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Home My WebLink About2019-01-09 Form 460 - PS Fire Safetyr Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from __ O_c_t_o_be_r_2_1_,_2_0_1_8_ December 31, 2018 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 (JIJso Complete Pert 5) liZl General Purpose Committee ® Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information 0 Controlled 0 Sponsored (Also Complete Pert 6) D Primarily Formed Candidate/ Officeholder Committee (Also Complete Pert 7) I.D. NUMBER 881536 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Palm Springs Fire Safety Association PAC STREET ADDRESS (NO P.O. BOX) CITY Yucaipa STATE ZIP CODE CA 92262 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE OPTIONAL: FAX I E-MAIL ADDRESS 4. Verification AREA CODE/PHONE ( AREA CODE/PHONE Date Stamp : ! Date of election if applicable: CALIFORNIA FORM Page _ __;__ • 460 of 3 (Month, Day, Year) 20 JhH -9 Pll 2: 16 For Official Use Only I j -· November 6, 2018 2. Type of Statement: D Preelection Statement !;ll Semi-annual Statement D Termination Statement I, 1 .... (Also file a Form 410 Termination) D Amendment (Explain below) Treasurer(s) NAME OF TREASURER Brandon Wright MAILING ADDRESS CITY Yucaipa NAME OF ASSISTANT TREASURER, IF ANY Damien Myers MAILING ADDRESS CITY Temecula OPTIONAL: FAX I E-MAIL ADDRESS D Quarterly Statement D Special Odd-Year Report STATE ZIP CODE CA 92262 STATE CA ZIP CODE 92592 AREA CODE/PHONE ( AREA CODE/PHONE ( I have used all reasonable diligence in preparing and reviewing this statement and to the best of Executed on 1/8/2019 Date Executed on Date Executed on Date Executed on Date By By By By Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor Signature of Controlling Officeholder. Candidate. State Measure Proponent Signature of Controlling Officeholder. Candidate. State Measure Proponent 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 Safety 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 .................................... Add Lines 3 + 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 1 0. Nonmonetary Adjustment.. ....................................................... Schedule c. Line 3 11. TOTAL EXPENDITURES MADE. ....................................... AddLinesB+9+ 10 $ Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 13. Cash Receipts ....................... ............................. ....... Column A. Line 3 above 14. Miscellaneous Increases to Cash.................................. Schedule 1. Line 4 15. Cash Payments . ........ ..................... ....... .................... Column A, Line B 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 18. Cash Equivalents................................................ See instructions on reverse $ 19. Outstanding Debts.............................. Add Line 2 +Line 9 in Column B above $ Amounts may be rounded to whole dollars. Column A TOTAL THIS PERIOD (FROM ATIACHED SCHEDULES) 3360 3360 3360 5361.85 3360 8721.85 SUMMARY PAGE Statement covers period from __ o_c_t_o_b_e_r 2_1_,_2_0_1_8_ CALIFORNIA 460 FORM through December 31,2018 Page __ 2_ 01 __ 3_ $ $ $ $ $ $ Column B CALENDAR YEAR TOTAL TO DATE 9944.69 9944.69 9944.69 2196.81 2196.81 2196.81 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 is the first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). 1.0. NUMBER 881536 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 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@fppc.ca.gov (866/275-3772) www.fppc.ca.gov • Schedule A SCHEDULE A Monetary Contributions Received Amounts may be rounded to whole dollars. Statement covers period CALIFORNIA 460 FORM from __ o_c_t_o_be_r_2_1_,_2_0_1_8_ SEE INSTRUCTIONS ON REVERSE through December 31, 2018 Page_3 __ of __ 3_ NAME OF FILER Palm Springs Fire Safety Association PAC DATE RECEIVED 11/23/18 12/23/18 FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITIEE. ALSO ENTER 1.0. NUMBER) CODE * Palm Springs Fire Safety Association 180 N Luring Dr. Palm Springs, CA 92262 #881536 Palm Springs Fire Safety Association 180 N Luring Dr. Palm Springs, CA 92262 #881536 DIND 0COM DOTH 0PTY Osee OIND OCOM DOTH DPTY Osee DIND DcoM DOTH DPTY Osee OIND 0COM DOTH DPTY Osee DIND 0COM DOTH DPTY Osee Schedule A Summary IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED. ENTER NAME OF BUSINESS) AMOUNT RECEIVED THIS PERIOD $1680 $1680 SUBTOTAL $ 3360 1. Amount received this period -itemized monetary contributions. (Include all Schedule A subtotals.) ......................................................................................................... $ _____ 3_3_6_0 2. Amount received this period -unitemized monetary contributions of less than $100 ........................... $ _______ o 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ...................... TOTAL $ _____ 3_3_6_0 I.D. NUMBER 881536 CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) *Contributor Codes IND -Individual COM -Recipient Committee (other than PTY or SCC) OTH-Other (e.g., business entity) PTY-Political Party SCC -Small Contributor Committee FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov