HomeMy WebLinkAbout2021-12-30 Form 460 - PS Fire SafetyRecipient Committee
C .mpa�,gn Statement
Cover Page
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from 7/1/21
through 12/31/21
1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4.
❑ Officeholder, Candidate Controlled Committee
❑ Primarily Formed Ballot Measure
0 State Candidate Election Committee
Committee
0 Recall
0 Controlled
(Also Complete Patt 5)
0 Sponsored
(Also Complete Part 6)
m General Purpose Committee
• Sponsored
❑ Primarily Formed Candidate/
Small Contributor Committee
Officeholder Committee
Political Party/Central Committee
(Also Complete Part7)
3. Committee Information 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
STATE
ZIP CODE
AREACODE/PHONE
Palm Springs
CA
92262
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY
STATE
ZIP CODE
AREACODE/PHONE
Yucaipa
CA
92399
OPTIONAL: FAX I E-MAIL ADDRESS
COVER PAGE
Date Stamp
RECEDED
CITY OF PP,LN SPRI age 1 of 4
Date of election if applicable:
(Month, Day, Year) 2021 DEC 30 AN 9: ' 2 For Official Use Only
T"Fi+ICE CF T#'Jt CITY G
2. Type of Statement:
❑ Preelection Statement ❑ Quarterly Statement
m Semi-annual Statement ❑ Special Odd -Year Report
❑ Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
Brandon Wright
MAILING ADDRESS
CITY
STATE
ZIP CODE
AREACODE/PHONE
Yucaipa
CA
92399
NAME OF ASSISTANT TREASURER, IF ANY
Damien Myers
MAILING ADDRESS
CITY
STATE
ZIP CODE
AREACODE/PHONE
Temecula
CA
92592
OPTIONAL: FAX I E-MAIL ADDRESS
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the inf tion 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
Executed on By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor
Executed on By
Dale Signature of Controlling Officeholder, Candidate, State Measure Proponent
Executed on B
Date y 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
Amounts may be rounded
SUMMARY PAGE
Summary Page
to whole dollars.
Statement covers period
CALIFORNIA
, 6 0
from 07/01/2021
• -
12/31/2021
Page 2 of 4
SEE INSTRUCTIONS ON REVERSE
through
NAME OF FILER
I.D. NUMBER
Palm Springs Fire Association PAC
881536
Contributions Received
Column A Column B
Calendar Year Summary for Candidates
TOTAL THIS PERIOD CALENDAR YEAR
(FROM ATTACHED SCHEDULES) TOTAL TO DATE
Running in Both the State Primary and
General Elections
1. Monetary Contributions................................................... Schedule A, Line 3
$
10470 $ 20790
1/1 through 6/30 7/1 to Date
2. Loans Received................................................................ Schedule e, Line 3
3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2
$
10470 $ 20790
20. Contributions
Received $ $
4. Nonmonetary Contributions ............................................ Schedule C, Line 3
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED...............................Add Lines 3+4
$
10470 $ 20790
Made $ $
Expenditures Made
Expenditure Limit Summary for State
6. Payments Made................................................................ Schedule E, Line 4
$
0 $ 50
Candidates
7. Loans Made....................................................................... Schedule H, Line 3
8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7
$
0 $ 50
22. Cumulative Expenditures Made*
(If Subject to Voluntary Expenditure Limit)
9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3
Date of Election Total to Date
10. Nonmonetary Adjustment......................................................... Schedule C, Line 3
(mm/dd/yy)
11. TOTAL EXPENDITURES MADE....................................Add Lines 8+9+10
$
0 $ 50J
$
�_� $
Current Cash Statement
12. Beginning Cash Balance ............................ Previous Summary Page, Line 16
$
34737.25
To calculate Column B,
13. Cash R2C@IptS........................................................... Column A, Line 3 above
10470
add amounts in Column
14. Miscellaneous Increases to Cash .................................. Schedule /, Line 4
A to the corresponding
amounts from Column B
*Amounts in this section may be different from amounts
reported in Column B.
15. Cash Payments......................................................... Column A, Line 8 above
0
of your last report. Some
amounts in Column A may
16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15
$
.
4520725
be negative figures that
should be subtracted from
If this is a termination statement, Line 16 must be zero.
previous period amounts. If
this is the first report being
17. LOAN GUARANTEES RECEIVED ................................ Schedule e, Part 2
$
filed for this calendar year,
only carry over the amounts
from Lines 2, 7, and 9 (if
Cash Equivalents and Outstanding Debts
any).
18. Cash Equivalents ................................................ See instructions on reverse
$
—9
19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above
$
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A Amounts may be rounded SCHEDULE A
Monetary Contributions Received to whole dollars.
Statement covers period
CALIFORNIA , 6 0
from 07/01/2021
-
SEE INSTRUCTIONS ON REVERSE
through 12/31/2021
Page 3 of 4
NAME OF FILER
I.D. NUMBER
Palm Springs Fire Association PAC
881536
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
RECEIVED
CONTRIBUTOR
CODE *
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
RECEIVED THIS
CALENDAR YEAR
TO DATE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
OF BUSINESS)
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
07/15/21
Palm Springs Firefighters Association
❑ IND
S1770
❑ CoM
Z OTH
Palm Springs, CA 92262
❑ PTY
❑ SCC
08/15/21
Palm Springs Firefighters Association
❑ IND
$1740
❑ COM
(� OTH
Palm Springs, CA 92262
❑ PTY
❑ SCC
09/15/21
Palm Springs Firefighters Association
❑ IND
$1740
❑ COM
m OTH
Palm Springs, CA 92262
❑ PTY
❑ SCC
10/15/21
Palm Springs Firefighters Association
❑ IND
$1740
❑ COM
m OTH
Palm Springs, CA 92262
❑ PTY
❑ SCC
11/15/21
Palm Springs Firefighters Association
❑ IND
$1740
❑ COM
m OTH
Palm Springs, CA 92262
❑ PTY
❑ SCC
SUBTOTAL $ 8730
Schedule A Summary
1. Amount received this period — itemized monetary contributions.
(Include all Schedule A subtotals.).........................................................................................................$
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.)..........
10470
................... $
......TOTAL $ 10470
'Contributor Codes
IND — Individual
COM — Recipient Committee
(other than PTY or SCC)
OTH — Other (e.g., business entity)
PTY — Political Parry
SCC — Small Contributor Committee
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.)
Monetary Contributions Received to whole dollars.
Statement covers period
• . ,
from 07/01/2021
• - • '
through 12/31/2021
Page 4 of 4
NAME OF FILER
I.D. NUMBER
Palm Springs Fire Association PAC
881536
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
AMOUNT
CUMULATIVE TO DATE
PER ELECTION
CONTRIBUTOR
*
OCCUPATION AND EMPLOYER
RECEIVED THIS
CALENDAR YEAR
TO DATE
RECEIVED
CODE
(IF SELF-EMPLOYED, ENTER NAME)
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
OF BUSINESS)
PERIOD
(JAN. 1 - DEC. 31)
(IF REQUIRED)
12/15/21
Palm Springs Firefighters Association
❑ IND
$1740
❑ COM
Z OTH
Palm Springs, CA 92262
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
❑ SCC
❑ IND
❑ COM
❑ OTH
❑ PTY
SCC
SUBTOTAL $ 1740
"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