. AND STREET OR P.O. BOX
CITY
STATE
ZIP CODE
AREA CODU ONE
Palm Springs
CA
92263
OPTIONAL: FAX I E-MAIL ADDRESS
Date Stamp
RECEJVED
:11 Y OF PALM SPRING
Date of election If applicabl-7 7 JAM 31 PM 2: (4
(Month, Day, Year)
2. Type of Statement:
❑ Preelection Statement
® Semi-annual Statement
❑ Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
Treasurer(s)
Page 1 of —
For Official Use Only
❑ Quarterly Statement
❑ Special odd Year Report
NAME OF TREAS URE R
James Williamson
MAIUNGADDRESS
CITY
STATE
ZIPCODE AREACODE/PHONE
Palm Springs
CA
92262
NAME OF ASSISTANT TREASURER, IFANY
Steve Mele
Cray
STATE
23PCODE AREACODEIPNONE
Washington
DC
20003
OPTIONAL: FAX I E4AAILADDRESS
4. Verification
of my knowledge the information contained) herein and in the attached schedules is true and complete. I
I have used all reasonable diligence in preparing and reviewing this statement and to the best
certify under penalty of perjury under the laws of the State of California that the
By
34nowns ofContrMv oftahc5r. Ga te, Stab memure Proponent
(3y �- S ure Co r, tale uie raportenl
FPPC Form 460 (Jan/2016)
FPPC Advice: advloe@10pc.ca.gow 1866/275-3772)
www.fopc.ca.gov
Recipient Committee
Campaign Statement
Cover Page --- Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Geoff KOrs
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IFAPPLICABLE)
Held. City Council Member
RESIDENTIALJBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP
Palm Springs CA 92262
Related Committees Not Included In this Statement: ustanycommittees
not Included in this statement that we controlled by you or are pdmarity formed to receive
contribudons or mare expendflures on behalf of your candfdacy.
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODEPHONE
I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COVER PAGE - PART 2
page 2
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
of 4_
BALLOT NO, OR LETTER JURISDICTION
❑ SUPPORT
❑ OPPOSE
Identify the controlling of icaholder, candidate, or state measure proponent, If any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
DISTRICT NO. IF ANY
7. Primarily Formed Candidate/Offlceholder Committee ust names or
of Iceholderfs) or candid uft(s) for which this com►nitreo is prlma►tly 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
CITY STATE ZIP CODE AREA CODEIPHONE Attach condnuadon sheets if necessary
FPPC Form 450 (lw/2016)
FPPC Advice: edvice@fppc.ca.gov (866/27S-3772)
www.fppc.ca.gov
Campaign Disclosure Statement Amounts �Y rounded
to while dollars.
Summary Page
inY 11n'Mnkle nki ockmaCL
NAME OF FILER
Contributions Received
1. Monetary Contributions................................................... schedule A, Line 3 $
2. Loans Received................................................................ Schedule a Line 3
3. SUBTOTAL CASH CONTRIBUTIONS .............................. AddUnes 1+2 $
4. Nonmonetary Contributions ............................................ Schedule C, L#W 3
5. TOTAL CONTRIBUTIONS RECEIVED..,.... ............................ Add Lines 3+4 $
Expenditures Made
6. Payments Made................................................................ schedule E Line 4
7. Loans Made....................................................................... Schedule H, Line 3
8. SUBTOTAL CASH PAYMENTS .......................................... AddLines6+7
9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3
10. Nonmonetary Adjustment......................................................... Schedule C, Line 3
11. TOTAL EXPENDITURES MADE ... _........ _......................... Add Unes8+9+10
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 ►, Line 4
15. Cash Payments......................................................... Column A, Line s above
16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14 sran subtract Line f5
if this is a termination statement Line 16 must be zero.
Column A
TOTA L THISPERIOD
(FROM ATTACHED SCHEDULES)
0.00
0.00
0.00
0.00
0.00
$ 147.15
0.00
$ 147.15
0.00
0.00
$ 147.15
$ 32,160.05
147.15
$ 32,012.90
17. LOAN GUARANTEES RECEIVED ................................ SchedulOA Part2 $ 0.00
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ................................................ sae irWnrcWns on reverse $
19. Outstanding Debts .............................. Add Line 2 +line 9 in Column 9 above $
rE r
from
staument covers period
711 /2016
SUMMARY PAGE
through 12/31/2016 I pg. 3 of 4
Column B
CALe"R YEAR
TOTAL TO DATE
0.00
0.00
$ 0.00
0.00
$ 0.00
$ 2,870.96
0.00
$ 2,870.96
0.00
0.00
$ 2,870.96
To calculate Column B,
add amounts in Column
Ato the corresponding
amounts from Column B
of your last report Some
amounts in Column A may
be negative figures that
should be subtracted from
previous period amounts. if
this is the first report being
filed for this calendar year,
only carry over the amounts
from tines 21 7, and 9 (if
any).
1376802
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
11t thrOU0 sm 711 to pate
2o. Contributions
Received $ $
21. Expenditures
Made $ $
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made"
In Sub]W to whnfty Expen& w'e un*l
Date of Election
(mrMddlyy)
-J-___1 $
Total to Date
•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.cm.gov
Schedule E
Payments Made
INSTRUCTIONS
Amounts may be rounded
to whole dollars.
Statement covers period
from 7/1 /2016
through 12/31 /2016
SCHEOULE
Pave - or
1376802
CODES: If one of the following codes accurately describes the payment, you may enter the code.
Otherwise, describe the payment.
CMP
CNS
campaign paraphemalia/misc.
campaign consultants
MBR
member communications
RAD
radio airtime and production costs
CT8
contribution (explain nonmonetary)'
MTG
OFC
meetings and appearances
office expenses
RFD
returned contributions
CVC
FIL
civic donations
candidate filing/ballot fees
PET
petition circulating
SAL
TEL
campaign workers' salaries
tv. or cable airtime and production costs
FND
fundraising events
PHO
POL
phone banks
polling and survey research
TRC
TRS
candidate travel, lodging, and meals
IND
LEG
independent expenditure supportinglopposing others (explain)`
legal defense
POS
postage, delivery and messenger services
TSF
1, to i
staff/spouse travel, lodging, and meals
transfer between committees of the same candidate/sponsor
LIT
campaign literature and mailings
PRO
PRT
professional services (legal, accounting)
VOT
voter registration
print ads
WEB
information technology costs (Internet, email)
NAME AND ADDRESS OF PAYEE
(IF COMMTMM- ALSO ENTER I.D. NUMBER)
First Bank Merchant Services
5565 Glenridge Connector NE, Ste 2000
Atlanta, FL 30342-1651
CODE OR DESCRIPTION OF PAYMENT
Merchant Services/Bank Fees
OFC
AMOUNT PAID
147.15
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 147.15
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.)............ $
2. Unitemized payments made this period of under$100................................................
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (a).) ................. $.......................................................
4. Total payments made this period, (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)............ .... TOTAL $
147.15
147.15
FPPC Form 460 ()an/2016)
FPPC Advice: advice@fppe.co.gov (866/275-3"2)
www.fppc.ca.gov
Recipient Committee
Campaign Statement
Cover Page
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from 1/1/2016
through 6/30/2016
I. Type of Recipient Committee: All Committees — Complete Parts 1, 2, s, and 4.
Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure
Q State Candidate Election Committee Committee
0 Recall 0 Controlled
wsoComp"Part 5) 0 Sponsored
(Also Complete Part 6)
❑ General Purpose Committee
O Sponsored ❑ Primarily Formed Candidate/
O Small Contributor Committee Officeholder Committee
Q Political PartylCentral Committee (Also CompefePert7)
3. Committee Information I I.D. NUMBER
1376802
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Geoff Kors for City Council 2015
STREETADDRESS (NO P.O. BOX)
1455 N Vine Ave
CITY
STATE
ZIP CODE
AREACODUPHONE
Palm Springs
CA
92262
7605370061
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
PO Box 1585
CITY
STATE
ZIP CODE
AREACODE/PHONE
Palm Springs
CA
92263
7605370061
OPTIONAL: FAXIE-MAILADDRESS
Date of election if applicable:
(Month, Day, Year)
2. Type of Statement:
Stamp
RECEI
1T Y U pt L 1 5i'R
2916 AUG - I pM y; 1-2
JAMES Tl<iUi
CITY CLERK
❑
Preelection Statement
❑
Semi-annual Statement
❑
Termination Statement
(Also file a Form 410 Termination)
❑
Amendment (Explain below)
❑ Qi Statement
❑ Special Odd -Year Report
COVER PAGE
Of
Treasurer(s)
NAME OFTREASURER
James Williamson
MAILING ADDRESS
1455 N Vine Ave
CITY
STATE
ZIP CODE AREA CODE/PHONE
Palm Springs
CA
92262 7605370060
NAME OF ASSISTANT TREASU R ER, IFANY
Steve Mele
MAILING ADDRESS
611 Pennsylvania Ave
CITY
STATE
ZIP CODE AREACODE/PHONE
Washington
DC
20003-4303
OPTIONAL: FAXlE-MAILADDRESS
geoffkorsps@gmail.com williamsonjg@gmail.com
4. 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 perjury under the laws of the State of California that the foregoing is true and correct. __7�/;
Executed on
Executed on
July 28, 2016
Date
July 28, 2016�z
By
i 5' tureof reasurerorAssislantTreasurer
Date
Signature of Controllin icehoker, Candidate, State Measure Proponent or Responsible Officer of Sponsor
Executed on
Date
By
Signature ofControling Officeholder, Candidate, Slate Measure Proponent
Executed on
Date
By
Signature ar Conlraging Officeholder, Candidate, Slate Measure Proponent
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fplpc.ca.gov (866/275-3772)
www.fppc.ca.gov
Recipient Ccrrimittee
Campaign Statement
('A'over Page -s Part 2
6. Officeholder or a; andidate Con•tro led Committee
hJAME OF OFFICEHI L.CiE-R. OR CANDIDATE
!'leoff Kors
FFICE SOUGHT OF HEl-D (INCLUDE LOCATIhJ AND DISTRICT NL' 4; GNR IF APPLICABLE]
Held: City Coun(J1 Member
7EEIDENTIALIBUSINL!":5 ADDRESS (NO-4.111::� :�fREET) CITY STATE "I �-
1455 N.Vine A% ,: Palm Spririgs CA
Related Committees Not Included in this State l>IvaHit: List anycorrtnPWous
neat Included in this s rarement that are cony oNed by you or are ,u.' uoarily formed to deceive
contributions or ra4A a expenditures on boghaJ? of your candidacy.
COMMITTEE NAME LL PLUMBER
P,IAME OF TREASURFR CC:11'41 ROLLED CQMMITTFF
L,.... 5'ES ❑ NO
STREET AC.'_)1'ifESS (NO P.O. BOX)
{;ITY 6'1I TE ZIP CODE AREA CODE0''r1,"71IJE
C:QMMl I ILL NAME
I.C. NUMBER
hLWE OF TREASURE' CCSNTROLLED COMMITTEE"'
C_] 'YES ❑ NO
t'.':OMMITTEEADDREiF:6 a STREET ACF,1RESS (NO P.O. BO
CITY "TC"TE ZIP CON AREACODEJ,k--iblE
1::C'i''JER PAGE - PART'
Page __..._.....— of ,.,.
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASI :- ---
SAL L.C-T NO. OR LETTER JURI5DICTI0r1
SUPPORT k1OPPOSE
Ide.nfify the controlling officeholder, candlcW:r , or state mesa uFo I:anaaponent, if any.
NAPIL OF OFFICEHOLDEkI, „ANDIDATE, OR PRCI;1:11 .:, =NT
CF'f'lCl= SOUGHT OR HEI- I
OISTRICT f,A"l IFANY
7. Primarily Formed C;&' ndidate/Officeholder Committee Listrrames of
off'ceholderis) or candidarq's) for which this ''ormmlttee is primarily Fore ed.
l,! - OF OFFICEHOLDER 3'
W�; CANDIDATE
�
��IFFICE SOUGHT OR HI'L_C:
��
❑ SUPPOP'l
❑ OPPO61'.I.
--• `
N, .Fi'Ei CF OFFICEHOLDE -.' n-? CANDIDATE
�
.""-'ICE SOUGHT ORIJi:..f
❑ SUPPOR--
❑ OPPOSE
r ,'.........
OF OFFICEHOLDEI'.� �:i �: CANDIDATE
...._... . --
-`��ICE SOUGHT OR HL=LL)
❑ SUPPOf�
❑ OPPOSI
OF OFFICEHOLDER OR CANDIDATE
',-FICE SOUGHT OR Hl',I D
❑ SUPPOfi1
❑ OPPO6F-
+!h Ptach continuarlon simets if necessary
F PPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ce.gov (866/275-J772)
www.fppc.c4.G0v
Campaign Disclosure Statement
Summary Page
Amounts may be rounded
to whole dollars.
from
Statement covers period
1/1/2016
SUMMARY PAGE
through
6/30/2016
Page of
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
1376802
Contributions Received
Column A
TOTAL THIS PERIOD
Column B
Calendar Year Summary for Candidates
(FRCMATTACHED SCHEDULES)
CALENDAR YEAR
TOTAL TO DATE
Running in Both the State Primary and
General Elections
1. Monetary Contributions............................ .......................
Schedule A, Line 3
$
$0.00
$
$ 0 .C) d
$0.00
$0.00
111 through 6130 711 to Date
2. Loans Received................................................................
Schedule e, Line 3
_
3, SUBTOTAL CASH CONTRIBUTIONS.. .... ................
...... Add Lines I +2
$
$0.00
$
$ dab(}
20. Contributions
Received $ _ $
4. Nonmonetary Contributions ..................... ..................
Schedule C, Line 3
$0.00$
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED....................................Add
Lines 3+4
$
$0.00
$
$ 10,00
Made $ _____ $
Expenditures Made
Expenditure Limit Summary for State
6. Payments Made................................................................
Scheduie E, Line 4
$
$1,223.81
$
$ I 2181
Candidates
7. Loans Made.......................................................................
Schedule rr, Line 3
$0.00
$0.00
8. SUBTOTAL CASH PAYMENTS ..........................................
AddLiness+T
$
.,
$1,2�.3.81
$
$�`Q' ��
22. Cumulative Expenditures Made*
(If Subject to Voluntary Expenditure Limit)
9. Accrued Expenses (Unpaid Sills) ..........................................
Schedule F, Line 3
-$1,5C)0.00
-4 /�$ 00.00
Date of Election Total to Date
10. Nonmonetary Adjustment.........................................................
schedule C, Line 3
$i0.00
$ 0,00
(mmiddlyy)
11. TOTAL EXPENDITURES MADE... .....................................
Add Lines 8 + 9 + 10
$
_ 2,2.
$7381
$
� ��-� r
,' ,
I J $
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 8above
16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 13
If this is a termination statement, Line 16 must be zero.
$ 34,44.5.57
$0.00
$438.29
$2,723.81
$ $32,160.05
17. LOAN GUARANTEES RECEIVED ................................ ScheduieB, Part2 $
1.0.00
Cash Equivalents and Outstanding Debts
18, Cash Equivalents ................................................ See instructions on reverse $ $0.00
19. Outstanding Debts- ............................ Add Line 2 +Line gin Column 8 above $ $i0.00
To calculate Column B,
add amounts in Column
A to the corresponding "Amounts in this section may be different from amounts
amounts from Column B reported in Column B.
of your last report. Some
amounts in Column A may
be negative figures that
should be subtracted from
previous period amounts. It
this is the first report being
filed for this calendar year,
only carry over the amounts
from Lines 2, 7, and 9 (if
any).
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
Amounts may be rounded
to whole dollars.
SCHEDULE E
Statement covers period CALIFORNIA
'
1/1/2016 • "
from
through 6/30/2016 Page of
I.D. NUMBER
1376802
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP
campaign paraphernaliaimisc.
MBR
member communications
RAD
radio airtime and production costs
CNS
campaign consultants
MTG
meetings and appearances
RFD
returned contributions
CTS
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 filinglballot 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)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMDERi
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
First Bank Merchant Services
Merchant Services
5565 Glenridge Connector NE, Ste 2000
OFC
$23.61
Atlanta, FL 30342-1651
Payroll Data Processing
Payroll Process Fee (Year end reporting)
4224 Henderson Blvd
OFC
$279.60
Tampa, FL 33629-5611
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ $303.21
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................. $
2. Unitemized payments made this period of under$100.......................................................................................................................................... $
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)............................................................................. $
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................... TOTAL $
1,223.81
1,223.81
FPPC Form 460 (Jan/2816}
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule E Amounts may be rounded SCHEDULE E (CONT.)
(Continuation Sheet) to whole dollars. Statement covers period CALIFORNIA '0
Payments Made from, 1/1/2016 FORM
6/30/2016
SEE INSTRUCTIONS ON REVERSE through Page of
NAME OF FILER
I.D. NUMBER
1376802
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP
campaign paraphernalialmisc.
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 filinglballot fees
PHO
phone banks
TRC
candidate travel, lodging, and meals
FND
fundraising events
POL
polling and survey research
TRS
staff apouse travel, lodging, and meals
IND
independent expenditure supportinglopposing others (explain)*
POS
postage, delivery and messenger services
TSF
transfer between committees of the same candidatelsponsor
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)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, AL50 ENTER 1.6, NUMBERJ
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
First Bank Merchant Services
Merchant Services
5565 Glenridge Connector NE, Ste 2000
OFC
$19.95
Atlanta, FL 30342-1651
First Bank Merchant Services
Merchant Services
5565 Glenridge Connector NE, Ste 2000
OFC
$19.95
Atlanta, FL 30342-1651
First Bank Merchant Services
Merchant Services
5565 Glenridge Connector NE, Ste 2000
OFC
$19.95
Atlanta, FL 30342-1651
First Bank Merchant Services
Merchant Services
5565 Glenridge Connector NE, Ste 2000
OFC
$109.95
Atlanta, FL 30342-1651
First Bank Merchant Services
Merchant Services
5565 Glenridge Connector NE, Ste 2000
OFC
$19.95
Atlanta, FL 30342-1651
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ $189.75
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov 1866/275-3772)
www.fppc.ca.gov
Schedule E Amounts may be rounded SCHEDULE E (CONT.)
(Continuation Sheet) to whole dollars. Statement covers period
Payments Made from 1/1/2016
SEE INSTRUCTIONS ON REVERSE
6/30/2016 h
through
Page of
NAME
OF FILER
I.D. NUMBER
1376802
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP
campaign paraphernalialmise.
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
PCL
polling and survey research
TRS
stafflspouse travel, lodging, and meals
IND
independent expenditure supporting/opposing others (explain)'
PCs
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)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.O. NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
Citibusiness Card
Credit card payment
1500 Boltonfield St
$300.00
Columbus, OH 43228-3669
Subvendor: NGP VAN
Memo: $300.00 Database & Email
1101 15th St NW, Ste 500
WEB
Washington DC 20005-5006
Citibusiness Card
Credit card payment
1500 Boltonfield St
$322.57
Columbus, OH 43228-3669
Subvendor: NGP VAN
Memo: $322.57 Database & Email
1101 15th St NW, Ste 500
WEB
Washington DC 20005-5006
Citibusiness Card
Credit card payment
1500 Boltonfield St
$108.28
Columbus, OH 43228-3669
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 730.85
FPPC form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule E
(Continuation Sheet)
Payments Made
Amounts may be rounded
to whole dollars.
Statement covers period
from
111 /2016
SCHEDULE E (CONT)
6/30/2016
SEE INSTRUCTIONS ON REVERSE throughPage of
NAME OF FILER I'D. NUMBER
1376802
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
stafflspouse travel, lodging, and meals
IND
independent expenditure supportinglopposing others (explain)*
POS
postage, delivery and messenger services
TSF
transfer between committees of the same candidatelsponsor
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)
NAME AND ADDRESS OF PAYEE
jF COMMITTEE, ALSO ENTER LID. NUMBER)
CODE DR DESCRIPTION OF PAYMENT
AMOUNT PAID
Subvendor: NGP VAN
1101 15th 5t NW, Ste 500
Washington DC 20005-5006
WEB
Memo: $108.28 Database & Email
' Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 0.00
FPPC Form 460 (Jan/2016)
FPPC Advice: advice9fppc.ca.gov (866/275-3772)
www.fppc.ca.gav
SCHEDULE F
Schedule F
Accrued Expenses (Unpaid Bills)
Amounts may be rounded
to whole dollars.
Statement covers period
from 1/1/2016
through 6/30/201 fi
SEE INSTRUCTIONS ON REVERSE Page of
NAME OF FILER
I.D. NUMBER
1376802
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP
campaign paraphernalia/mist.
MBR
member communications
RAID
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 candidatelsponsor
LEG
legai defense
PRO
professional services (legal, accounting)
VOT
voter registration
LIT
campaign literature and mailings
PRT
print ads
WEED
information technology costs (internet, e-mail)
NAME AND ADDRESS OF CREDITOR
(IFCOMMITTEE.ALsoENTER I.o. NuMBER)
CODE OR
DESCRIPTION OF PAYMENT
(a)
OUTSTANDING
BALANCE BEGINNING
(b)
AMOUNT INCURRED
THIS PERIOD
(c)
AMOUNT PAID
THIS PERIOD
(d)
OUTSTANDING
BALANCEATCLOSE
OF THIS PERIOD
(ALSO REPORT ON E)
OF THIS PERIOD
Nikki Stone
Palm Springs, CA 92262
CNS, Consulting fee
$1,500.00
$1,500.00
$0.00
* Payments that are contributions or independent expenditures must also be C3TOTALS $� ,SOD.00 $ 0.00
summarized on Schedule D. SU$1,500.00 $ $
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 $
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 $
3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and
$0.00
$1, 500.00
onthe Summary Page, Column A, Line 9.) ............................................................................................................................................................................... ... NET $ -$1,500.00
May be a negative number
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule I
Miscellaneous Increases to Cash
DATE
RECEIVED
111 /2016
1/1/2016
FULL NAME ANDADDRESS OF SOURCE
(IF COMMITTEE,ALSO ENTER LD. NUMBER)
City of Palm Springs
3200 Tahquitz Canyon Way
Palm Springs, CA
Various
Amounts may be rounded
to whole dollars.
Statement covers period
from 1/1/2016
threuah 6/30/2016
DESCRIPTION OF RECEIPT
110315 election fee refund
Uncashed expense checks
SCHEDULEI
Page of
I.D. NUMBER
1376802
AMOUNT OF
INCREASE TO CASH
$78.97
$359.32
Attach additional information ors appropriately labeled continuation sheets. SUBTOTAL $ $438.29
Schedule I Summary
1. Itemized increases to cash this period ................................ $438.29
2. Unitemized increases to cash of under $100 this period ........................................... .....................$ $0.00
3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).)... ...... ......... ..................... $ $438.29
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
SummaryPage, Line 14.)............................................................................................................................. TOTAL $ $438.29
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov