HomeMy WebLinkAbout2019-09-26 Form 460 - KorsCOVER PAGE Recipient Committee
Campaign Statement
Cover Page
C £ I V '£'t')Slamp
,-------------r-----~:ri-t--+-1.H-1P f , L H SPRINGS Statement covers period
CALIFORNIA 460
FORM
Date of electla'I If applicable:
07/01/2019 from (Month,Day,Y1ft19SE 26 PH 3: 08 1 Page __ _ 21 of ___ _
through 09/21/2019 1110512offi:FI CE o THE CITY CL[;,,'..
For Official Use Only
1. Type of Recipient Committee: All CommltlBee-eomp.. Parta 1, 2. 3, and 4
!xJ Officeholder, Candidate Controlled Committee
0 State Candidate Election Committee •Recall
(Also Complete Part 5)
0 General Purpose Committee
D Sponsored
D Small Contributor Committee
0 Political Party/Central Committee
D Pnmariy Formed Ballot Measure
Committee
D Controlled
D Sponsored
(Also Complere Patt 6J
D Pnrnarlly Formed Cendldatel
Officeholder Committee
(Also Complete Part 7)
3. Committee lnfonnation j i .D. NUMBER 1376802
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Geoff Kors For City Council, D istrict 3 , 2019
STREET ADDRESS (NO P 0. BOX)
CITY
Palm Springs, CA 92262
STATE
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O BOX
CITY
Palm Springs, CA 92263
OPTIONAL: FAX / E-MAIL ADDRESS
4. Verfflcatlon
STATE
ZIP CODE
ZIP CODE
AREA CODE/PHONE
AREA CODE/PHONE
2. Type of statement
00 Preelection Statement
0 Sem~annual Statement
0 Termination Statement
(Also file a Form 410 Termlnahon)
00 Amendment (Explain Below)
Original report not filed so not an Amendment
Treasurer(s)
NAME OF TREASURER
James G. Williamson
MAILING ADDRESS
CITY
Palm Springs , CA 92262
NAME OF ASSISTANT TREASURER IF ANY
MAILING ADDRESS
CITY
OPTIONAL: FAX/ E•MAIL ADDRESS
0 Quarterl~Statement
0 Special Odd-Year Report
STATE ZIP CODE
STATE ZIP CODE
AREA CODE/PHONE
(
AREA CODE/PHONE
I have used all reasonable diligence in preparing and reviewi ng 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 Slate of California that the foregoing is true and correct.
Executed on 09/26/2019
DATE
Executed on 09/26/2019
DATE
Executed on
DATE
Executed on
DATE
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e
By ____________________________ _
Signature of Controlling Officeholder, Gandidato, Stale Measure Proponent
By ____________________________ _
Signature of Controfflng Officeholder. Candidate, Slate Measure Proponent
FPPC Fonn 460 (Jan/2016)
FPPC Advice : advlce@fppc.ca.gov (868/27&-3m)
www.fppc.ca.gov
Recipient Committee
Campaign Statement
Cover Page -Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Geoffrey R. Kors
OFFICE SOUGHT OR HELO (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
City Council Member Palm Springs
RESIDENTIALJBUS!NESS ADDRESS (NO. AND STREET)
3
CITY STATE
Palm Springs, CA 92262
ZlP
Related Commlttaes Not Included In this Statement:u.otany-s
not lnr;Judod In th1a slalemont that BIO r:onflD/lod byyau orate -lyfDtmedfl>mcelve conlrlbutlans
ormakBexp,mdlturesonbe-ofyo,,rcandldacy
COMMITTEE NAME
NAME OF TREASURER
COMMITTEE ADDRESS
CITY
COMMITTEE NAME
NAME OF TREASURER
COMMITTEE ADDRESS
CITY
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l.D.NUMBER
CONTROLLED COMMITTEE? •YES •ND
STREET ADDRESS (NO P.O. BOX)
STATE ZIP CODE AREA CODE/PHONE
1.0.NUMBER
CONTROLLED COMMITTEE? •YES •NO
STREET ADDRESS (NO P.O. BOX)
STATE ZIP CODE AREA CODE/PHONE
CALIFORNIA 460
FORM
Page _2_ of _2_1 _
6. Primarily Fanned Ballot Measum Commlttea
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER JURISDICTION • SUPPORT • OPPOSE
Identify the controlling officeholder, candidate, or state measum proponent, If any.
NAME OF OFRCEHOLDER, CANDIDATE, OR PROPONENT
OFFICE SOUGHT OR HELD I DISTRICTNO. IF""'
7. Primarily Fonned Candidate/Officeholder Commlttae List names of
offlceho/derfs) or csndidats(s) for which this comm/1188 Is primarily formad.
NAME OF OFFICEHOLDER OR CANDIDATE
NAME OF OFFICEHOLDER OR CANDIDATE
NAME OF OFFICEHOLDER OR CANDIDATE
NAME OF OFFICEHOLDER OR CANDIDATE
OFACE SOUGHT OR HELD • SUPPORT • OPPOSE
OFFICE SOUGl-fT OR HELO • SUPPORT • OPPOSE
OFFICE SOUGHT OR HELD • SUPPCRT • OPPOSE
OFFICE SOUGHT OR HELD • SUPPORT • OPPOSE
FPPC Fonn 460 (Jan/2016)
FPPC Advice: advlce@fppc.ca.gov (866/275-3TT2)
www.fppc.ca.gov
SUMMARY PAGE Campaign Disclosure Statement
Summary Page
Amounts may be rounded
lo whole dollaJs. Statement covers pe~ad CALIF0RNIA46O
FORM
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Geoff Kora For City Council, District 3, 2019
Column A
Contributions Received TOTAl THIS PERIOD
(FROM ATTACHED SCHEDULES)
1. Monetary Contributions ...••...•....•..••••.........•••.....•• Schedule A, Line 3 $ 17,960.56
2. Loans Received ......••..•......•.............••......••...•.... Schedule B, line 3 .00
3. SUBTOTAL CASH CONTRIBUTIONS ••••••••••••••.••••••••• AddUnos 1 +2 $ 17,960.56
4. Nonmonetary Contributions .................................. ScheduleC,Line3 2,500.00
20,460.56 5. TOTAL CONTRIBUTIONS RECEIVED •••••.•••..•.•••.•.•••• AddUnes3+4 $ _____ _
Expenditures Made
6. Payments Made ••.••...••••••••...••••••••..••.••••••••••••.••• ScheduleE, Line4 $ __ 4-"6~7~3~6~.8~1'--_
7. Loans Made ..................................................... Schedule H, Line 3 .00
8, SUBTOTAL CASH PAYMENTS, •.•••••.• ,., •••..•••.•••••••••. Addlin•s6+7 s __ 4~6~7~3~6~.8""1 __
9. Accrued Expenses (Unpaid Bills) •••. , •••••••.•••.••••.•.•• Schedule F, Uno3 .OD
10. Nonmonetary Adjustment .. , ••• ,, ••...•••••• , ., • , ••••.• ,. , • Schedule c, Uno 3 2 500.00
11. TOTAL EXPENDITURES MADE. •• , •••.••••.••• , •••..•.• AddLlnesB+9+ 10 s 49,236.81 --~-~~-
Current Cash Statement
from
through
CalumnB
CALENDAR YEAR
TOTAL TO DATE
$ 99,171.68
.oo
$ 99,171.68
5 428.77
$ 104,600.45
$_~5~9~5~92~·~15~-
.oo
$_~5~9~5~9~2.~15~-
.o •
5 428,77
$ __ 6~5~,0~2_0._9_2 __
To calculate Column B,
add amounts in Column
12. Beginning Cash Balance ..................... Previ'ous summal}'Page, Lina 16 $_--'9'-'9-",5'-'4"'-9=.2"-1 __ 1 A to the corresponding
13. Ca Sh Receipts ............................................. Column A, Line 3 above ___ 1_7_.9_6_•_.5_6 __ 1 amounts from Column 8
of your last report. Some
14. fy1iscellaneous Increases to Cash ••••••.•••.••••••.••••••• Schedule I, Line 4 .00 amounts in Column A may
be negative figures that
15. Cash Payments ........................................... Column A, Line 8 above 46, 736,81 should be subtracted from
16. ENDING CASH BALANCE previous period amounts. If
Add lines 12 + 13 + 14, then subtractUne 15 $ ___ 7_0,_7_7_2._9_6 __ 1 this Is the first report being
If this is a termination statement, Une 16 must be zero. filed for this calendar year,
------------------------------------1 only carry over the amounts
17. LOAN GUARANTEES RECEIVED •.•...••• , •••.•••..•.••• , Schedule 8, Une2 S .00 from Lines 2, 7, and 9 [ii ____________________ ....:__:_======\•ny).
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ............................ See instructions on reverse $ ___ 10_0_.o_o __ _
19. Outstanding Debts ............... Addl!ne2+Une9inColumnBabove $ ____ .O_D __ _
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07/01/2019
09/21/2019 Page __ 3_ of ----'2"-'1-
1.D. NUMBER
1376802
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
1/1 through 6/30 711 to Data
.00 20. Contributions $
ReceWed ------
s ,00 ------
.00 s .00 21. Expenditures $
Made ------------
Expenditures Limit Summary for State
Candidates
22. Cumulative Expendilllrss Made•
(If SUbjod lo Volunlmy Elcpend-Limit)
Date of Election
(mmldd/yy)
T alal ta Date
$ _____ _
$ _____ _
$ _____ _
$ _____ _
$ _____ _
'"Amounts in this section may be different from amounts
reported in Column 8.
FPPC Fann 460 (Jan/2016)
FPPC Advice: advlce@fppc.ca.gav (8661275-'lm)
www.fppc.ca.gav
NAME OF FILER
Geoff Kors For City Council, District 3, 2019
FORM REFERENCE
CA460 Cover
Pcmered by ISPolltlcal.com
NOTES
1
1.D. NUMBER
1376802
FPPC Fonn 460 (Jan/2016)
FPPC Advice: edvlce@fppc.ca.gov (868/275-3772)
www.tppc.ca.gov
Schedule A
Monetary Contributions Received
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Geoff Kors For City Council, District 3, 2019
DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF
CONTRIBUTOR RECEIVED
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
Shirelle Alexander
69587 Encanto Court
08/08/2019
Rancho Mirage, CA 92270
Lloyd D. Carden
304 Tiffany Cir E
07/08/2019
Palm Springs, CA 92262 nae
Don Cecil
300 Beny Street Unit 505
09/11/2019
San Francisco, CA 94158
Desert Stonewall Democrats
67555 East Palm Canyon Drive Suite C-104
07/22/2019
Cathedral City, CA 92234
1D:1220539
Ouard Ventures, LLC
1717 East Vista Chino
07/02/2019
Palm Springs, CA 92262
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Amounts may ba rounded
lo whole dollara.
CONTRIBUTOR
IF INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER
NAME OF BUSINESS)
CODE
il!I IND •COM
00TH •PTY •sec
il!I IND •COM
00TH •PTY •sec
il!I IND •COM
00TH •PTY •sec
•IND
il!I COM
00TH •PTY •sec
•IND •COM
il!I 0TH •PTY •sec
Retired
Retired
Retired
Retired
Principal
MC2 Bay Area Public Affairs
CClnsulting
SUBTOTAL-$
SCHEDULE A
Statement covers period
07/01/2019 from _______ _ CALIF0RNIA46O
FORM
fflrough 09/21/2019 Page -~4-of _2_1~
AMOUNT RECEIVED
THIS PERIOD
50.00
150.00
250.00
1,000.00
1,000.00
2,450.00
1.0. NUMBER
1376802
CUMULATIVE TO DA TE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
100.00
150.00
250,00
1,000.00
1,000.00
PER ELECTION TO DATE
(IF REQUIRED)
100,00 G-2019
150,00 G-2019
250.00 G-2019
1,000.00 G-2019
1,000.00 G-2019
FPPC Fenn 460 (Jan/2016)
FPPC Advice: advlce@lppc.ce.gov (866/275-3TT2)
www.fppc.ca.gov
Schedule A
Monetary Contributions Received
SE:E INSTRUCTIONS ON REVERSE
NAME OF FILER
Geoff Kors For City Council, District 3, 2019
DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF
CONTRIBUTOR RECEIVED
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER)
Richard Foglia
2222 North Palermo Drive
09/16/2019
Palm Springs, CA 92262
Louise Hampton
2905 East Tahqultz Canyon Way
09/14/2019
Palm Springs, CA 92262
Mariah T. Hanson
61116 Devils Ladder Road
07/16/2019
Mountain Center, CA 92561
Dorothy Lefkowitz
SOD West Stevens Road
08/08/2019
Palm Springs, CA 92262
Harold Matzner
555 North Patenclo Road
08/19/2019
Palm Springs, CA 92262
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Amounts may be mundod
lowholadolam.
CONTRIBUTOR
IF INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER
NAME OF BUSINESS)
CODE
00 IND •COM •oTH •PTY •sec
00 IND •COM
00TH •PTY •sec
00 IND •COM
00TH •PTY •sec
00 IND •COM
DOTH •PTY •sec
[l!J IND •COM
00TH •PTY •sec
Retired
Retired
Realtor
Berkshire Hathaway HomeServices
Owner
Club Skirts
Retired
Retired
Chair
Palm Springs International FHm
Festival
SUBTOTAL$
SCHEDULE A
Sta1ement covers period
07/01/2019 from ________ _
CALIF0RNIA46O
FORM
09/21/2019 through ______ _ 5 21 Page ___ of __ _
AMOUNT RECEIVED
THIS PERIOD
250.00
250.00
1,000.00
500.0D
10,000.00
12,000.00
l,D.NUMBER
1376802
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
250.00
250,00
1,000.00
500.00
15,000.00
PER ELECTION TO DATE
(IF REQUIRED)
250.00 G-2019
250,00 G-2019
1,000.00 G-2019
500,00 G-2019
15,000.00 G-2019
FPPC Fann 460 (Jan/2016)
FPPC Advice: advlce@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
Schedule A
Monetary Contributions Received
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Geoff Kora For City Council, District 3, 2019
DATE
RECEIVED
08/16/2019
09/10/2019
08/12/2019
08/09/2019
07/08/2019
FULL NAME, STREE:T ADDRESS AND ZIP CODE OF
CONTRIBUTOR
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER)
Stephen Moses
333 West Stevens Road
Palm Springs, CA 92262
Palm Springs Firefighters Association
44719 Johnston Drive
Temecula, CA 92592
1D:881536
Southwest Reglonal CouncU of Carpenters PAC
533 South Fremont Ave, 10th Floor, Los Angeles, CA 9007110th
Los Angeles, CA 90071
10:870169
Beau Stinnette
3637 Quiet Side Streat
Palm Springs, CA 92262
Darrell Tucci
401 S El Cielo RoadUnit 113
Palm Springs, CA 92262
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Amounts mey ba rounded
to whole dollars.
CONTRIBUTOR
CODE
ll!J IND •COM
00TH •PTY •sec
•IND
OOcoM
00TH
0PTY •sec
0JND
ll!J COM
00TH
0PTY •sec
00 IND •COM
00TH
0PTY •sec
ll!I IND •coM •oTH •PTY •sec
IF INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER
NAME OF BUSINESS)
Retired
Retired
Designer
Foley & Stinnette
Chief Development Officer
Desert AIDS Project
SUBTOTAL$
SCHEDULE A
Slalement covers period
07/01/2019 from _______ _
CALIF0RNIA46O
FORM
through 09/21/2019 Page __ e __ of __ 2_1_
AMOUNT RECEIVED
THIS PERIOD
250.00
1,000.00
2,000.00
100.00
27.78
3,377.78 I
I.D. NUMBER
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
500.00
1,o'00.00
2,000.00
100.00
138.90
1376802
PER ELECTION TO DATE
(IF REQUIRED)
500.00 G-2019
1,000.00 G-2019
2,000.00 G-2019
100.00 G-2019
138.90 G-2019
FPPC Fenn 460 (Jan/2016)
FPPC Advice: advlce@lppc.ca.gov (8661275-3TT2)
www.fppc.ca.gov
Schedule A
Monetary Contributions Received
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Geoff Kors Far City Council, District 3, 2019
DATE
RECEIVED
09/08/2019
FULL NAME, STREET ADDRESS AND ZIP CODE OF
CONTRIBUTOR
(IF COMMITTEE, ALSO ENTER 1.D. NUMBER)
Darrell Tucci
401 S El Cfelo RoadUnit 113
Palm Springs, CA 92262
Schedule A Summary
Amounts may bt!I rounded
to whofa dollars.
CONTRIBUTOR
CODE
ll!i IND •coM
00TH
0PTY •sec
IF INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER
NAME OF BUSINESS)
Chief Development Officer
Desert AIDS Project
Sla1ement covers perlad
07/01/2019 from -----'----'----
through 09/21/2019
SCHEDULE A
CALIFORNIA460
FORM
7 21 Page -~-of __ _
l,D. NUMBER
1376802
AMOUNT RECEIVED
THIS PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN, 1 • DEC. 31)
PER ELECTION TO DATE
(IF REQUIRED)
27,78 166.68
166.68 G-2019
• Contributor Codes
1. Amount received this period -itemized monetary contributions. 17,855.56
(Include all Schedule A subtotals.}-------------------------------_$ --------IND -Individual
COM -Recipient Committee
105,00 2.Amountrecelvedlhlsperlod-unltemlzedmonetarycontribuliansoflessthan$10Q.. _____________ $ _______ _ (other than PTY or SCC)
0TH -Other (e.g., business entity)
PTY -Political Party 3. Total monetary contributions received this period. 17,960.56
(add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.). ____________ TOTAL $ --------sec -Small Contributor Committee
SUBTOTAL$
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27.78
FPPC Fenn 460 (Jan/2016)
FPPC Advice: advlce@lppc,ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule B -Part 1
Loans Received
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Geoff Kors For City Council, District 3, 2019
Amounts may be munded
ID wholo dollars. Slatemenl coveis pertod
07/01/2019 from _______ _
through 09/21/2019
FULL NAME, STREET ADDRESS AND
ZIP CODE OF LENDER
(IF COMMITTEE, ALSO ENTER 1.D. NUMBER)
IF INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER
NAME OF BUSINESS)
(a) OUTSTANDING
BALANCE
BEGINNING TI-US
PERIOD
(b)AMOUNT
RECEIVED THIS
PERIOD
(c) AMOUNT PAID
OR FORGIVEN
THIS PERIOD .,.
(d) OUTSTANDING
BALANCE AT
CLOSE OF THIS
PERIOD
(e) INTEREST
PAID THIS
PERIOD
$ $
0 PAID
$ ----• FORGIVEN
$
$ __ _ %
RATE
$ •• IND • COM 00TH OPTYO SC ----------------OATEOUE
Schedule B Summary
1. Loans received this period _________________________________ $ ____ .o_o ___ _
(Total Column (b) plus unitemized loans of less than $100.)
2. Loans paid or forgiven this period ______________________________ .$ ____ .o_o ___ _
(Total Column (c) plus loans under $100 paid or forgiven)
(Include loans paid by a third party that are also itemized on Schedule A.)
3. Net change this period. (Subtract Line 2 from Line 1.) NET$ ____ .o_o __ _
Enter the net here and on the Summary Page, Column A, Line 2 (May boa negative number)
SUBTOTALS$ $ $ $
(Enter (e) on
SCHEDULE B -PART 1
CALIFORNIA 460
FORM
e 21 Paga ___ of __ _
I.D. NUMBER
1376802
(~ORIGINAL
AMOUNT OF
LOAN
$ __ _
DATE INCURRED
• Contributor Codes
IND -Individual
(g) CUMULATIVE
CONTRIBUTIONS
TO DATE
CALENDAR YEAR
$
PER ELECTION',.
COM -Recipient Committee
(other than PTY or SCC)
0TH -Other (e.g., business entity)
PTY -Pollt!cal Party
sec -Small COntrlbutor Committee
•Amounts forgiven or paid by another party also must be reported on Schedule A
.. If required.
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Schedule e. Line 3) FPPC Fonn 460 (Jen/2016)
FPPC Advice: edvlco@fppc.ca.gov (866127~m)
www.fppc.ca.gov
Schedule B -Part 2
Loans Received
NAME OF FILER
Geoff Kors For City Council, District 3, 2019
FULL NAME, STREET ADDRESS AND
ZIP CODE OF GUARANTOR
(IF COMMITTEE. ALSO ENTER I.D. NUMBER)
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CONTRIBUTOR
CODE
• IND • COM • 0TH • PTY • sec
Amounts may be rounded
In whole do-.
JF AN INDIVIDUAL, ENTER
OCCUPATION ANO EMPLOYER
(IF SELF-EMPLOYED. ENTER
NAME OF BUSINESS)
Slalament covera period
07/01/2019 from _______ _
through _ _;_09_/2_1_/2_0_19 __
LOAN
LENDER
DATE
SUBTOTAL $
AMOUNT
GUARANTEED
THIS PERIOD
SCHEDULE B -PART 2
CALIF0RNIA46O
FORM
9 21 Page -..C...-of __ _
I.D. NUMBER
1376802
CUMULATIVE
TO DATE
CALENDAR DATE
'-----1
PER ELECTION
(IF REQUIRED)
Enter on Summary I
Page. Line 17 only.
BALANCE
OUTSTANDING
TO DATE
FPPC Fenn 460 (Jan/2016)
FPPC Advice: advfce@fppc.ca.gov (866/275-3m)
www.fppc.ca.gov
Schedule C
Nonmonetary Contributions Received
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Geoff Kors For City Council, District 3, 2019
DATE
RECEIVED
07/07/2019
FULL NAME, STREET ADDRESS
AND ZIP CODE OF CONTRIBUTOR
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
Merchain Catering
2685 North Junlpero Avenue #2
Palm Springs, CA 92262
Schedule C Summary
Amounta mey be rounded
ta whole dollaJO.
IF INDIVIDUAL, ENTER
Statement covers period
07/01/2019 from _______ _
through 09/21/2019
CONTRIBUTOR OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT! FAIR
MARKET VALUE CODE• (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES
NAME OF BUSINESS)
2,500.00
SCHEDULEC
CALIF0RNIA46O
FORM
Paga __ 1_0_ of __ 2_1_
1.0. NUMBER
1376802
CUMULATIVE TO
DATE
CALENDAR YEAR
2,500.00
PER ELECTION
TO DATE
(IF REQUIRED)
0 IND
0 COM
~ 0TH
0 PTY • sec
In-kind contribution of
catering expense for
fundraising event
1---------'--------i 2,500.00 G-2019
,. Contributor Codes
1. Amount received this period -Itemized nonmanetary contributions. 2,500.00
(lncludeaJIScheduleCsublotals.)-------------------------------_$ _______ _ IND -Individual
COM -Recipient Committee
2. Amount received !his period -unitemized nonmonetary contributions of Jess than $100 ____________ $ ____ .o_o ___ _ (other than PTY or SCC)
0TH -Other (e.g., business entity)
PTY -Political Party 3, Total nonmonetary contributions received this period.
(add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.). ________ TOTAL $ ___ 2_,5_o_o_.o_o __ _ sec -Small Contributor Committee
SUBTOTAL$
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FPPC Fann 460 (Jan/2016)
FPPC Advice: advlce@lppc.ca.gov (866/275--!TT2)
www.fppc.ca,gov
Schedule D
Summary of Expenditures
Supporting/Opposing Other
Candidates, Measures, and Committees
NAME OF FILER
Geoff Kors For City Cauncll, Dls1rict 3, 2019
DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR
MEASURE NUMBER OR LETTER ANO JURISDICTION,
OR COMMITTEE
0 Support D Oppose
SCHEDULE D SUMMARY
Amounts may be rounded
to whola dollara,
TYPE OF PAYMENT
D Moneta,y
Contribution D Nonmonetary
Contribution
D Independent
Expendilure
DESCRIPnON
(IF REQUIRED)
1. Itemized contributions and Independent expenditures made this period. (Include all Schedule D subtotals.)
SCHEDULED
statement covers period CALIF0RNIA46O
FORM from
through
07/01/2019
09/21/2019 Page ----'1.;.1_ al --=2"-1-
AMOUNT
THIS PERIOD
1.0. NUMBER
1376802
CUMULATIVE TO DATE
CALENDAR VEAR
(JAN. 1 -DEC. 31)
PER ELECTION TO
DATE
(IF REQUIRED)
____________________ $ ___ .o_o __
2. Unitemized cantributians and independent expenditures made this period of under $100 ---------------------------$ ___ ._oo __ _
3. Tata! contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) ---------TOTAL$ ___ .o_o __ _
SUBTOTAL
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$
FPPC Fenn 460 (Jan/2016)
FPPC Advice: advlce@fppc.ca.gcv (866/275-3TT2)
www.fppc.ca.gcv
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Geoff Kors For City Council, District 3, 2019
Amounts may be rounded
fowholodollam. Statement covers period
07/01/2019 from
through 09/21/2019
SCHEDULEE
CALIFORNIA460
FORM
Page __ 1_2_ of __ 2_1_
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 paraphemalla/mlsc.
CNS campaign consultants
CTB contribution (explain nonmonetaryr
eve civic donations
FIL candidate filing/ballot fees
FND fundralslng events
IND Independent expenditure supporting/opposing others (explainr
LEG legal defense
LIT campaign literature and mafllngs
NAME ANO ADDRESS OF PA YEE
(IF COMMITTEE, ALSO ENTER 1.0, NUMBER)
Burke Rix Communications, LLC
431 South Palm Canyon Drive
Palm Springs, CA 92262
Burke Rix Communications, LLC
431 South Palm Canyon Drive
Palm Springs, CA 92262
City Of Palm Springs
3200 East Tahquitz Canyon Way
Palm Springs, CA 92262
Costco
72800 Dinah Shore Drive
Palm Desert, CA 92211
MBR member communications
MTG meetings and appearances
OFC office expenses
PET petition circulating
PHO phone banks
POL polling and survey research
POS postage, delivery and messenger services
PRO professional services (legal, accounting)
PRT print ads
CODE OR
CNS
CNS
FIL
FND
• Payments that ere contributions or independent expenditures must also be summarized on Schedule D.
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RAD radio airtime and production costs
RFD returned contributions
SAL campaign workers' salaries
TEL t.v. or cable airtime and production costs
TRC candidate travel, lodging, and meals
TRS stafUspouse travel, lodging, and meals
TSF transfer between committees of the same candldatelsponsor
VOT voter registration
WEB Information technology costs (internet, e-mail)
DESCRIPTION OF PAYMENT
Socia! media
Social media
Ballot filing fees
Beverages for kick art event
AMOUNT PAID
12,500.00
12.500.00
350.00
252.95
SUBTOTAL$ 25,602.95
FPPC Fonn460 (Jan/2016)
FPPC Advice: advlce@lppc.ca.gov (866/27fh!TT2)
www.fppc.ca.gov
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Geoff Kors For City Council, District 3, 2019
Amounts may be rounded
to whole dolam. Statement covers period
07/01/2019 fi'om
through 09/21/2019
SCHEDULE E
CAUF0RNIA46O
FORM
Page __ 1_3_ of __ 2_1_
I.•. 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.
CNS campaign consultants
CTB contribution (explaln nonmonetary)*
CVC civic donations
FIL candidate filing/ballot fees
FND fundraising events
IND Independent expenditure supporting/opposing others (explainr
LEG legal defense
LIT campaign literature and mailings
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
Decals By Design
1325 Pico Street Suite 105
Corona, CA 92881
Frank Properties Ltd
266 North Palm Canyon Drive
Palm Springs, CA 92262
Frank Properties Ltd
266 North Palm Canyon Drive
Palm Springs, CA 92262
Integrated Solutions: Political
4142 Adams Avenue Suite 103-550
San Diego, CA 92116
MBR member communications
MTG meellngs and appearances
OFC office expenses
PET petition circulating
PHO phone banks
POL polling and survey research
POS postage, delivery and messenger services
PRO professional services (legal, accounting)
PRT print ads
CODE OR
CMP
OFC
OFC
RAD radio airtime and production costs
RFD returned contributions
SAL campaign workers' salaries
TEL t.v. or cable airtime and production costs
TRC candidate travel, lodging, and meals
TRS staff/spouse travel, lodging, and meals
TSF transfer between committees of the same candidate/sponsor
VOT voter registration
WEB Information technology costs (internet, e-mail)
DESCRIPTION OF PAYMENT AMOUNT PAID
Printing bus shelter ads
798.14
Security deposit -campaign office
3.360.00
Rent -campaign office
3,360.00
OFC Accounting and compllance software
250.00
• Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 7,768.14
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FPPC Fenn 460 (Jan/2016)
FPPC Advice: advlce@lppc.ca.gov (866/275-,"lm)
www.fppc.ca.gov
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Geoff Kors For City Council, District 3, 2019
Amounls may be mundod
to whole dollars. Statement covers period
07/01/2019 from
through 09/21/2019
SCHEDULEE
CALIF0RNIA46O
FORM
Page _1_4_ of _2_1_
I.•. NUMBER
1376802
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphemalialmisc.
CNS campaign consultants
CTB contribution (explain nonmonetary)*
eve civic donations
FIL candidate filing/ballot fees
FND fundraising events
IND Independent expenditure supporting/opposing others (explain)'"
LEG legal defense
UT campaign literature and mailings
NAME ANO ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER 1.D. NUMBER)
Integrated Solutions: Political
4142 Adams Avenue Suite 103-550
San Diego, CA 92116
Integrated Solutions: Political
4142 Adams Avenue Suite 103-550
San Diego, CA 92116
Mark Ouebner Design
1660 East El Alameda
Palm Springs, CA 92262
Mark Duebner Design
1660 East El Alameda
Palm Springs, CA 92262
MBR member communications
MTG meetings and appearances
OFC office expenses
PET petition circulating
PHO phone banks
POL polling and survey research
POS postage, delivery and messenger services
PRO professional services (legal, accounting}
PRT print ads
CODE OR
OFC
CFC
CNS
CNS
• Payments that are contributions or Independent expenditures must also be summarized on Schedule 0.
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RAD radio airtime and production costs
RFD returned contributions
SAL campaign workers' salaries
TEL t.v. or cable airtime and productlon costs
TRC candidate travel, lodging, and meals
TRS staff/spouse travel, lodging, and meals
TSF transfer bel\Neen committees of the same candidate/sponsor
VOT voter registration
WEB information technology costs (internet, e--mail)
DESCRIPTION OF PAYMENT
Compliance software
Compliance software
Graphic design services
Graphic design servlces
AMOUNT PAID
250.00
250.00
1,200.00
1,200.00
SUBTOTAL$ 2,900.00
FPPC Fonn460 (Jan/2016)
FPPC Advice: advlce@lppc.ca.gov (866/276-3m)
www.fppc.ca.gov
Schedule E
Payments Made
SEE: INSTRUCTIONS ON REVERSE
NAME OF FILER
Geoff Kors For City Council, District 3, 2019
Amounts may be rounded
to whole dolla!s. Statement covers period
07/01/2019 from
through 09/21/2019
SCHEDULEE
CALIF0RNIA46O
FORM
15 21 Page ___ of __ _
1.0. 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.
CNS campaign consultants
CTB contribution (explaln nonmonetaryr
eve civic donations
FIL candidate filing/ballot fees
FND fundraising events
IND Independent expenditure supporting/opposing others (explain)'"
LEG legal defense
UT campaign literature and malllngs
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER 1.D. NUMBER)
Nidia Martin
PO BoK 1108
Palm Springs, CA 92263
Merchain Catering
2685 North Junlpero Avenue #2
Palm Springs, CA 92262
' Mizell Senior Center
480 South Sunrise Way
Palm Springs, CA 92262
Morel Ink
4824 NE 42nd Ava
Portland, OR 97218
MBR member communications
MTG meeUngs and appearances
OFC office expenses
PET petition circulating
PHO phone banks
POL polling and survey research
POS postage, delivery and messenger services
PRO professional services (legal, accounting)
PRT printads
CODE OR
OFC
RAD radio airtime and production costs
RFD returned contributions
SAL campaign workers' salarles
TEL t.v. or cable airtime and production costs
TRC candidate travel, lodging, and meals
TRS staff/spouse travel, lodging, and meals
TSF transfer between committees of the same candldate/sponsor
VOT voter registration
WEB Information technology costs (internet, e-mail)
DESCRIPTION OF PAYMENT AMOUNT PAID
Campaign office cleaning
180.00
FND Catering expanse for rundraislng event
480.00
MTG Sponsorship of Senior Expo
500.00
LIT Invite printing & mailing
507.86
• Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 1,667.86
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FPPC Fenn 460 (Jan/2016)
FPPC Advice: edvlce@fppc.ca.gov (868/276-3m)
www.fppe.ca.gov
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Geoff Kors For City Council, District 3, 2019
Amounts may be rounded
lo whole dollam. statement covers period
07/01/2019 fmm
through 09/21/2019
SCHEDULE E
CALIF0RNIA46O
FORM
16 21 Page ___ of __ _
l,D. NUMBER
1376602
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphernalia/misc.
CNS campaign consultants
CTB contribution (explain nonmonetary,-
CVC civic donations
FIL candidate filing/ballot fees
FND fundraising events
IND Independent expenditure supporting/opposing others (explain)"
LEG legal defense
LIT campaign literature and mailings
NAME ANO ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
Morel Ink
4B24 NE 42nd Ave
Portland, OR 97218
Morel Ink
4824 NE 42nd Ave
Portland, OR 97218
Palm Springs Chamber of Commerce
190 West Amado Road
Palm Springs, CA 92262
Signrocket.com
340 Broadway Avenue
Saint Paul Park, MN 55071
MBR member communicaUons
MTG meetings and appearances
OFC office expenses
PET petition circulating
PHO phone banks
POL polling and survey research
POS postage, delivery and messenger services
PRO professional services (legal, accounting)
PRT print ads
CODE OR
CMP
LIT
WEB
CMP
• Payments that are contributions or independent expenditures must also be summarized on Schedule D.
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RAD radio airtime and production costs
RFD returned contributions
SAL campaign workers' salaries
TEL t.v. or cable airtime and production costs
TRC candidate travel, lodging, and meals
TRS staff/spouse travel, lodging, and meals
TSF transfer between committees of the same candidate/sponsor
VOT voter registration
WEB Information technology costs (Internet, e-mail)
DESCRIPTION OF PAYMENT
Business cards & note cards
Mailer
Email blast expense
Lawn signs
AMOUNT PAID
1,516.73
3,668.37
100.00
875.00
SUBTOTAL$ 6,160.10
FPPC Fenn 460 (Jen/2016)
FPPC Advice: advlco@l'ppc.ca.gov (888/275-;lm)
www.l'ppc.ca.gov
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Geoff Kem For City Council, District 3, 2019
Amounts may be rounded
lo whole dollam. Slatament covem period
07/01/2019 from
through 09/21/2019
SCHEDULEE
CALIF0RNIA46O
FORM
17 21 Paga ___ of __ _
1.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.
CNS campaign consultants
CTB contribution (explain nonmonetaryt
eve civic donations
Fil candidate filing/ballot fees
FNO fundraising events
IND independent expenditure supporting/opposing others (explalnr
LEG legal defense
LIT campaign literature and mailings
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
Sunline Transit Agency
32505 Harry Oliver Trall
Thousand Palms, CA 92276
Schedule E Summary
MBR member communications
MTG meetings and appearances
OFC office expenses
PET petition clrculating
PHO phone banks
POL polling and survey research
POS postage, delivery and messenger services
PRO professional services (legal, accounting}
PRT printads
CODE OR
CMP
RAD radio airtime and production costs
RFD returned contributions
SAL campaign workers' salaries
TEL t.v. or cable airtime and production costs
TRC candidate travel, lodging, and meats
TRS staff/spouse travel, lodging, and meals
TSF transfer between committees of the same Gandidate/sponsor
VOT voter registration
WEB Information technology costs (internet, e--mall)
DESCRIPTION OF PAYMENT AMOUNT PAID
Bus stop advertisements
2,400.00
1. Itemized payments made this period. (Include all Schedule E subtotals.). __________________________________ .$ ----'4"'6,'-'4"-99:::·c:c0S::.._ __
2. Unilemized paymenls made !his period of under $100.. -__ -_ -__ ---_ --------------------------------='-"-"-----$ 237.76
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).J. ___________________________ $ ___ __.:-0:::0::..._ __ _
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) _______________ TOTAL $ __ __.:4c..6,~7c..36"."-Bc..1 __
• Payments that are contributions or Independent expenditures must also be summarized on Schedule D.
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SUBTOTAL$ 2,400.00
FPPC Fann 460 (Jan/2016)
FPPC Advice: advlce@ll>pc.ca.gov (886/276-3772)
www.fppc.ca.gov
Schedule F
Accrued Expenses (Unpaid Bills)
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Geoff Kors For City Council, District 3, 2019
Amounts may be rounded
to whole dollaJs. statement covers period
07/01/2019 from
through 09/21/2019
SCHEDULE F
CALIF0RNIA46O
FORM
Page __ 18_ of _2_1_
1,0, 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.
CNS campaign consultants
CTB contr'iblrtion (explafn nonmonetary)*
eve civic donations
FIL candidate filing/ballot fees
FNO fundraising events
IND independent expenditure supportingfopposing others (explaint
LEG legal defense
LIT campaign literature and mailings
NAME AND ADDRESS OF CREDITOR
(IF COMMITTEE, ALSO ENTER 1.D. NUMBER)
SCHEDULE F SUMMARY
MBR member communications
MTG meetings and appearances
OFC office expenses
PET petition circulating
PHO phone banks
POL polling and survey research
POS postage, delivery and messenger services
PRO professional services Oegal, accounting)
PRT print ads
(a) CODE OR DESCRIPTION OUTSTANDING BALANCE OF PAYMENT BEGINNING OF THIS PERIOD
RAD radio airtime and production costs
RFD returned contributions
SAL campaign workers' salaries
TEL t.v. or cable airtime and production costs
TRC candidate travel, lodging, and meals
TRS staff/spouse travel, lodging, and meals
TSF transfer between committees of the same candidate/sponsor
VOT voter registration
WEB Information technology costs (internet, e-mail)
(b) (c) (d)
AMOUNT PAID THIS OUTSTANDING BALANCE AT AMOUNT INCURRED
THIS PERIOD PERIOD (ALSO CLOSE OF THIS PERIOD ,..,...,,.....,,..QNS::'
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 $100.)-__ -___ -_______ --_ -. INCURRED TOTALS$ ---~·o_o ___ _
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 $100.L _________________ PAID TOTALS$ ___ ....:c-0..:0 ___ _
3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and
on Iha Summary Page, Column A, Line 9.). ___________________________________________ NET $ --'------'"-'-ooc..... __ _
• Payments thal are contributions or Independent expenditures must also be
summarized on Schedule D.
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SUBTOTALS $ $ $ $
FPPC Fenn 460 (Jan/2016)
FPPC Advice: advlce@lppc.ca.gov (866/276-3772)
www.fppc.ca.gov
Schedule G
Payments Made by an Agent or Independent
Contractor (on Behalf of This Committee)
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Geoff Kora For City Council, District 3, 2019
NAME OF AGENT OR INDEPENDENT CONTRACTOR
Amounls may be rounded
ID whole do!lan!. Slatement covers period
07/01/2019 from
through 09/21/2019
SCHEDULEG
CALIFORNIA460
FORM
Page __ 19_ of _2_1_
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.
CNS campaign consultants
CTB contribution (explain nonmonetary)•
eve civic donations
FIL candidate filing/ballot fees
FND fundraising events
IND independent expenditure supporting/apposing others (explain)*
LEG legal defense
LIT campaign literature and mallings
NAME ANO ADDRESS OF PAYEE
MBR member communications
MTG meetings and appearances
OFC office expenses
PET petition clrculatlng
PHO phone banks
POL polling and survey research
POS postage, delivery and messenger services
PRO professional services (legal, accounting)
PRT print ads
RAD radio airtime and production costs
RFD returned contributions
SAL campaign workers' salaries
TEL t.v. or cable airtime and production costs
TRC candidate travel, lodging, and meals
TRS staff/spouse travel, lodging, and meals
TSF transfer between committees of the same candidatefsponsor
VOT voter registration
WEB lnformatlon,technology costs (internet, e-mail)
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
• Payments that are contributions or Independent expenditures must also be summarized on Schedule D.
.. Do not transfer lo any other schedule or to the Summary Page, This total may not equal the amount paid to the agent or
Independent contractor as reported on Schedule E.
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TOTAL•$
FPPC Fenn 460 (Jan/2016)
FPPC Advice: advlce@fppc.ca.gov (866/275-3772)
www.lppc.ca.gov
Schedule H
Loans Made to Others*
Amounts may be rounded
ID whola do!am. SCHEDULEH
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Geoff Kors For City Council, District 3, 2019
FULL NAME, STREET ADDRESS AND
ZIP CODE OF RECIPIENT
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER)
IF INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED. ENTER
NAME OF BUSINESS)
(a) OUTSTANDING
BALANCE
BEGINNING THIS
PERIOD
$ ___ _
SUBTOTALS
*Loans that are contributions to another candidate or committee must also be
ummarized on Schedule D. Loans forgiven must also be reported on Schedule E
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$
(b)AMOUNT
LOANED THIS
PERIOD
$ ___ _
Slatement covers period
07/01/2019 frnm ________ _
CALIFORNIA 460
FORM
through 09/21/2019 Paga
(c) REPAYMENT
OR FORGIVENESS
THIS PERIOD •
0 PAID
$ ___ _
• FORGIVEN
$ ___ _
$
(d) OUTSTANDING
BALANCE AT
CLOSE OF THIS
PERIOD
$ ___ _
DATE DUE
$
(e) INTEREST
RECEIVED
1.D. NUMBER
1376802
(f) ORIGINAL
AMOUNT OF
LOAN
(g) CUMULATIVE
LOANS TO DATE
CALENDAR YEAR
$.===:----,,.=-% $ _____
1
PERELECTION ..
RATE
$
$
----
DATE INCURRED
FPPC Fenn 460 (Jan/2016)
FPPC Advice: advlce@lppc.ca.gov (866/27~772)
www.fppc.ca.gov
I
Schedule I
Miscellaneous Increases to Cash
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Geoff Kors For City Council, District 3, 2019
DATE
RECEIVED
Schedule I Summary
FULL NAME AND ADDRESS OF SOURCE
(IF COMMITTEE, ALSO ENTER 1.D. NUMBER)
Amounts may be rounded
to whole dollam. Slalamenl covers period
07/01/2019 from _______ _
through 09/21/2019
DESCRIPTION OF RECEIPT
$ .00 1. ltemizedincreasestocashthisperiod.------------------------------------------
2. Unitemized increases to cash of under $100 lhis period-___________________________ $ ___ ..:.-0:.:0:.._ __ _
3. Total of all interest received this period on lcians made to others. (Schedule H, Column (e).). ______________ $ ___ ...;•::.00:;_ __ _
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
Summary Page, Line 14.)_ ___________________________________ TOTAL $ ___ ...;·::.o0:.._ __ _
SUBTOTAL$
SCHEDULE I
CALIF0RNIA46O
FORM
21 21 Page ___ of __ _
1.0. NUMBER
1376802
AMOUNTOF
INCREASE TO CASH
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FPPC Fonn 460 (Jan/2016)
FPPC Advice: advlce@fppc.ca.gov (8861275-3m)
www.fppc.ca.gov