HomeMy WebLinkAbout2025-05-19 Measure J - Form 410•
Statement of Organization
Recipient Committee
Date Stamp CALIFORNIA 410
FORM ,--------------.------------,--------------i Statement Type O Initial 0 Amendment liil Term ination -See Part 5
RECEIVED
MAY 1 9 2025 0 Not y et qualifi ed
o r
0 Date qualification threshold met Date qualification threshold me t
1. Committee Information
NAME OF CO MMITTEE
PA LM SPRIN GS FORWARD
STR EET A DDRESS (NO P.O. BOX)
1801 EAST TAHQU I TZ CANYON WAY ,
I
I.D. Number
(if opplkobk}
#1 01
I
1 4 71 000
CITY STATE ZI P COD E AREA CODE/PHONE
PALM S PRING S C A 92262 (2 13)62 4 -6 200
FULL M AILING A DDRESS (IF DI FF ERENT)
515 s. FIGUEROA ST. , STE. 1 1 1 0 LOS ANGELES, C A 90071
E-MA IL ADDRE SS OF COMMITTEE (REQUIRED)/ FAX (O PTIONAL)
sos fil i ngs@p o l itica llaw.com
COUNTY OF DOMICILE r U RI SDICTION WHERE COMMITTEE IS ACT IVE
RIVERSIDE C I T Y OF P ALM SPR I N GS
Attach a dditional information on appro priate ly labe led continuatio n sh e ets .
3. Verification
I have used all reasona ble diligence in prepari ng t his stat ement and to th
pena lty of perjury under the laws of the Stat e of Californi a that t he fore
Executed on 05/02/2025 By
DATE
Executed on By
DATE
Execut ed on By
Fo r Offic ial Use Onl y
Date of t ermination
0 4 oa 1 2025
O ~FICE OF THE CITY I LEAK
2. Treasurer and Other Pr incipal Officers
NAME OF TREAS URER
CARY DAVIDSON
STR EET ADDRESS (NO P.O . BOX) CITY STATE ZI P CODE
515 s. F I GUEROA ST. , STE . 111 0 LOS ANGEL ES C A 90071
EMAIL ADDRESS OF TREASURER (REQUIRED) AREA COD E/PHONE
c ary@politicall aw .c om (2 13 ) 624-6200
NA M E OF ASSISTANT TREA SURER, I F ANY
MICHAEL F ARR
STR EET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE
515 s . FIGUEROA ST. , STE . 1110 LOS ANGELES CA 90071
EM AI L ADDR ES S OF A SSISTAN T TR EASURER (REQUI RED) AR EA CO DE/PH ON E
michae l @poli t ical law.com (213) 624 -6200
NAM E OF PRINCIPAL O FFICER(S)
D AV E L. BARON
STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP COD E
515 s. F IGUEROA ST. , STE . 1110 LOS ANGELES CA 90071
EMAIL ADDRE SS OF PR INCIPAL OFFICER(S) (R EQUI RED) AREA CO DE/PH ON E
baron @s b emp .com (213)624-6200
the information contai ned herein is true an d complete . I certify under
t .
ISTANT TREASURER
DATE SIG NATURE Of CO NTRO LLIN G OFFICEH OLDER, CANDIDATE, OR STATE ME ASURE PROPONENT
Execut ed on By
DATE SI GNATUR E OF CONTROLLING OFFIC EHOLDER, CANDIDATE, OR STATE M EASURE PROPONENT
FPPC Form 410 (October /2023}
FPPC Advice : a dvi ce@fppc.ca .gov (866/27S-3772}
www.fppc.ca.gov
netfile.com
Statement of Organization
'' Recipient Committee
CALIFORNIA 410 FORM
INSTRUCTIONS ON REVERSE
Page 2 of 3
COMMITT~E NAME PALMS RINGS FORWARD 1.0. NUMBER14?l000
. All committees must list the financial institution where the campaign bank account is located and the persori(s) authorized to obtain bank records •
NAME OF FINANCIAL INSTITUTION AND PERSON(S) AUTHORIZED TO OBTAIN BANK RECORDS AREA CODE/PHONE
CALIFORNIA BANK & TRUST (213) 228-1728
MICHAEL FARR, NATHAN HARDY
ADDRESS OF FINANCIAL INSTITUTION CITY
550 s. HOPE ST., #100 LOS ANGELES
4. Type of Committee Complete the opp/icoble secHons.
Controlled Committee
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.
BANK ACCOUNT NUMBER
5802671163
STATE ZIP CODE
CA 90071
List the political party with which each officeholder or candidate is affiliated or check "nonpartisan:' Stating "No party preference" is acceptable.
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)
YEAR OF
ELECTION
PARTY
CHECK ONE
Nonpartisan Partisan
Nonpartisan Partisan
(list political party below)
(Hst political party below)
Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANOIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER)
IF A RECALL. STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME.
CANDIDATE(SJ OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE
FPPC Form 410 (October/2023)
FPPC Advice: advlce@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
• Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
PALM SPRINGS FORWARD
4. Type of Committee /Continued)
CALIFORNIA
FORM
Page 3 of 3
General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
Ix] CllY Committee O COUNTY Committee O STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
TO SUPPORT OR OPPOSE LOCAL MEASURES
Sponsored Committee List additional sponsors on an attachment.
NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE AREA CODE/PHONE
Small Contributor Committee o _ _,, _ __,
Date qualified
5. Termination Requirements By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or ponent certify that all of the following conditions have been met:
This committee has ceased to receive contributions and make expenditures;
This committee does not anticipate receiving 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-
89518, and are subject to Elections Code Section 18680 and FPPC Regulation 18521.5.
FPPC Form 410 (October/2023)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov