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Home My WebLink About2019-10-07 Form 460 - PS Fire SafetyRecipient Committee Campaign Statement Cover Page Date Stamp COVER PAGE CALIFORNIA 460 FORM ECEIYED ,-:-S:-t:-a'.'"te_m_e_n:-l-c_o_v-er_s_p_e_r=-io:-dc--.-=o-at'.'"e-o:-f:-e:-le-c""r:-10-n:-i:-f a-p-p€:tic7a"'bre': fJf PA L H SPRINGS Page __ 1~-of __ 4 __ from ____ 7/_1_/1_9 __ _ SEE INSTRUCTIONS ON REVERSE ';· 9/21/19 through ________ _ 1. Type of Recipient Coininittee: All Comm;ttees -Complete Paris 1, 2, 3, and 4. D Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall (Also Comp/et& Part SJ ~ General Purpose Committee ® Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information D Primarily Formed Ballot Measure Committee 0 Controlled 0 Sponsored (Also Comp/eta Part 6J D Primarily Formed Candidate/ Officeholder Committee (Also Comp/et& Part 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 Palm Springs STATE ZIP CODE CA 92399 MAILING ADDRESS (IF DIFFERENT) NO. ANO STREET OR P.O. BOX CITY STATE ZIP CODE OPTIONAL: FAX/E-MAILADDRE~S 4. Verification AREA CODE/PHONE AREA CODE/PHONE (Month, Day, Year~019 Q _ l T :.:7 AM 8: 55 For Official Use Only 1115119 OF~ICE F THE CITY CLER!\ 2i Type of Statement: li2I Preelection Statement D Semi-annual Statement D Termination Statement (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/ E-MAILADDRESS D Quarterly Statement D Special Odd-Year Report STATE ZIP CODE CA 92399 STATE ZIP CODE CA 92592 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 contai certify under penalty of perjury under the laws of the State of California that the for'egoing is true and herein and in the attached schedules is true and complete. Executed on 10/6/19 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 Sp_onsor Signature of Conlrolllng Officeholder, Candidate, State Measure Proponent Signature of Control!ing Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Palm Springs Fire Safety Association PAC · Cdntributions Received ~-- t. 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. Paymenls Made................................................................ Schedule E, Line 4 $ 7. Loans Made....................................................................... Schedule H, Une 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. ....................................... Addlines8+9+10 $ Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summa,Y Page, Line 16 $ 13. Cash Receipts ............................................ 0 •••••••••••••• ColumnA,Line3above 14. Miscellaneous Increases to Cash.................................. Schedule 1, Line 4 15. Cash Payments ......................................................... ColumnA,Line8above 16. ENDING CASH BALANCE .................. Add Lines 12 + 13 + 14, then subtractune 15 $ If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Parl 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See instructions on reverse $ 19. Outstanding, Debts.............................. Add Line 2 + Lina 9 in Column B above $ Amounts may be rounded to whole dollars. Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) 4950 4950 4950 1106.54 1106.54 1106.54 16996.26 4950 1106.54 20839.72 SUMMARY PAGE Statement covers period CALIFORNIA 460 FORM 7/1/19 from _________ _ 2 4 9/21/19 through ________ _ Page ___ of __ _ $ $ $ $ $ $ Column B CALENDAR YEAR TOTAL TO DATE 14910 14910 14910 2792.13 2792.13 2792.13 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). I.D.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) 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 Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Palm Springs Fire Safety Association PAC AmOunts may be rounded to whole dollars. DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONT°R.JBlJTOR CONTRIBUTOR (IF COMMITTEE,ALSO ENTER 1.D. NUMBER) . CODE * IF.AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) 7/15/19 8/15/19 9/15/19 Palm Springs Firefighters Association 180 N Luring Dr. Palm Springs, CA 92262 ID# 881536 Palm Springs Firefighters Association 180 N Luring Dr. Palm Springs, CA 92262 ID# 881536 Palm Springs Firefighters Association 180 N Luring Dr. Palm Springs, CA 92262 ID# 881536 Schedule A Summary •IND !!".ICOM 00TH •PTY •sec •IND iZJCOM 00TH •PTY •sec •IND li2l COM •oTH •PTY •sec •IND •COM DOTH •PTY •sec •IND •COM 00TH •PTY •sec SU_BTOTAL$ SCHEDULE A Statement covers period CALIFORNIA 460 FORM from ____ 7_/_1_/1_9 __ _ through ___ 9_12_1_1_19 __ _ Page __ 3 __ of __ 4 __ AMOUNT REC-EIVED THIS PERIOD $1650 $1650 $1650 I.D. NUMBER 881536 CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 • DEC. 31) $11610 $13260 $14,910 PER ELECTION TO DATE (IF REQUIRED) *Contributor Codes IND -Individual 1. Amount received this period -itemized monetary contributions. (Include all Schedule A subtotals.) ......................................................................................................... $ _____ 4_9_5_0 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 $ _____ 4_9_5_0 sec -Small Contributor Committee 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 Safetf-'Assciciation PAC !':. DATE 9/6/19 NAME OF CANDIDATE, OFFICE, AND DlSTRICT, OR MEASURE NUMBER OR LETTER ANO JURISDICTION, OR COMMITTEE Geoff Kors, City Council, District 3 D Support D Oppose· D Support D Oppose D Support D Oppose Schedule D Summary Amounts may be rounded to whole dollars. -:c.....,.. TYPE OF PAYMENT iZI Monetary Contribution • Non monetary Contribution • Independent Expenditure • Monetary Contribution • Nonmonetary Contribution • Independent Expenditure • Monetary Contribution • Nonmonetary Contribution • Independent Expenditure ~ DESCRIPTION (IF REQUIRED) SUBTOTAL Statement covers period from ----'-7'--'/1"-/1-'-9'--- through, ___ 9"-/"'2-'-1 /'-'1~9 __ SCHEDULED CALIFORNIA 460 FORM Page __ 4_ of __ 4_ I.D. NUMBER ,., 881536'>-. !':. AMOUNT THIS PERIOD CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 -DEC. 31) PER ELECTION TO DATE (IF REQUIRED) $1000 $1000 $ 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) ....................................................... $ ____ ..c10,,,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 .. $ _____ 1,.,0,,0"'0'-- FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov