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Home My WebLink About2018-02-26 Form 460 - PS Fire ManagementRecipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from ___ 0_7_/0_1_/2_0_17 __ 12/31/17 through ________ _ 1. Type of Recipient Committee: All Committees-Complete Parts 1, 2,3, and 4. D Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee D Primarily Formed Ballot Measure Committee 0 Recall jAlso Complell Psi 5) 1iZ1 General Purpose Committee ® Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information 0 Controlled 0 Sponsored /Ar.oC.,,,,,,.,.F\orf8J D Primarily Formed Candidate/ Officeholder Committee flll.,o Compllllri Fwt7) I.D.NUMBER 1248897 COMMITTEE NAME {OR CANDIDATE'S NAME IF NO COMMITTEE) Palm Springs Fire Management Association STREET ADDRESS (NO P.O. BOX) CITY Palm Springs STATE ZIP CODE CA 92262 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE Palm Springs CA 92263 OPTIONAL: FAX/ E-MAIL ADDRESS 4. Verification AREA CODE/PHONE ( AREA CODE/PHONE Date of election if applicable: {Month, Day, Year) 2. Type of Statement: Dale Stamp 2018 FEB 26 D Preelection Statement D Semi-annual Statemeot D Termination Statement D Quarterly Statement D Special Odd-Year Report (Also file a Form 410 Termination) Ill Amendment (Explain below) Correction of coverage period dates Treasurer(s) NAME OF TREASURER Ron Beverly MAILING ADDRESS CITY Palm Springs NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY OPTIONAL: FAX/ E-MAILAODRESS STATE ZIP CODE CA 92262 STATE ZIP CODE AREA CODE/PHONE ( AREA CODE/PHONE 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 Executed on 02/26/18 Date Executed an Date Executed an Date Executed 011 Date BY------,s,,.~-nm..,.u_ra_c..,.1c"'o""'~,...rn""iiln-g""'oln,.....ce ... ho ... lde.,.r-,C=-a-nd.,..id.-m,..e,-=s.,...ta1-,-e..,.,M,...ea-s-ur-•""Prn-p-0n-em-.------ BY------,S""'ig-nm-.ur_e_m.,.,C""o""nt,-m""mn-g""'Offic,.,,,...e.,.ho-.ld.,..er""',c""an_d.,..idal.,-,-~""'s,,..~""te""M:-ea""s-ura....,,.Propo_rten....,.,t _____ _ FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule D Summary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees SEE INSTRUCTIONS ON REVERSE NAME OF FILER Palm Springs Fire Management Association DATE 08/28/17 NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LETTER AND JURISDICTION, OR COMMITTEE "Yes on Measure D" Ill Support D Oppose D Support D Oppose D Support D Oppose Schedule D Summary Amounts may ba rounded to whole dollars. TYPE OF PAYMENT liZI Monetary Contribution • Nonmonetary Contribution • Independent Expenditure • Monetary Contribution • Non monetary Contribution • Independent Expenditure • Monetary Contribution • Non monetary Contribution • Independent Expenditure DESCRIPTION (IF REQUIRED) SUBTOTAL SCHEDULED Statement covers period CALIFORNIA 460 FORM from __ 0_7/_0_1/_20_1_7 __ through __ 1_2_/3_1_/_17 __ Page ___ of __ _ $ AMOUNT THIS PERIOD 2,500.00 I.D. NUMBER 1248897 CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 • DEC. 31) 2,500.00 PER ELECTION TO DATE (IF REQUIRED) I 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) ....................................................... $ ---=2 ... ,5 ..... o-=o ...... o ..... o_ 2. Unitemized contributions and independent expenditures made this period of under $100 .................................................................................... $ _____ _ 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) .......... TOTAL .. $ ----=2=,5=0=0=.0=0~ FPPC Form 460 (Jan/2016) FPPC Advice: advlce@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE E Schedule E Payments Made Amounts may be rounded to whole dollars. Statement covers period 07/01/2017 kom ________ _ CALIFORNIA 460 FORM SEE INSTRUCTIONS ON REVERSE through __ 1_2/_3_1_/1_7 __ Page ___ of __ _ NAME OF FILER Palm Springs Fire Management Association CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. 1.0. NUMBER 1248897 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 staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)" POS postage, delivery end 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 OF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Deane & Company "Yes on Measure D" 1787 Tribute RD, Ste K CTB City of Palm Springs tax measure 2,500.00 Sacramento, CA 95815 "Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................................................. $ ___ 2 _,s_oo_._oo_ 2. Unitemized payments made this period of under $100 .......................................................................................................................................... $ _____ o_.o_o_ 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ............................................................................. $ _____ o_.o_o_ 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................... TOTAL $ ___ 2_,s_o_o_.o_o_ FPPC Form 460 IJan/2016) FPPC Advice: advice@lfppc.ca.gov {866/275-3772). www.fppc.ca.gov Schedule I Miscellaneous Increases to Cash SEE INSTRUCTIONS ON REVERSE NAME OF FILER Palm Springs Fire Management Association DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE jlF COMMITTEE, ALSO ENTER tD. WMBER) Attach additional information on appropriately labeled continuation sheets. Schedule I Summary Amounts may be rounded to whole dollars. Statement covers period 07/01/2017 ~om _______ _ through __ 1_2/_3_1_/1_7 __ DESCRIPTION OF RECEIPT SUBTOTAL$ 1. Itemized increases to cash this period ............................................................................................................................ $ _____ o_.0_6_ 2. Unitemized increases to cash of under $100 this period ................................................................................................. $ _____ _ 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ....................................... $ _____ _ 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Line 14.) ............................................................................................................................. TOTAL $ ____ O_.O_G_ SCHEDULE I CALIFORNIA 460 FORM Page ___ of __ _ 1.0. NUMBER 1248897 AMOUNT OF INCREASE TO CASH FPPC Form 460 IJan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-37721 www.fppc.ca.gov ~ COVER PAGE ~ Re~pient Committee Campaign Statement Cover Page Date Stamp , t.l\ \; o•••' -E') >-,, t~£Ct.W /., .. pd'.,' () F fl ,, L M ,) ' I'\ ' •. CALIFORNIA 46 0 FORM --------------r----------+-._.-1 Date of election If applicable: I. 1 lo\\\: 22 Page ___ of __ _ Statement covers period from ___ 1_0_/2_1_/2_0_1_7 __ SEE INSTRUCTIONS ON REVERSE 12/31/2017 through ________ _ 1. Type of Recipient Committee: AH Committees -complete Parts 1, 2, 3, ;md 4. D Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee D Primarily Formed Ballot Measure Committee 0 Recall (Al&a c""""""' Pst51 0 Controlled 0 Sponsored /Alfo Comp/ate Pm 6} fill General Purpose Committee ® Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee D Primarily Fanned Candidate/ Officeholder Committee (AJ.,o CompJele PM 7J 3. Committee Information I.D. NUMBER 1248897 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Palm Springs Fire Management Association STREET ADDRESS (NO P.O. BOX) 300 N El Cielo Rd CITY Palm Springs STATE ZIP CODE CA 92262 MAILING ADDRESS (IF DIFFERENT) NO. AIIC> STREET OR P.O. BOX PO Box 1761 CITY STATE ZIP CODE Palm Springs CA 92263 OPTIONAL: FAX I E-MAIL ADDRESS 4. Verification AREA CODE/PHONE (760) 323-8181 AREA CODE/PHONE (Month, Day, Year) ?0\1 J~N 2'+ t\ i \H~ d' ·1 CLL 1110112011 .-1.;;•r:1; E CJ \,_ I ' 2. Type of Statement: For Official Use Only D Preelection Statement l;;zJ Semi-annual Statement D Termination Statement D Quarterly Statement (Also file a Form 410 Termination) D Amendment (Explain below) Treasurer(s) NAME OF TREASURER Ron Beverly MAILING ADDRESS 1453 E Gem Cir CITY Palm Springs NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY OPTIONAL: FAX I E-MAIL ADDRESS D Special Odd-Year Report STATE ZIP CODE AREA CODE/PHONE CA 92262 (760) 218-7103 STATE ZIP CODE AREA CODE/PHONE I have used all reasonable diligence In preparing and reviewing this statement and to the best of my knowledge the infonnation contained herein and in the attached schedules is true and complete. I certify under penally of perjury under the laws of the Stale of California that the foregoing is true and rrecl. Executed on 01/24/2018 Date Executed on Dale Executed on Date Executed 0n Date BY------=---,--=--.-=-===-.,,,==-=~=~==~-----Signalure or Controlling Officeholder, Candidale, Slale Measure Proponent By _____ ...,.,.__,_..,......,....,.....,,..,....,....,......,,.....,,..,..,...-=-.,...,.,---,,....--,------ Signalure ol ControRing Officeholder, Candidale, Slale Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-37n) www.fppc.ca.gov Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Palm Springs Fire Management Association Contributions Received 1. Monetary Contributions .. ................................... .............. Schedule A. Line 3 $ 2. Loans Received................................................................ Schlldute B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS.............................. Add Lines 1 + 2 $ 4. Nonmonetary Contributions............................................ Schedule c, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED .................................... Add Lines 3 + 4 $ Expenditures Made 6. Payments Made................................................................ Schedule E, L;ne 4 $ 7. Loans Made....................................................................... Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6 + 7 $ 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F, Line 3 10. Nonmonetary Adjustment... ...................................................... Schedule c, Line 3 11. TOTAL EXPENDITURES MADE ........................................ Add Lines a+ 9 + 10 $ Current Cash Statement 12. Beginning Cash Balance............................ Previous Summary Page, Line 16 $ 13. Cash Receipts ................................................... , ....... ColumnA,Line3above 14. Miscellaneous Increases to Cash.................................. Schedule 1. Line 4 15. Cash Payments ................. ........................................ Column A, Line 8 above 16. ENDING CASH BALANCE .................. Add Lines 12 + 13 + 14, than subtract Line 15 $ ff this is a tennlnat/on statement, Line 16 must be zero. Amounts may be rounded to whole dollars. Column A TOTAL THIS PERIOD (FROM ATT/\CHE0 SCHEDULESl 573.34 0.06 573.40 SUMMARY PAGE Statement covers period 10/21/2017 from ________ _ CALIFORNIA 460 FORM 12/31/2017 through _______ _ Page ___ of __ _ $ $ $ $ $ $ ColumnB CALENDAR VEAR TOTAL TO DATE To calculate Column B, add amounts in Column A to 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 1.D. NUMBER 1248897 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Dale 20. Contributions Received $ ____ _ $ ____ _ 21. Expenditures Made $ ____ _ $ ____ _ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made" Ill Subject to Voluntary Expenditure Limit) Date of Election (mm/dd/yy) __J___j __ __J___J __ Total lo Date $ _____ _ $ ___ _ "Amounts in this section may be different from amounts reported in Column B. -------------------------------------11 this is the first report being 17. LOAN GUARANTEES RECEIVED................................ Schedule B. Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents................................................ See inslnlctions on reverse $ 19. Outstanding Debts.............................. Add Line 2 + Line 9 in Column B above $ filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 flf any). FPPC Form 460 (Jan/2016) FPPC Advice: ad11ice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule I Miscellaneous Increases to Cash SEE INSTRUCTIONS ON REVERSE NAME OF FILER Palm Springs Fire Management Association DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE. ALSO ENTER I.C. NUMBER) Attach additional information on appropriately labeled continuation sheets. Schedule I Summary Amounts may be rounded to whole dollars. Statement covers period from __ 1_0_/2_1_/2_0_1_7 __ lhrough __ 1_2/_3_1/_2_01_7 __ DESCRIPTION OF RECEIPT SUBTOTAL$ 1. Itemized increases to cash this period ............................................................................................................................ $ _____ 0_._0_6 2. Unitemized increases to cash of under $100 this period ................................................................................................. $ _____ _ 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ....................................... $ _____ _ 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Line 14.) ............................................................................................................................. TOTAL $ ____ 0_.0_6_ SCHEDULE I CALIFORNIA 460 FORM Page ___ of __ _ 1.0. NUMBER 1248897 AMOUNT OF INCREASE TO CASH FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov • • .VER PAGE Recipient Committee ·campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from ___ 0_9_/2_4_/2_0_1_7 __ 10/21/2017 through ________ _ 1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4. D Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall (Nm Comp/ol!J -5) liZI General Purpose Committee ~ Sponsored 0 Small Contributor Committee 0 Polilical Party/Central Commiltee 3. Committee Information D Primarily Formed Ballot Measure Committee 0 Controlled 0 Sponsored /Also ea...,. ,,.,, 6J D · Primarily Formed Candidate/ Officeholder Committee ,,.,.. CGmp/ol8 Pait 71 LO.NUMBER 1248897 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Palm Springs Fire Management Association STREET ADDRESS (NO P.O. BOX) 300 N El Cielo Rd CITY Palm Springs STATE ZIPCOOE CA 92262 MAILING ADDRESS (IF DIFFERENTI NO. AND STREET OR P.O. BOX PO Box 1761 CITY STATE ZIP CODE Palm Springs CA 92263 OPTIONAL: FAX/ E-MAIL ADDRESS 4. Verification AREA CODE/PHONE (760) 323-8181 AREA CODE/PHONE Date stamp R EC E \ \/ E_D U' ::: I l '( 0 F p Al M SF' R I h ,~ CALIFORNIA 460 FORM Date of election If. applicable~ 17 OCT 2 6 (Month, Day, Year) , ~M II: 2 ~P_a_ge __________ ot,::_-_-__ _ For Official Use Only 11/07/2017 ,1r,:::-o·•,:7 ~11...1 1E CITY CLE :L iJf u.- 2. Type of Statement: l2l Preelection Statement D Semi-annual Statement D Termination Statement (Also file a Form 410 Termination) D Amendment (Explain below) Treasurer(s) NAME OF TREASURER Ron Beverly MAILING ADDRESS 1453 E Gem Cir CITY Palm Springs NAME OF ASSISTANT TREASURER, IF ~V MAILING ADDRESS CITY OPTIONAL: FAX I E-MAIL ADDRESS D Quarterly Statement D Special Odd-Year Report STATE ZIP CODE CA 92262 STATE ZIP CODE AREA CODE/PHONE (760) 218-7103 AREA CODE/PHONE t have used all reasonable diligence in preparing and reviewing this statement and lo the best of my knowledge lhe information contained herein and in the attached schedules is true and complete. certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on 10/26/2017 Date E,ceculed on Date Executed on Date · Executed on Date BY-----...,,..---,.-..,....-,-..,.....,,.,,,....,...,....-,,,.---.,.,..,......,..,....,....--.,,.---,------s;gnalure of Canlrollln9 Officeholder, Candidate, Slale Measure Proponent By_·-------,S"'"ig_na...,.lu-re-of-==Cllf\-,-tro""'lli_ng...,Qffi=-oe..-h...,.olde..--~..-Ca-n""dida.,..,..le...,,S,.,..la.,..le...,.M.,...ee-su-r-e-=-Pr-oP-•-ne-nt,------- fpp( Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov 1866/275-3772) www.fppc.ca.gov • .Campaign Disclosure Statement· Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Palm Springs Fire Management Association Contributions Received 1. Monetary Contributions ................................... -................ Schedule A. Une 3 $ 2. Loans Received ............. -.................. :................................ Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS.............................. Add Lines 1 + 2 $ 4. Nonmonetary Contributions............................................ Schedule c, Une 3 5. TOTAL CONTRIBUTIONS RECEIVED .................................... Add Lines 3 + 4 $ Expenditures Made 6. Payments Made................................................................ Schedule E. LJne 4 $ 7. Loans Made ....................................................................... Schedule H, Line·a 8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6 + 7 $ 9: Accrued Expenses (Unpaid Bills) .......................................... Schedule F. LJne 3 · 10. Nonmonetary Adjustment... ...................................................... Schedule c, Line 3 11. TOTAL EXPENDITURES MADE. ....................................... AddLines8+!1+10 $ Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Une 16 $ 13. Cash Receipts ............... ..... ........ ................. .............. Column A, Line 3 above 14. Miscellaneous Increases to Cash.................................. Scheduler, Line 4 15. Cash Payments ......................................................... Column A, Line B above 16. ENDING CASH BALANCE .................. AddUnes 12 + 13 + 14, then subtract Line 15 $ If this is e termination statement, LJne 16 must be Z'ero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ Seeinstrucfionsonreverse $ 19. Outstanding Debts.............................. Add Une 2 + Line 9./n Column B above $ • Amounts may be rounded to whole dollars. Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) 573.28 0.06 573.34. • SUMMARY PAGE Statement covers period 09/24/2017 from ________ _ I CALIFORNIA 460 FORM 10/21/2017 through _______ _ Page ___ of __ _ $ $ $ $ $ $ Column B CALENDAR VEAR TOTAL TO DATE To calculate Column B, add amounts in Column A to 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 ls the first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). I.D.NUMBER 1248897 Calendar Year Summary for Candidates Running In Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 20. Contributions Received $ _____ $ ____ _ 21. Expenditures Made $ ____ _ $ ____ _ Expenditure Limit Summary for.State Candidates 22. Cumulative Expenditures Macie* (I' SubJecl to Volunlllry Expenditure Limit! Date of Election (mmldd/yy) __J__J __ __J__J __ 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 1866/275-3772) www.fppc.ca.gov • Schedule D Summary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees SEE INSTRUCTIONS ON REVERSE NAME OF FILER Palm Springs Fire Management Association DATE 08/28/2017 NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LETTER AND JURISDICTION, OR COMMITTEE "Yes on Measure o· 121 Support D Oppose D Support D Oppose D Support D Oppose Schedule D Summary • Amounts may be rounded to whole dollars. TYPE OF PAYMENT '21 Monetary Contribution • Non monetary Contribution • Independent Expenditure • Monetary Contribution • No·nmone1ary Contribution • Independent Expenditure • Monetary Contribution • Nonmonetary Contribution • Independent Expenditure . DESCRIPTION (IF REQUIRED) SUBTOTAL $ • SCHEDULED Statement covers period from __ 0_9_/_24_/_2_0_17 __ CALIFORNIA 460 FORM through __ 1_0_/2_1_/_2_01_7 __ Paga_. __ of __ _ AMOUNT THIS PERIOD 0.00 I.De NUMBER 1248897 CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) 2,500.00 PER ELECTION TO DATE (IF REQUIRED) 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) ....................................................... $ --~2=,5=0=0~.0=0- 2. Unitemized contributions and independent expenditures made this period of under $100 .................................................................................... $ _____ _ 3. Totai contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) .......... TOTAL.. $ __ .....,2 .... ,5=0 .... 0....,.0...,0'- .FPPC Form 460 (Jan/2016) FPPC Advice: advice@)fppc.c:a.gov (866/275-3772) www.fppc.ca.gov • Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Palm Springs Fire Management Association • Amounts may be rounded to whole dollars. Statement covers period from __ 0_9_/2_4_/2_0_1_7 __ through __ 1_0_/2_1_/2_0_17 __ -SCHEDULE E CALIFORNIA 460 FORM Page ___ of_. __ t.O. NUMBER 1248897 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP CNS CTB eve FIL FND IND LEG LIT campaign paraphernalia/misc. campaign consullants contribution (explain nonmonelary)" civic donations candidate filing/ballot fees fundraising events independent expenditure supporting/opposing others (explain)* · legal defense campaign literature and maiHngs NAME AND ADDRESS OF PAYEE (IF COMMITTEE, Al.SO ENTER LO. NUMBER) Deane & Company 1787 Tribute Rd, Ste K Sacramento, CA 95815 MBR MTG OFC PET PHO POL POS PRO PRT member comrmmicalions meetings and appearances office expenses petition circulating phone banks polling and survey research postage, delivery and messenger services professional services (legal, accounting) print ads CODE OR RAD RFD SAL TEL TRC TRS TSF VOT WEB radio airtime and production costs returned contributions campaign workers' salaries l.v. or cable airtime and11roduction costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor voter registration information technology costs (Internet, e-mail) DESCRIPTION OF PAYMENT AMOUNT PAID ''Yes on Measure D" CTB City of Palm Springs tax measure 2,500.00 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 2,500.00 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................................................. $ ___ 2_,_5o_o_._oo_ $ 0.00-2. 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).) ............................................................................. $ ____ o_.o_o_ 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................... TOTAL $ ___ 2 ,_5o_o_.o_o_ FPPC Form 460 (Jan/2016) FPPC Advice: advlce@fppc.ca.gov (866/27S-3772) www.fppc.ca.gov ••• Schedule I Miscellaneous Increases to Cash SEE INSTRUCTIONS ON REVERSE NAME OF FILER Palm Springs Fire Management Association DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE ~FCOMMITTEE.AL50 ENTER I.D. NUMBER) Attach additional information on appropriately labeled continuation sheets. Schedule I Summary • Amounts may be rounded to whole dollars. Statement covers period 09/24/2017 from _______ _ through __ 1_0_/2_1_/2_0_1_7 __ DESCRIPTION OF RECEIPT SUBTOTAL$ 1. Itemized increases to cash this period ............................................................................................................................ $ _____ 0_._06_ 2. Unitemized increases to cash of under $100 this period ................................................................................................. $ _____ _ 3. Total of_ all interest received this period on loans made to others. (Schedule H, Column (e).) ....................................... $ _____ _ 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Line 14.) ............................................................................................................................. TOTAL $ ____ 0_.0_6_ • SCHEDULE I CALIFORNIA 46 0 FORM Page __ of __ 1.0. NUMBER 1248897 AMOUNT OF .INCREASE TO CASH FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Statement of Organization Recipient Committee Statement Type D Initial Nol yet qualified D or 121 Amendment List I.D. number: # 113652985 I ' D Termination -See Part S list 1.0. number: # _______ _ I ,_ R in th Dab!Stamp EIVED AND Fn .. ZG office of the Secretary of Stats of 111e Stile of Catiiornia JUL 31 2017 Ul -< G:r, ~~ ~("') ::,0 rr, ,...._ __ _,, ,_ Dale qualified as committee Date qualified as committee (If appllcablel Date of Termination ~< . ,rn 1.~<Cqffiijl~¢::!nfo.t"'1.atlot1,;~;~[';C::•·· ;, .\ -c:~;{ ,,,:,.,:~<>;M;:·;,:_::::: .\, .. ,:,;,,;::,.;,r;,,~:.s,:;[t:, ; . .;;.: . :;~:,'.t:::,. 2~xrr~a'surer and;Qt~~rsPiin'clp;;al{Qffl.~,~-:~'.i,,k·J:i::EAt:•::jl~:•ff '.·,;ir·~~;~;~::~~;;'i:\">:· •: ;jfjk :ds:i NAME OF TREASURER C';" • • NAME OF COMMITTEE f"" -Palm Springs Fire Management Association PAC Ron Beverly r·-o STREET ADDRESS [NO P.O. BOXI 1453 E Gem Circle STREET ADDRESS INO P.O. 80XI CITY STATE ZlPCOOE AREA CODE/PHONE 300 N El Cielo Rd Palm Springs CA 92262 (760)218-7103 CITV STATE ZIP CODE AREA CODE/PHONE NAME Df ASSISTANT TIW\SOREII, IF ANY Palm Springs CA 92262 (760)323-8181 nla MAIUNG ADDRESS !IF DlffEIUNTl. STREET ADDRESS INO P.O. BOXI P.O. Box 1761 Palm Springs, CA 92263 FAX/ E-MAIL ADDRESS CITY STATE ZIPCOl>E AREA CODE/PHONE COUNTV OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PIUNCll'AI. OFFICER(5) Riverside Jason Loya STREET ADDRESS (NO P.O. IOXI 78-465 Via Sevilla Attach additional information on appropriately labeled conttnuatfon sheets. CITY STATE ZIP CODE La Quinta CA 92253 AREA CODE/PHONE (760)927-5770 penalty of perjury under the laws of the State of California that th regolng i and c ~ <?J ~ : Executedon 07/27/2017 DATE Executed on By DATE Executed on By DATE Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR 51'.IITE MWURE PROPON£NT SIGNATURE OF CONTRDLLINl'i OFFICEHOLDER, CANDIDATE, OR STATE MEIISURE PROPONENT :::---(".7 ---,, .~-~ f"":'. ..,.-::: ___ ..!) ,.:_: .... ~::-::~ ~-_. ·, l . , ~ ' I -.J FPPC Form 410 (Jan/2016) FPPC Advice: advlce@lfppc.ca.guv (866/275-3772l www.fppc.ca.1ov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME Palm Springs Fire Management Association PAC CALIFORNIA 410 FORM 1,D.NUMDER 113652985 • All committees must 11st the flnanclal Institution where the campaign bank account Is located. NAME Of FINANCIAL INSTITUTION AREA CODE/PHONE BANI ACCOUNT NUMBER Sun Community Federal Credit Union (760)327-7 47 4 50109510 ADDIESS STATE ZIPCOOE 425 N Civic Dr Palm Springs CA 92262 Controlled Com,wttet: • 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:' • 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 HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) nAR OF ELECTION P1 /fnnnly fu,med Comn'ittee Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(SJ NAME OR MEA5UREl5} FUtl TlnE (INCWDE BALLOT NO. OR LETTER) CANDIOATEjS) OFFICE SOUGHT 011 HHD OR MEASURE(S) JURISDICTION [INCWDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) PARTY D Nonpartisan 0 Nonpartisan CHECK ONE T rO§, FPPC Form 410 (Jan/ZOl&t FPPC Advice: advlce@lfppc.ca.gov (866/275•37nt www.fppc.ca.1ov Statement of Organization Recipient Committee INSTRUCTIONS ON RfVERSE COMMlmE NAME Palm Springs Fire Management Association PAC CALIFORNIA 410 FORM l,D,NUMBER 113652985 General Purpose Cnmm1tlPP Not formed to support or oppose specific candidates or measures in a single election. Check only one box: 12] CITY Committee • COUNTY COmmittee • STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITV Sponsored Lomm,ttce List additional sponsors on an attachment. NAME Of Sl'ONSOft INDUSTRY GROUP OR AFFILIATION OF SPONSOR Palm Springs Fire Management Association snEET ADDRESS NO. ANO STR~U CITY STATE ZIP CODE P.O. Box 1761 Palm Springs CA 92263 Small Conti rbutor Comm1ttl'e •-----DIie qualfied S;.Term.ln~tlo~!~@qijl,~!ti~lil!t~Ii:fi"'fs,~~~~:~:~®i:a~.~~t~etreasu~r,ass~~;:~.#.~~~tlf;f!DPJ!~~~f!!tigid.~f/~r·p¥j,i,nrmtci!ftl':v·~·~.(.ti!:~,<>!1~ij[~~~~?~t~~~~~:.rfa1!i;:)i/Jc":i.•···. •· • This committee has ceased to receive contributions and make expenditures; • This committee does not anticipate receMng 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 89511-89S18, and are subject to Elections code Section 18680 and FPPC Regulation 18521.5. FPPC Form 410 (Jan/2016) FPPC Advice: advlcel!Pfppc.ca,eov (866/Z75-37n) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page RECEIVED . _____________________ ... ·• ....... ,_.__ .. .,..) F P t, L M SP R l h C ; SEE INSTRUCTIONS ON REVERSE Statement covera period 01/01/2017 from ________ _ 06/30/2017 through _______ _ 1. Type of Recipient Committee: A• Comm1tmea-eompia Parm 1, 2, 3, and 4. D• of election if applicable: (Mooth, Day, Year) 2111 UL 2 7 PH 2: 5 0 2. Type of Statement: D Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee D Primarily Fonned Ballot Measure Committee D Preeleclion Statement 121 Semi-annual Statement D Termination Statement D Quarterly Statement Q Recall 0 Controlled • Special Qdd.Year Report ~~,,.,ii! liZI General Purpose Committee ~ Sponsored 0 SmaU ContributorConvnittee 0 Political Party/Central Committee 3. Committee Information 0 Sponsored (A/111~,,.,8/ D Primarily Formed Candidate/ Officeholder Committee (Also~ P1117J 1.0.NUMBER 11-3652985 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Palm Springs Fire Management Association-PAC STREET ADDRESS (NO P.O. BOX) 300 N El Cielo Rd CITY Palm Springs STATE ZIP CODE CA 92262 WJLINGADDRESS (IF DIFFERENT) NO.ANO STREET OR P.O. BOX P.O. Box 1761 crtv STATE ZIP CODE Palm Springs CA 92263 OPTIONAL: FAX/ E-MAIL ADDRESS 4. Verification AREA CODEIPttONE (760) 323-8181 AREA CODE/PHONE (Also file a Fonn 410 Termination) D Amendment (Explain below) Treasurer(s) NAME OF TREASURER Ron Beverly loWUNG ADDRESS 1453 E Gem Circle cliv Palm Springs NAME OF ASSISTANT'TREASURER, IF AtN n/a MAILING ADDRESS CITY OPTIONAL: FAX/ E-MAIL ADDRESS STATE ZIP CODE CA 92262 STATE ZIP CODE AREA CODE/PHONE (760) 218-7103 AREA CODE/PHONE I have used aH 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 peljury under the laws of the State of Cafifomia that the foregoing is true and~ ~ Executed on 07/27/2017 Bv-------1-1------•-!'"t-.-......-. _ __....._...,..,....,._--=---------- Om& s· ori; or · T"'- Exeamid on----......., ..... -----ay_....,.,..,..,.,.....,.,....,.....,..,...,.,.,..,.,.........,..,..,.,,..,,...,......,,..,...,.,,,....,,....,.,....-,...-,.......;;;;:::---,---,--.,............,.,,..,.....,.,,.........,..,,.......-,--Oale Slgnabn d CcnUohlg Offtceho1der, candidale, State Measure Proponent or Reaponsible OfflaK of Sponsor Executedon-----Dala==------ Executedon-----.6~ • ..------ Bv----...... ..--......................... .,._ ...... ..,...._....,......,......, _ __,,,.........., ____ _ Signalllr8 of Coolralli1111 Ollahddllr. Candidate, stale~ PnlpQnent Bv-------,Slplute,,......-,--'""'ol""'Conrall--.-""ing--,,,ofiicafioidai-.,,..........,...,.. __ C.,.. _ _,,.,ic1a1""'a-•, siaie.....,..""Me'""asure-'""P'""roponen--,1----- FPPC Form 460 tJan/2016) FPPC Advica: advlce@)fppc.ca.pv (866/275-3772) www.fppc.ca.aov SUMMARY PAGE Campaign Disclosure Statement Summary Page Amounts mil)' be rounded to whole dolars. Statement covers period 01/01/2017 from _______ _ CALIFORNIA 460 FORM SEE INSTRUCTIONS ON REVERSE 06/30/2017 ~rough ______ _ Page ___ of __ _ NAME OF FILER Palm Springs Fire Management Association-PAC Contributions Received 1. Monetary Contributions................................................... ScheduleA. Line 3 $ 2. Loans Received ................................................................ Schedules, Unal ColumnA Ta™. 1lil8 PERIOO (FAC-..ATTActED SCHED1Jt.ES1 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Addl.ines1+2 S ------ 4. Nonmonetary Contributions............................................ Schedule c, Une 3 5. TOTAL CONTRIBUTIONS RECEIVED ................................... .Add Linn 3 + 4 $ Expenditures Made 6. Payments Made................................................................ St:hedule E, L/nt!I 4 $ 7. Loans Made....................................................................... Schedule H. Line 3 8. SUBTOTAL CASH PAYMENTS ......................•................... Add Lines o + 7 $ 9. Accrued Expenses (Unpaid BiUs) .......................................... Schedule F. Lines 10. Nonmonetary Adjustment.. ....................................................... Schfldu/e ~ Line 3 11. TOTAL EXPENDITURES MADE. ....................................... Add Lines 8 + 9 + 10 $ Current Cash Statement 12. Beginning Cash Balance ............................ Pr9vious Summary Page, une 10 $ 573.16 13. Cash Receipts .............................................. ..... ........ Coiumn A. Line 3 above 14. Miscenaneous Increases to Cash .................................. Schewie 1, Lil9 4 .12 15. Cash Paynients .............. ..... ...................................... Column A, Linll 8 above 16. ENDING CASH BALANCE .................. Add Lines 12 + 13 + 14, then subtract Line 15 $ 573.28 If this is a tennination statement, Um 16 must be zero. $ s $ $ $ $ ColumnB CALENDAR VEAR TOTAL TO 0,1.TI: To calallate Coloom B, add amounts in Column A to 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 amo1.11ts. If ---------------------------------1 thisisthefirstreportbeing EES RECEIVED filed for this calendar year, 17. LOAN GUARANT ................................ Schedule B, Patt 2 $ only carry aver the amounts _C_a_s_h_E_q_u_i_v_a-le_n_ts_a_n_d_O_u_ts_ta_n_d_i_n_g_D_e_b_ts _____________ from Lines 2, 7, alld 9 (If any). 18. Cash Equivalents................................................ See /nstnJdions on rc,i,e,se $ 19. Outstanding Debts.............................. Add une 2 + Line 9 in Column B abol/8 $ I.D.NUMBER 11-3652985 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 111 thmugh 6/30 7/1 lo Date 20. Contributions Received $ $ 21. Expendih.res Made $ $ Expenditure Limit Summary for State Candidates 22. Cumullltlva Expendituree Made* llfSubfecllo~E...-.,.IJRIII) Date of Election (mmlddlyy) __ ....,, __ _./ I Total to Date $ _____ _ $ _____ _ *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (Jan/2016) FPPC Advice: advlce8fppc.ca.10Y (866/275-3772) www.fppc.ca,gov Schedule A Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Palm Springs Fire Management Association-PAC Amounts fflllJ be rounded towhoktdollara. DAlE RECEIVED FULL NAME, STREET ADDRESS ANO ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMrTTeE. Al.SO ENTeR 1.0. NUMBER) CODE * IF AN IN0MDUAL, ENTER OCCUPATION AND EMPLOYER ~F SELF-BiFI..OYED, ENTER NAME OF BIJSINE88) Schedule A Summary 1. Amount received this period -itemized monetary contributions. •IND •COM DOTH •PTY •sec •IND •COM DOTH 0PTY •sec DINO •COM 00TH •PTY •sec •IND •COM 00TH 0PTY •sec •IND •COM DOTH 0PTY •sec SUBTOTALS Statament covens period 01/01/2017 from _______ _ 06/30/2017 through ______ _ SCHEDULE A CALIFORNIA 46 0 FORM Page ___ of __ _ I.D. NUMBER 11-3652985 AMOUNT RECEIVED THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 • DEC. 31) PER ELECTION TO DATE (IF REQUIRED) *Contributor Codes IND -Individual (Include all Schedule A subtotals.) .............•...•...•................................................................................... $------'---COM -Recipient Committee (other than PTY or SCC) 0TH -Other (e.g., business entity) PTY -Political Party 2. Amount received this period -unitemized monetary contributions of less than $100 ........................... $ ______ _ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ...................... TOTAL $ ______ o_ sec -Small Contri>utor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advlce@fppc.ca.pv (866/275-3772) www.fppc.ca.pv Schedule B -Part 1 Loans Received SEE INSTRUCTIONS ON REVERSE NAME OF FU.ER Palm Springs Fire Management Association-PAC Amounts may be rounded to whole dolars. Statement covers period 01/01/2017 ~om _______ _ 06/30/2017 through ______ _ SCHEDULE B -PART 1 CALIFORNIA 460 FORM Page ___ of __ _ I.D.NUMBER 11-3652985 FULL NAME, STREET ADQRESSAND ZIP CODE OF LENDER IF AN INDMDUAL, ENTER OCCUPATION AND EMPLOYER (F SELF-EMPLOYED, ENTER NAME OF BUSINl!SS) Cc) OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING BEG~~:8'ittis RECEIVED THIS OR FORGIVEN c~~~l.Afis • INTEREST ORIGINAL AMOUNT OF LOAN CUMULATIVE CONTRIBUTKlNS TO DATE (IF COMMITTEE. ALSO ENTER I.D. NUUIIER) PERIOD PERIOD THIS PERIOD• PERIOD 0 PAID $ $ D FORGIVEN to INO O COM O 0TH O PTY O sec •----• DATE DUE D PAID s $ 0 FORGIVEN to IND O COM O 0TH O PTY O sec , ___ _ , ___ _ s DATE DUE 0 PAID s s 0 FORGIVEN •----to IND O COM O 0TH O PTY O SCC , ___ _ • OATEOUE SUBTOTALS $ $ $ Schedule B Summary 1. Loans received this period .................................................................................................................... $ (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period ......................................................................................................... $ (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 $ Enter the net here and on the Summary Page, Column A, Line 2. (May tie• 119tift ffll'nller) '"Amounts forgiven or paid by another party also must be reported on Schedule A. "" If required. $ s s $ PAID THIS PERIOD --"' RAlE --"' RATE --"' Rl\lE (Enter (eJ on CALENDAR YEAR s s PER ELECTION" s DATE INCURRED CALENDAR VEAR $ • PER ELSCTlON .. • DA"llo INCURRED CALENDAR YEAR s s PER ELECTION .. s DATE INCURRED SchadlAe E, Line 3) tContributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) 0TH -Other (e.g., business entity) PTY -Political Party SCC -SmaU Contributor Convnittee FPPC Form 460 tJan/2016) FPPC Advice: advlcel!Pfppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULEE Schedule E Payments Made Amounts may be rounded to whole dollars. Stalament covers period 01/01/2017 from _______ _ CALIFORNIA 460 FORM SEE INSTRUCTIONS ON REVERSE 06/30/2017 through ______ _ Page __ of __ NAME OF FILER Palm Springs Fire Management Association-PAC CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. 1.0.NUMBER 11-3652985 CMP campaign paraphernalia/misc. MBR member commooications RAD radio airtime and production costs CNS campaign consultan1s MTG meetings and appearances RFD returned contributions CTB contl1bution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries eve 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 fwtdraising events POL poling and sun,ey 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 prote&Sional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads VI/EB information lechnology costs (intamet, e-mail) NAME AND ADDRESS OF PAYEE (F COMMITTEE.ALSO EN11:R 1.0. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID • Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL$ Schedule E Summary 0 1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................................................. $ _____ _ 0 2. Unitemized payments made this period of under $100 .......................................................................................................................................... $ _____ _ 0 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ............................................................................. $ _____ _ 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 $ _____ _ FPPC Form 460 (Jan/20161 FPPC Advice: advlce.,ppc.ca.gov (B66/275-3nzt www.fppc.ca.gov Schedule I Miscellaneous Increases to Cash SEE INSTR TIONS ON REVERSE NAMEOFRLER Palm Springs Fire Management Association-PAC DATE RECEIVED FULL NAME ANO ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) Attach additional information on appropriately labeled continuation sheets. Schedule I Summary Amounts may be rounded to whole dollars. Statement covers period 01/01/2017 from _______ _ 06/30/2017 through ______ _ DESCRIPTION OF RECEIPT SUBTOTAL$ 1. Itemized increases to cash this period ............................................................................................................................ $ _____ ._12_ 2. Unitemized increases to cash of under $100 this period •................................................................................................ $ _____ _ 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ....................................... $ _____ _ 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Line 14.) ............................................................................................................................. TOTAL $ _____ ._12_ SCHEDULE I CALIFORNIA 460 FORM Page __ of __ I.D. NUMBER 11-3652985 AMOUNT OF INCREASE TO CASH FPPC Form 460 (Jan/2016) FPPC Advice: acMce@fppc.ca.pv (866/275-3772) www.fppc.c:a.gov . Recipient Committee Campaign Statement Cover Page -Af"'\enc1ed SEE INSTRUCTIONS ON REVERSE Statament coven period 07/01/2016 from ________ _ 12/31/2016 ~rough _______ _ 1. lype of Recipient Committee: AH Comm111Ns-Comp1ete Patti 1, 2, l, 1111d 4. D Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee D Primarly Formed Balot Measure Committee Q Recall (A/lo ~Ari 5} liZI General Purpose Committee e Sponsored 0 SrnaD Contributor Committee 0 Political Party/Central Committee 3. Committee lnfonnatlon 0 Controled 0 Sponsored (Allo~l'Mf) • Primarily Formed Candidate/ Officeholder Committee (Alla eom,,ille Plrl 1) I.D.NUMBER 11-3652985 COMMITTI::E NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Palm Springs Fire Management Association STREET ADORESS (NO P.O. BOX) 300 N El Cielo Rd CITY Palm Springs STATE ZIP CODE CA 92262 MAILING ADDRESS (IF 01FFERENT) NO. AND STREET OR P.O. BOX P.O. Box 1761 CITY STATE ZIP CODE Palm Springs CA 92263 OPTIONAL: FAX I E-MAllADORESS 4. Verification AREA CODE/PHONE (760) 323-8181 AREA CODE/PHONE Date Stamp Date of •IIICtion if applicable: (Month, Day, Year) 2. Type of Statement: D Preelection Statement 121 Semi-annual Statement D Termination Statement (Also file a Form 410 Termination) D Amendment (Explain below) Treasurer(s) NAME OF mEASURER Cory Gorospe MXILINdAbbREss 68070 Madrid Rd CllY Cathedral City NAME OF ASSISTANT TREASURER, IF ANY n/a MAILING ADDRESS CITY OPTIONAL: FAX I E-MAIL ADDRESS For Official Use Only 0 9. _,, ~ ~ • Quarterty s~ --< 0 Special Odd-~r Ra,IIQrt O ?,:> 0 ~ -.;~ I I ?fi\ --r--rn ~.c:. S ~ o,11' STATE ZIP CODE AREA CODE/PHONE CA 92234 (760) 673-1896 STATE ZIP CODE AREA CODE/PHONE I have used au reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the i ormati 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 anm~rP.d Execullld on Executed on Executed on Execu1edon 01/2412017 Date biiie Date Da1lt ey _____ Signafu""'·=""'re""or""c""'o"'niroiing=""'0111""1101""'""110kler=~, c""'~==c-, ""s-,,..,....,Ma=asu""re,,...P""ra""ponen1=,,......---- By _____ S""'igna=1ur~e""or""c..,.o.~,b~Ol~ing,-Office=-.-holdet-.~. C:,o,llncldale~-,-, ""st111e,,..,....,MNIUB=~Pr""op=0nen1~----- fPPC Form 460 (Jan/2016) FPPC Advice: advlcet!Pfppc.ca.gov (866/275-3772) www.fppc.ca.gov -•· Campaign Disclosure Statement Summary Page see INSTRUCTIONS ON REVERSE NAME OF FILER Palm Springs Fire Management Association Contributions Received 1. Monetary Contributions................................................... ScheduleA, Line 3 $ 2. Loans Received................................................................ Sdledule s. Line 3 3. SUBTOTAL CASH CONTRIBUTIONS.............................. Add lines 1 + 2 $ 4. Nonmonetary Contributions............................................ Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED ................................... .Adc/Unes3+4 $ Expenditures Made 6. Payments Made................................................................ SchedlJle E, Lm 4 $ 7. Loans Made....................................................................... Schedule H, LN 3 B. SUBTOTAL CASH PAYMENTS.......................................... Add Unes 6 + 7 $ 9. Accrued Expenses (Unpaid BiHs) .......................................... Schedule F, Une 3 10. Nonmonetary Adjustment.. ....................................................... Schedule c, Line 3 11. TOTAL EXPENDITURES MADE. ....................................... AddLinesB+9+ 10 $ Current Cash Statement 12. Beginning Cash Balance ............................ Ptellfous SUmma,y Page, Line 16 $ 13. Cash Receipts ........................................................... Column A, Une J above 14. Miscellaneous Increases to Cash .............. .................... Schedule 1, Line 4 15. Cash Payments......................................................... Column A, Lines above 16. ENDING CASH BALANCE .................. Add Lines 12 + 13 + 14, then subtract Line 15 $ ff this is a tennination statement, LJne 16 must be zero. 17. LOAN GUARANTEES RECENED ................................ ScheduleB,Part2 $ Cash Equivalents and Outstanding Debts Amounts may be rounded to whole dolars. ColumnA TOTAL THIS PEAIOO (FROMATTACIED SCHEDULESI 573.04 .12 573.16 18. Cash Equivalents ................................................ Seeinstruc:liansoon,11111.rse $ 19. Outstanding Debts .............................. AddL.ine2+L.ine9inColumnBabove $ SUMMARY PAGE Statement covers period 07/01/2016 kom ________ _ CALIFORNIA 460 FORM 12/31/2016 through _______ _ Page ___ of __ _ $ Columns CALENDAR YEAR TOTAL TC DATE $ ------- $ $ $ $ To calculate Column B, add amounts in Column A to the con-esponding amounts from Column B of your last report. Some amounts in Column A may be negative figures tha1 should be subtracted from previous period amounts. If this is the first report being filed for this calendar year, only cany over the amounts from Lines 2, 7, end 9 (if any). 1.0.NUMBER 11·3652985 Calendar Year Summary for Candidates Running in Both the State Primary and General Electlona 1/1 through 6130 7/1 to Date 20. Conbibutions Received $ ____ _ S----- 21. Expencll1ures Made $ ____ _ $ ____ _ Expenditure Limit Summary for State Candidates 22. Cumulative Expendituree Made• pr SU111«t fill VDllntuy Eiipandlln Lllllltl Date of Election (mm/dd/yy) I __ _.I, __ _,/ 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 (866/27S-3772, www.fppc.ca.gov -· Schedule A Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Palm Springs Fire Management Association Amounts may be rounded to whole dollan.. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OF COMMITTEE, ALSO ENTER LD. NUMBER) CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SEL.F-EliFLOYED, ENTER NAME OF BUSINESS) Schedule A Summary 1. Amount received this period -itemized monetary contributions. •IND •COM 00TH OPTY •sec •IND •COM DOTH OPTY •sec •IND •COM DOTH •PTY •sec DINO •COM 00TH OPTY •sec •IND •COM 00TH •PTY •sec SUBTOTAL$ SCHEDULE A Statement covers period 07/01/2016 from ________ _ CALIFORNIA 460 FORM ttlrough __ 1_21_3_1_12_0_1_6 __ Page ___ of __ _ AMOUNT RECEIVED THIS PERIOD 1.0.NUMBER 11-3652985 CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) *Contributor Codes IND-Individual (Include all Schedule A subtotals.) ......................................................................................................... $ _____ _ COM -Recipient Committee (other than PTY or SCC) 0TH -Other (e.g., business entity) PTY -Political Party 2. Amount received this period -unitemized monetary contributions of less than $100 ........................... $ ______ _ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ...................... TOTAL $ ______ o_ sec -Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advlce@fppc.ca,gov (866/275-3772) www.fppc.ca.gov Schedule B -Part 1 Loans Received SEE INSTRUCTIONS ON REVERSE NAME Of FILER Palm Springs Fire Management Association Amounts may be rounded to whole dollars. Statement covera period 07/01/2016 from _______ _ 12/31/2016 through ______ _ SCHEDULE B -PART 1 CALIFORNIA 460 FORM Page___ of __ _ I.D. NUMBER 11-3652985 FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER ~FSELF-EMPLOVED,ENTER NAME OF l!USINESS) (CJ OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING BALANCE RECENED THIS OR FORGIVEN BALANCE AT • INTEREST ORIGINAL AMOUNT OF LOAN II CUMULATIVE CONTRIBUTIONS TO DATE (F COMMITTEE, ALSO ENTER 1.0. NUMBER) BEG~:~io THIS PERIOD THIS PERIOD• CLO~iR?iJHIS 0 PAID $ • 0 FORGIVEN to IND O COM O 0TH O PTY O sec •----•----• DATE DUE •PAID $ s 0 FORGIVEN to IND O COM O 0TH O PTY O sec $ ___ _ $ DATEOUE 0 PAID $ s 0 FORGIVEN to IND • COM • 0TH • PTY O sec , ___ _ , ___ _ $ DATE DUE SUBTOTALS $ $ $ Schedule B Summary 1. Loans received this period .................................................................................................................... $ (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period ......................................................................................................... $ (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 $ Enter the net here and on the Summary Page, Column A, Line 2. (M9y 11e • ~ ninberl *Amounts forgiven or paid by another party also must be reported on Schedule A. ,... If required. $ $ $ s PAIOTHIS PERIOD --" RATE --" RAlE --" RATE (Enler(e)oo CALENDAR VEAR $ I PER ELECTION .. s DATE INCURRED CALENDAR VEAR $ • PER ELECTION .. $ DATE INCURRED CALENDAR YEAR $ $ PER ELECTION.,. $ DATE INCURRED Schedla E, Line 31 tcontributor Codes IND -Individual COM -Recipient Convnittee (other than PTY or SCC) 0TH -Other (e.g., business entity) PTY -Po&tical Party SCC -Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advlce@Pfppc.ca.sav 1866/275-3772) www.fppc.ca.gov -. . SCHEDULEE Schedule E Payments Made Amounts may be rounded to whole dollars. Statement covers period 07/01/2016 wom _______ _ CALIFORNIA 460 FORM SEE INSTRUCTIONS ON REVERSE through __ 1_2/_3_1/2_01_6 __ Paga ___ of __ _ NAME OF FILER Palm Springs Fire Management Association CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. 1.0. NUMBER 11-3652985 CMP campaign paraphemalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearancies RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition c:i-cuating TEL l.v. or cable airtime and production costs FIL candidate fillng/balot fees PHO phone banks TRC candidate travel, lodging, and meals FND funclraising events POL poHing and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)* POS postage, deivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration UT campaign literature and mailings PRT print ads WEB infonnation technology costs (internet, a-mail) NAMEANDADDRESS OF PAYEE Clf CO!Affl"Tee, Al.SO eNTl:R I.D. NUM81!R} CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ Schedule E Summary 0 1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................................................. $ _____ _ 0 2. Unitemized payments made this period of under $100 .......................................................................................................................................... $ _____ _ 0 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).} ............................................................................. $ _____ _ 0 4. TotaJ payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................... TOTAL $ _____ _ FPPC Form 460 (Jan/2016) FP9C Advice: advlceOfppc.ca.gov {866/275-3772) -.fppc.ca.gov .. . . Schedule I Miscellaneous Increases to Cash SEE INSTRUCTIONS ON REVERSE NAME OF ALER Palm Springs Fire Management Association DATE RECEIVED RJLL NAME AND ADDRESS OF SOURCE ~F COMMITTEE, ALSO ENTER 1.0. NUMBER) Attach additional information on appropriately labeled continuation sheets. Schedule I Summary Amounts may be rounded to whole dollar... Statement covers period 07/01/2016 from _______ _ through __ 1_2/_3_1/2_01_6 __ DESCRIPTION OF RECEIPT SUBTOTAL$ 1. Itemized increases to cash this period ............................................................................................................................ $ _____ ._12_ 2. Unitemized increases to cash of under $100 this period ................................................................................................. $ _____ _ 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ....................................... $ _____ _ 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Line 14.) ............................................................................................................................. TOTAL $ _____ ._12_ SCHEDULE I CALIFORNIA 460 FORM Paga __ of __ LO.NUMBER 11-3652985 AMOUNT OF INCREASE TO CASH FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov ,. R,ecipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE ent covers period 06/30/2016 from----~;::::~.::::.::::.::::::::::=:= 1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4. D Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee D Primarily Formed Ballot Measure Committee 0 Recall (Also Coo,p/ele Pall SJ liZI General Purpose Committee ® Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information 0 Controlled 0 Sponsored (Also Complete Parl 6) D Primarily Formed candidate/ Officeholder Committee /Also C01111Jleli> Par! 7) 1.0.NUMBER 11-3652985 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Palm Springs Fire Management PAC STREET ADDRESS (NO P.O. BOX) 300 N El Cielo Rd CITY Palm Springs STATE ZIP CODE CA 92262 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX P.O. Box 1761 CITY STATE ZIP CODE Palm Springs CA 92263 OPTIONAL: FAX/ E-MAIL ADDRESS 4. Verification AREA CODE/PHONE 760-323-8181 AREA CODE/PHONE ... Date Stamp ~ c.Ct.lV ED ur-.:. F p~LH SPRlnv•- CALIFORNIA 460 FORM Date of election If appllcabl~ (Month, Day, Year) ti\ I ~N 24 AM\\: 09 Page ___ of __ _ For Official Use Only 2. Type of Statement: D Preelection Statement 1121 Semi-annual Statement D Termination Statement (Also file a Form 410 Termination) D Amendment (Explain below) Treasurer(s) NAME OF TREASURER Cory Gorospe MAILING ADDRESS 68070 Madrid Rd CITY Cathedral City NAME OF ASSISTANT TREASURER, IF ANY n/a MAILING ADDRESS CITY OPTIONAL: FAX I E-MAIL ADDRESS D Quarterly Statement • Special Odd-Year Report STATE ZIP CODE CA 92234 STATE ZIP CODE AREA CODE/PHONE (760) 673-1896 AREA CODE/PHONE 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. certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. E~ecutedoo _____ \ __ l L_4+-l.__l'"\-__ Date Executed llll-----,,,_oa..,.te _____ _ Executed on-----,,,-08..,.te _____ _ Executed on _____ ,,,,08..,.te _____ _ BY-----....,,,---,-..,.,,,....,....,,,......,,.,....,....,.,.....,,,.....,,.,..,.....,,.,...,...,.,..--.,,....---,------signalure of Conlrolling Officellolder, Gandidale, Stale Measure Proponenl BY------,S"'°ig-na-.-tu-,e-o.,,.fC"'"o-nt,-ro""'lli-ng-=om=-cet,=01de.,.-~.,..Ca--nd""'ida=1e-=,s,.,.1a.,..1e-,M.,..ees=-u,-e""Pr ... opo"="ne"""nt,------- FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov .. .. Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME Of FILER Palm Springs Fire Management Association PAC Contributions Received 1. Monetary Contributions................................................... Schedule A, Line 3 $ 2. Loans Received................................................................ Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS.............................. Add Lines 1 + 2 $ 4. Nonmonetary Contributions............................................ Schedule c. Line 3 5. TOTAL CONTRIBUTIONS RECEIVED ................................... AddUnes3+4 $ Expenditures Made 6. Payments Made................................................................ Schedule E. Line 4 $ 7. Loans Made....................................................................... Schedule H. Line 3 8. SUBTOTAL CASH PAYMENTS.......................................... Add Lines 6 + 7 $ 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F. Line 3 10. Nonmonetary Adjustment... ...................................................... Schedule c, Line 3 11. TOTAL EXPENDITURES MADE. ....................................... Add lines 8 + 9 + 10 $ Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summa,y 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 8 above 16. ENDING CASH BALANCE .................. Add Lines 12 + 13 + 14, then subtract Line 15 $ If this Is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED................................ Schedule B, Part 2 $ Cash Equivalents and Outstanding Debts Amounts may be rounded to whole dollars. Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEOUL£S) 573.04 .12 573.16 18. Cash Equivalents................................................ See instructions on reverse $ 19. Outstanding Debts.............................. Add Line 2 + Line 9 in Column B above $ $ $ $ $ $ $ Columns CALENDAR YEAR TOTAL TO DATE To calculate Column B, add amounts in Column A to the oorresponding 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 Lines 2, 7, and 9 (if any). 11-3652985 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1 /1 through 6/30 711 to Date 20. Contributions Received $ ____ _ $ ____ _ 21. Expenditures Made $-----$ ____ _ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election (mm/dd/yy) __j__j __ __J__J __ Total to Date $ _____ _ $ ___ _ •Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (Jan/2016) FPPC Advice: advice@lfppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Palm Springs Fire Management Association PAC Amounts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) Schedule A Summary 1. Amount received this period -itemized monetary contributions. •IND •COM 00TH OPTY •sec •IND •COM DOTH 0PTY •sec •IND •COM DOTH •PTY •sec •IND •COM DOTH •PTY •sec •IND •COM 00TH •PTY •sec SUBTOTAL$ SCHEDULE A Statement covers period 06/30/2016 from ___ ----::::=====:::... CALIFORNIA 460 FORM AMOUNT RECEIVED THIS PERIOD Page ___ of __ _ I.D. NUMBER 11~3652985 CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 • DEC. 31) PER ELECTION TO DATE (IF REQUIRED) -"Contributor Codes IND -Individual (Include all Schedule A subtotals.) ......................................................................................................... $ _____ _ COM -Recipient Committee (other than PTY or SCC) 0TH -Other (e.g., business entity) PTY -Political Party 2. Amount received this period -unitemized monetary contributions of less than $100 ........................... $ ______ _ 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ...................... TOTAL $ _____ ,J_ sec -Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov 1866/275-3772) www.fppc.ca,gov SCHEDULE B -PART 1 Schedule B -Part 1 Loans Received Amounts may be rounded to whole dollars. Statement covers period CALIFORNIA 460 FORM SEE INSTRUCTIONS ON REVERSE NAME OF FILER Palm Springs Fire Management Association PAC FULL NAME. STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE, ALSO ENTER 1.0. NUMBER) t • IND O COM O 0TH O PTY O SCC to IND • COM • 0TH • PTY • SCC to IND O COM O 0TH O PTY O sec Schedule B Summary IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF·EMPLOYEO, ENTER NAME OF BUSINESS) a OUTSTANDING BALANCE BEGINNING THIS PERIOD $ ___ _ $ ___ _ $ ___ _ SUBTOTALS $ (c) AMOUNT AMOUNT PAID OUTSTANDING RECEIVED THIS BALANCE AT OR FORGIVEN CLOSE OF THIS PERIOD THIS PERIOD • PERIOD 0 PAID $ $ 0 FORGIVEN $----$ DATE DUE 0 PAID $ $ 0 FORGIVEN $ DATE DUE D PAID $ $ 0 FORGIVEN $ ___ _ $ DATE DUE $ $ Page of I.D.NUMBER 11-3652985 • 8 INTEREST ORIGINAL CUMULATIVE PAID THIS AMOUNT OF CONTRIBUTIONS PERIOD LOAN TO DATE CALENDAR YEAR __ % $ $ Rl'TE PER B.ECTION"' $ DATE INCURRED CALENDAR YEAR --% $ $ R<ITE PER ELECTION .. $ s DATE INCURREO CALENDAR YEAR __ % $ $ RATE PER EUECTION** $ $ DATE INCURRED $ -(Enter (e) on Schedule E, Line 3) 1. Loans received this period .................................................................................................................... $ ---------'-._ (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period ......................................................................................................... $ (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 $ Enter the net here and on the Summary Page, Column A, Line 2. (Mayboanogalivenumber) 'Amounts forgiven or paid by another party also must be reported on Schedule A. •• If required. tContributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) 0TH -Other (e.g., business entity) PTY -Polillcal Party sec -Small Contributor Committee FPPC Form 460 {Jan/2016) FPPC Advice: advlce@fppc.ca.gov (866/27S-3772) www.fppc.ca.gov SeHEDULEE Schedule E Payments Made Amounts may be rounded to whole dollars. Statement covers period CALIFORNIA 460 FORM SEE INSTRUCTIONS ON REVERSE NAME OF FILER Palm Springs Fire Management Association PAC CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. Page of 1.0. NUMBER 11-3652985 CMP campaign paraphernalia/misc. MBR member oommunications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB oontribulion (explain nonmonetary)' OFC office expenses SAL campaign workers' salaries eve civic donations PET petition circulatlng TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundralslng events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supportingtopposing 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 casts (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, AlSO ENTI:R l,D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID • Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ Schedule E Summary 0 1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................................................. $ _____ _ 0 2. Unitemized payments made this period of under $100 .......................................................................................................................................... $ _____ _ 0 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (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$ _____ _ FPPC Form 460 (Jan/2016) FPPC Advice: advlce@lfppc.ca.gov (866/275-3772) www.fppc.ca.gov . Schedule I Miscellaneous Increases to Cash SEE INSTRUCTIONS ON REVERSE NAME OF FILER Palm Springs Fire Management Association PAC DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE. ALSO ENTER I.D. NUMBER) Attach additional information on appropriately labeled continuation sheets. Schedule I Summary Amounts may be rounded to whole dollars. Statement cavers period DESCRIPTION OF RECEIPT SUBTOTAL$ 1. Itemized increases to cash this period ............................................................................................................................ $ _____ ._1_2 2. Unitemized increases to cash of under $100 this period ................................................................................................. $ _____ _ 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ....................................... $ _____ _ 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Line 14.) ............................................................................................................................. TOTAL $ _____ ._12_ I.D.NUMBER 11-3652985 of __ _ AMOUNT OF INCREASE TO CASH FPPC Form 460 (Jan/2016) FPPC Advice: advice@lfppc.ca.gov (866/275-3n2) www.fppc.ca.gov