2019-01-10 Form 410 - Garnerr " .
Statement of Organization Date Stamp CALIFORNIA 41 Q
FORM Recipient Committee
~----------------------~--------------------~~--------------------~ Statement Type i211nitial 'l l
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e Not yet qualified
or
0 Date qualification threshold met Date qualification threshold met
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1~· ~com'mttl:ee lnform~ti~n i: · · 1.o. Number
·~ · (if applicable)
NAME OF COMMITTEE
Grace Garner for Palm Springs City Council District 1, 2019
STREET ADDRESS (NO P.O. BOX)
CITY
Palm Springs
FULL MAILING ADDRESS (IF DIFFERENT)
E-MAIL ADDRESS (REQUIRED)/ FAX (OPTIONAL)
COUNTY OF DOMICILE
Riverside
STATE ZIP CODE AREA CODE/PHONE
CA 92262
JURISDICTION WHERE COMMITTEE IS ACTIVE
Palm Springs
Attach additional information on appropriately labeled continuation sheets.
~~-·:l~@t; .. ,~tion :·:<.:~:',}~E~j!:tr.,~:if;t~):f:!::·:)~':::·, ·· . :.-.:·~.-· .· _
I have used all reasonable diligence in preparing
J.-J.,J ~ Executed on
OAT
Executed on 1·-3 ·-ICJ
DATE
D Termination -See Part 5 ' • 'l_.j.
2019 J;U./ I 0 Af1 9: 59
Date of termination
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~ ::· ·:. '-~·-~ ':··-' .· ·. . . . . . :.: ~.:' '"~.-::> ~ z. Tre.stir-~~nd·9ther:Priri.clp~J':~cers
NAME OF TREASURER
Scott Gordon
STREET ADDRESS (NO P.O. BOX)
CITY
Palm Springs
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.O. BOX)
CITY
NAME OF PRINCIPAL OFFICER(S)
Grace Garner
STREET ADDRESS (NO P.O. BOX)
CITY
Palm Springs
STATE
CA
STATE
STATE
CA
ZIP CODE
92262
ZIP CODE
ZIP CODE
92262
Executed on
DATE BY----------------------~~~~--------------------~~--~~--~-----------------SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on
DATE By------------------~~~~~~----------------~--~------~---------------------SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
For Official Use Only
AREA CODE/PHONE
AREA CODE/PHONE
AREA CODE/PHONE
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
Grace Garner for Palm Springs City Council District 1, 2019
• All committees must Jist the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE
Sun Community Federal Credit Union
ADDRESS CITY
1717 East Vista Chino, Suite J-1 0 Palm Springs
, Controlled Committee
BANK ACCOUNT NUMBER
Pending
STATE ZIP CODE
CA 92262
• 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
Grace Garner City Council, District 1 0
Nonpartisan
D
Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(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(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)
Democratic
(list political party below)
CHECK ONE
lJ OLl
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
• 'Ill 0
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Grace Garner for Palm Springs City Council District 1, 2019
CALIFORNIA 41 0
FORM
I. D. NUMBER
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 COUNTY 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 o--.t--1--
Date qualified
• 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 (866/275-3772)
www.fppc.ca.gov