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Home My WebLink About2019-01-30 Form 460 - Palm Springs ForwardRecipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON R EV ERS E Statement covers period July 1 I 2018 from ----------- December 3 1 I 20 through --------- 1. Type of Recipient Committee: All Committees-Comploto Parts 1, 2, 3, and 4. D Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall (Also Comploto Pan S) D General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee 3 . Committee Information li2l Primari ly Forme d Ballot Measure Committee 0 Controll ed 0 Sponsored (Also Comploto Pan 6! D Primari ly Formed Can didate/ Offi ce holder Committee (Also Comp/oto Pan 7) COMMITIEE NAME (OR CANDIDATE'S NAME IF NO COMMITIEE) P a lm Springs Forward Yeas on Measu re D 2017 STREET ADDRE SS (NO P.O. BOX) CITY Palm Springs STATE CA ZIP CODE 92262 M AILING A DDR ESS (IF DIF FERENT) NO. A ND STREET OR P.O . BOX CITY STATE ZIP CODE OPTION AL: FAX I E-MAIL ADDRESS 4 . Ve r ificat ion AREA COD E/PHONE AREA CODE/PHONE COVER PAGE Date Stamp CALIFORNIA 460 FORM -• I t 1 • L Date of el ection If appllcable2· 19 J O (Mon th. Day, Year) J:,:~ Page ___ of 3 P ; ; 12 : l l llr-----::----::-:c:-:-:-:-,----,-...,.....----i For Official Use Only 2. Typ e of State m ent: D Preelec tion Statement li2l Semi-annual Statement D Termina tion Statement (Also file a Form 410 Termination) D Amendment (Explain below) Treasurer(s) NAME OF TREASURER John S hay CITY Palm Springs NAME OF ASSISTANT TREASU RER , IF ANY MAILIN G ADDRESS CITY OPTION AL: FAX I E·M AIL ADDRESS STATE CA STATE D Quarterly Statem en t D Special Odd -Year Report ZIP CODE 92262 ZIP CODE AREA CODE/PHONE AREA CODE/PHON E I have used a ll re aso nable diligence in preparing and reviewing this s tatement and to the best of my knowledge the inform ation contained herei n and in the attached schedules is true and co mplete. certify under penalty of perjury under the laws of th e State o f Ca lifornia th at th e foregoing is true an d Jan uary 30, 2019 Executed on ------==-------Oate Executed on Date Executed on Date Executed on Date By --,.Si,.,'gna=tu:::re""'o""f c""on"'tr:::ol::::lln""o""o""ffice=ho::-:ld;:'er'"". c"'a""nd""ld::-:D:::-Io ,""s"'ta""te...,.M:-::ea::-:s""ur::-e "'-Pro""po=ne""nt"'or.,-;R:;-:e:::spo=ns""tb:::-le""Offi""t::-:ce-:-r o:;f""spo=ns""or,-- BY -----~Si~g=-=na:::t~u,-:-eo:;f~Co::-:n:::trol~17ong::-:O~n~oc"'oh""ot:::-do:::-~-;;C::-:an::-:d~oda"'to~.~St"'at-:-eM:-::e::-:a:::su:::~~P~ro""po::-:ne:::n:::t ------- BY -----~S~ig::-:na:::t~u,-:-eo:;f~Co::-:n:::trot~t7ong::-:O~n~oc"'oh""ot:::-do:::-~-;;C::-:an::-:d~oda"'te~.~St"'at-:-eM:-::e::-:a:::su:::~~P~ro""po::-:ne:::n:::t ------- FPPC Form 4 60 (J an /2016) FPPC Advice: a dvice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page -Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Related Committees Not Included in this Statement: List any committees not Included In this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behaff of your candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? 0 YES ONo COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? 0 YES 0NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE Measure D 2017 BALLOT NO. OR LETTER JURISDICTION 0 SUPPORT 0 OPPOSE D Palm Springs Riverside CTY Identify the controlling officeholder, candidate, or state measure proponent, If any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee List names of offlceholder(s) or candldate(s) for which this committee Is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT 0 OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT 0 OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT D OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT D OPPOSE Attach continuation sheets if necessary FPPC Form 460 (Jan/2016) FPPC Advice: advlce@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Summary Page SEE INSTRUCTI ONS ON REVERSE NAME OF FILER Palm Springs Fo rwa rd Yes on Measure D 2017 Contributions Received Amounts may be rounded to whole dollars. ColumnA TOTAL THIS PERIOD (FROM ATTACHED SCHEDU LES) 0 1 . Monetary Contributions ................................................... Schedule A. Line 3 s 0 2 . Loans Received ................................................................ Schedule B , Line 3 3 . SU BTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 + 2 s 4 . N onmonetary Contri butions............................................ Schedule c . Line 3 5 . TOTAL CONTRIBUTIONS RECEIVED .................................... Add Lines 3 + 4 0 s Expenditures Made 6. P ayments Made................................................................ Schedule E. Line 4 S 0 7 . Loans Made....................................................................... Sched ule H , Line 3 0 8 . SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6 + 7 S 0 9 . Accrued Expenses (Unpaid Bills) .......................................... Schedule F, Line 3 0 10. Nonmonetary Adj ustment... ...................................................... Sch edule C, Line 3 0 11 . TOTAL EXPENDITURES MADE. ....................................... Add Lines 8 + 9 + 10 S 0 Current Cash Statement 12. Beginni ng Cash Balance ............................ Previous Summary Page, Line 16 S 13. Cash Receipts ............. ....................... ...... ................. Column A , Line 3 above 14. Miscellaneous Increases to Cash .................................. Schedule I, Line 4 261.35 0 0 15. Cash Payments ... .................... .................. ........ ........ Column A, Line 8 above 16. END ING CASH BALANCE .................. Add Lines 12 + 13 + 14, t hen s ubtract Line 15 S 261 .35 0 If this i s a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule S , Part2 S 0 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See instructions o n reverse S 0 19. Outstanding Debts .............................. A dd Line 2 +Line 9 in Colum n B above S 0 SUMMARY PAGE Statement covers period CALIFORNIA 460 FORM July 1, 2018 from---------- s s s s s s Column B CALENDAR YEAR TOTAL TO DATE To ca lculate Co lumn B. add am ounts in Col umn 0 0 0 0 0 0 0 A to the corre spon ding amo unts from C olu mn B of your last report. Som e amounts in Column A may be negative figure s that shou ld be subt racted from previ ou s period amoun ts . If th is is the first report being filed for th is calendar year, onl y carry over th e amounts fro m Lines 2 , 7, and 9 (if any). December 31 , 2C 3 3 Page ___ of __ _ I.D. N UMBER 1399524 Calendar Year Summary for Candi dates Running in B oth the State Primary and General Elections 111 t hrough 6130 711 to Dat e 20 . Contribution s Received S ------ $ ____ _ 2 1. Expend iture s Made $ ______ _ $ ____ _ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Mad e' (If S ubject t o Vo lu ntory Expend iture Limit ) Dat e of Election (mm /dd/yy) Tota l to Date $ ____ _ $ ____ _ 'Amounts in this section may be different from am ounts reported i n Column B. FPPC Form 460 (J an/2016) FPPC Advice : advice@fppc .ca .gov (866/275-3772) www.fppc.ca.gov