2019-01-24 Form 410 - KorsStatement of Organization
Recipient Committee
Date Stamp CALIFORNIA 41 0
FORM
~--------------------~------------------~---------------------1 Statement Type D Initial i21 Amendment D Termination -See Part 5 For Official Use Only
0 Not yet qualified 2019 J:.; I 2 L} PriiZ : 3 6
or
0 Da te qualification th reshold met Date qualification threshold met Date of termination
I I I
1. 1376802 2. Treasurer and Other ~rincipal Officers
NAME OF COMMITTEE
Ggotf lo<or• fur City Col:lAeil 201Q cre:on==: ~e..s Fe~ c;i"'(
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE
Palm Springs CA 92262
FULL MA ILING ADDRESS (IF DIFFERENT)
E·MAIL ADDRESS (REQU IRED)/ FAX (OPTIONAL)
COUNTY OF DO MICIL E JURISDICTION WHERE COMMITTEE IS ACTIVE
Riverside City of Palm Spring s
AREA CODE/PHONE
Attach additional information an appropriately labeled continuation sheets.
3. Verification
NAM E OF TREASURER
James W illiamson
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
Palm Springs CA 92262
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/P HONE
NAME OF PRI NC IPAL OFFICER(S)
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
1-have' used all reasona bl e dilige nce in prepa ring this st atemen t ' and to t he beSt-o f ~y knowle dg e t he information con t ained herein i s t rue and compl ete. I ce rtify under
penalty of perjury under the laws of the State of California that the foregoing is rue and correct.
Executed on Jan 24, 2019
DATE
Executed on Jan 24,2019 By
DATE
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICHIOLDER, CANDIDATE. OR STATE ME ASU RE PROPONENT
Executed on By
DATE SIGNATURE OF CONTRO LLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PRO PONEN T
FPPC Form 410 (Augustl2018)
FPPC Advice: a dvice @fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Geoff Kor:s for C''¥ Co'1Rei1294tl\, cq'EVf-F ~f.S ~ at'Y c:.cJ1,JNt:.l/.... Dl!i?/Uc¥ .S, 2J:'JL<(
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
Bank of America 760.864.8611 3250 1336 9028
ADDRESS CITY STATE ZIP CODE
588 S Palm Canyon Drive Palm Springs CA 92264
Controlled Committee
1376802
• 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.
• 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
Geoffrey R. Kors City Councilmember, Palm Springs, District 3 2019 0
Nonpartisan
D
Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE($) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LEITER)
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME.
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
Partisan
D
Partisan
D
(list political party below)
(list political party below)
CHECK ONE I'D I§ SUPPORT
D
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Geoff l(o~ for City CasmciJ2Q~ ~~ )¢>~ ~ t:::.\"N ~t!-u-, Dl.S~C( S, ~rj
CALIFORNIA 41 0
FORM
1.0. NUMBER
1376802
General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
D CITY Committee D COUNlY Committee D STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
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 0 __ , __ , __
Date qualified
S~~~erf!l.!~~~~f.1?~eq~-'!l!.m~~tS:.; .-:_-::' .. ~y,~~8o~~~;tl_l#;~~!1f!?.·~o~;·,th~.~su'n!_r,:~~~~t~~~~rerari_d/r;;r·~ntrfda.t~i~~~~~1otd_~·r;o~·pro.P.CI~~-nt ~~rtifYtll~t:a·n:,oft~e~f!:illowlng·~ndltiqri.s,:_~a~~;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 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3n2)
www.fppc.ca.gov