2018-02-26 Form 460 - PS Fire ManagementRecipient Committee
Campaign Statement
Cover Page
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from ___ 0_7_/0_1_/2_0_17 __
12/31/17 through ________ _
1. Type of Recipient Committee: All Committees-Complete Parts 1, 2,3, and 4.
D Officeholder, Candidate Controlled Committee
0 State Candidate Election Committee
D Primarily Formed Ballot Measure
Committee
0 Recall
jAlso Complell Psi 5)
1iZ1 General Purpose Committee
® Sponsored
0 Small Contributor Committee
0 Political Party/Central Committee
3. Committee Information
0 Controlled
0 Sponsored
/Ar.oC.,,,,,,.,.F\orf8J
D Primarily Formed Candidate/
Officeholder Committee
flll.,o Compllllri Fwt7)
I.D.NUMBER
1248897
COMMITTEE NAME {OR CANDIDATE'S NAME IF NO COMMITTEE)
Palm Springs Fire Management Association
STREET ADDRESS (NO P.O. BOX)
CITY
Palm Springs
STATE ZIP CODE
CA 92262
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE
Palm Springs CA 92263
OPTIONAL: FAX/ E-MAIL ADDRESS
4. Verification
AREA CODE/PHONE
(
AREA CODE/PHONE
Date of election if applicable:
{Month, Day, Year)
2. Type of Statement:
Dale Stamp
2018 FEB 26
D Preelection Statement
D Semi-annual Statemeot
D Termination Statement
D Quarterly Statement
D Special Odd-Year Report
(Also file a Form 410 Termination)
Ill Amendment (Explain below)
Correction of coverage period dates
Treasurer(s)
NAME OF TREASURER
Ron Beverly
MAILING ADDRESS
CITY
Palm Springs
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY
OPTIONAL: FAX/ E-MAILAODRESS
STATE ZIP CODE
CA 92262
STATE ZIP CODE
AREA CODE/PHONE
(
AREA CODE/PHONE
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information 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 foregoing is true and
Executed on 02/26/18
Date
Executed an
Date
Executed an Date
Executed 011 Date
BY------,s,,.~-nm..,.u_ra_c..,.1c"'o""'~,...rn""iiln-g""'oln,.....ce ... ho ... lde.,.r-,C=-a-nd.,..id.-m,..e,-=s.,...ta1-,-e..,.,M,...ea-s-ur-•""Prn-p-0n-em-.------
BY------,S""'ig-nm-.ur_e_m.,.,C""o""nt,-m""mn-g""'Offic,.,,,...e.,.ho-.ld.,..er""',c""an_d.,..idal.,-,-~""'s,,..~""te""M:-ea""s-ura....,,.Propo_rten....,.,t _____ _
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule D
Summary of Expenditures
Supporting/Opposing Other
Candidates, Measures and Committees
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Palm Springs Fire Management Association
DATE
08/28/17
NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR
MEASURE NUMBER OR LETTER AND JURISDICTION,
OR COMMITTEE
"Yes on Measure D"
Ill Support D Oppose
D Support D Oppose
D Support D Oppose
Schedule D Summary
Amounts may ba rounded
to whole dollars.
TYPE OF PAYMENT
liZI Monetary
Contribution
• Nonmonetary
Contribution
• Independent
Expenditure
• Monetary
Contribution
• Non monetary
Contribution
• Independent
Expenditure
• Monetary
Contribution
• Non monetary
Contribution
• Independent
Expenditure
DESCRIPTION
(IF REQUIRED)
SUBTOTAL
SCHEDULED
Statement covers period
CALIFORNIA 460
FORM from __ 0_7/_0_1/_20_1_7 __
through __ 1_2_/3_1_/_17 __ Page ___ of __ _
$
AMOUNT THIS
PERIOD
2,500.00
I.D. NUMBER
1248897
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 • DEC. 31)
2,500.00
PER ELECTION
TO DATE
(IF REQUIRED)
I
1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) ....................................................... $ ---=2 ... ,5 ..... o-=o ...... o ..... o_
2. Unitemized contributions and independent expenditures made this period of under $100 .................................................................................... $ _____ _
3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) .......... TOTAL .. $ ----=2=,5=0=0=.0=0~
FPPC Form 460 (Jan/2016)
FPPC Advice: advlce@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
SCHEDULE E
Schedule E
Payments Made
Amounts may be rounded
to whole dollars.
Statement covers period
07/01/2017 kom ________ _
CALIFORNIA 460
FORM
SEE INSTRUCTIONS ON REVERSE
through __ 1_2/_3_1_/1_7 __ Page ___ of __ _
NAME OF FILER
Palm Springs Fire Management Association
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
1.0. NUMBER
1248897
CMP campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs
CNS campaign consultants MTG meetings and appearances RFD returned contributions
CTB contribution (explain nonmonetary)' OFC office expenses SAL campaign workers' salaries
CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs
FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals
FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals
IND independent expenditure supporting/opposing others (explain)" POS postage, delivery end messenger services TSF transfer between committees of the same candidate/sponsor
LEG legal defense PRO professional services (legal, accounting) VOT voter registration
LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail)
NAME AND ADDRESS OF PAYEE
OF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
Deane & Company "Yes on Measure D"
1787 Tribute RD, Ste K CTB City of Palm Springs tax measure 2,500.00
Sacramento, CA 95815
"Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................................................. $ ___ 2 _,s_oo_._oo_
2. Unitemized payments made this period of under $100 .......................................................................................................................................... $ _____ o_.o_o_
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ............................................................................. $ _____ o_.o_o_
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................... TOTAL $ ___ 2_,s_o_o_.o_o_
FPPC Form 460 IJan/2016)
FPPC Advice: advice@lfppc.ca.gov {866/275-3772).
www.fppc.ca.gov
Schedule I
Miscellaneous Increases to Cash
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Palm Springs Fire Management Association
DATE
RECEIVED
FULL NAME AND ADDRESS OF SOURCE
jlF COMMITTEE, ALSO ENTER tD. WMBER)
Attach additional information on appropriately labeled continuation sheets.
Schedule I Summary
Amounts may be rounded
to whole dollars. Statement covers period
07/01/2017 ~om _______ _
through __ 1_2/_3_1_/1_7 __
DESCRIPTION OF RECEIPT
SUBTOTAL$
1. Itemized increases to cash this period ............................................................................................................................ $ _____ o_.0_6_
2. Unitemized increases to cash of under $100 this period ................................................................................................. $ _____ _
3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ....................................... $ _____ _
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
Summary Page, Line 14.) ............................................................................................................................. TOTAL $ ____ O_.O_G_
SCHEDULE I
CALIFORNIA 460
FORM
Page ___ of __ _
1.0. NUMBER
1248897
AMOUNT OF
INCREASE TO CASH
FPPC Form 460 IJan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-37721
www.fppc.ca.gov
~
COVER PAGE
~ Re~pient Committee
Campaign Statement
Cover Page
Date Stamp , t.l\ \; o•••' -E') >-,,
t~£Ct.W /., .. pd'.,' () F fl ,, L M ,) ' I'\ ' •.
CALIFORNIA 46 0
FORM
--------------r----------+-._.-1
Date of election If applicable: I. 1 lo\\\: 22 Page ___ of __ _
Statement covers period
from ___ 1_0_/2_1_/2_0_1_7 __
SEE INSTRUCTIONS ON REVERSE 12/31/2017 through ________ _
1. Type of Recipient Committee: AH Committees -complete Parts 1, 2, 3, ;md 4.
D Officeholder, Candidate Controlled Committee
0 State Candidate Election Committee
D Primarily Formed Ballot Measure
Committee
0 Recall
(Al&a c""""""' Pst51
0 Controlled
0 Sponsored
/Alfo Comp/ate Pm 6}
fill General Purpose Committee
® Sponsored
0 Small Contributor Committee
0 Political Party/Central Committee
D Primarily Fanned Candidate/
Officeholder Committee
(AJ.,o CompJele PM 7J
3. Committee Information I.D. NUMBER
1248897
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Palm Springs Fire Management Association
STREET ADDRESS (NO P.O. BOX)
300 N El Cielo Rd
CITY
Palm Springs
STATE ZIP CODE
CA 92262
MAILING ADDRESS (IF DIFFERENT) NO. AIIC> STREET OR P.O. BOX
PO Box 1761
CITY STATE ZIP CODE
Palm Springs CA 92263
OPTIONAL: FAX I E-MAIL ADDRESS
4. Verification
AREA CODE/PHONE
(760) 323-8181
AREA CODE/PHONE
(Month, Day, Year) ?0\1 J~N 2'+ t\
i \H~ d' ·1 CLL 1110112011 .-1.;;•r:1; E CJ
\,_ I '
2. Type of Statement:
For Official Use Only
D Preelection Statement
l;;zJ Semi-annual Statement
D Termination Statement
D Quarterly Statement
(Also file a Form 410 Termination)
D Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
Ron Beverly
MAILING ADDRESS
1453 E Gem Cir
CITY
Palm Springs
NAME OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY
OPTIONAL: FAX I E-MAIL ADDRESS
D Special Odd-Year Report
STATE ZIP CODE AREA CODE/PHONE
CA 92262 (760) 218-7103
STATE ZIP CODE AREA CODE/PHONE
I have used all reasonable diligence In preparing and reviewing this statement and to the best of my knowledge the infonnation contained herein and in the attached schedules is true and complete. I
certify under penally of perjury under the laws of the Stale of California that the foregoing is true and rrecl.
Executed on 01/24/2018
Date
Executed on
Dale
Executed on
Date
Executed 0n Date
BY------=---,--=--.-=-===-.,,,==-=~=~==~-----Signalure or Controlling Officeholder, Candidale, Slale Measure Proponent
By _____ ...,.,.__,_..,......,....,.....,,..,....,....,......,,.....,,..,..,...-=-.,...,.,---,,....--,------
Signalure ol ControRing Officeholder, Candidale, Slale Measure Proponent
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-37n)
www.fppc.ca.gov
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Palm Springs Fire Management Association
Contributions Received
1. Monetary Contributions .. ................................... .............. Schedule A. Line 3 $
2. Loans Received................................................................ Schlldute B, Line 3
3. SUBTOTAL CASH CONTRIBUTIONS.............................. Add Lines 1 + 2 $
4. Nonmonetary Contributions............................................ Schedule c, Line 3
5. TOTAL CONTRIBUTIONS RECEIVED .................................... Add Lines 3 + 4 $
Expenditures Made
6. Payments Made................................................................ Schedule E, L;ne 4 $
7. Loans Made....................................................................... Schedule H, Line 3
8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6 + 7 $
9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F, Line 3
10. Nonmonetary Adjustment... ...................................................... Schedule c, Line 3
11. TOTAL EXPENDITURES MADE ........................................ Add Lines a+ 9 + 10 $
Current Cash Statement
12. Beginning Cash Balance............................ Previous Summary Page, Line 16 $
13. Cash Receipts ................................................... , ....... ColumnA,Line3above
14. Miscellaneous Increases to Cash.................................. Schedule 1. Line 4
15. Cash Payments ................. ........................................ Column A, Line 8 above
16. ENDING CASH BALANCE .................. Add Lines 12 + 13 + 14, than subtract Line 15 $
ff this is a tennlnat/on statement, Line 16 must be zero.
Amounts may be rounded
to whole dollars.
Column A
TOTAL THIS PERIOD
(FROM ATT/\CHE0 SCHEDULESl
573.34
0.06
573.40
SUMMARY PAGE
Statement covers period
10/21/2017 from ________ _
CALIFORNIA 460
FORM
12/31/2017 through _______ _ Page ___ of __ _
$
$
$
$
$
$
ColumnB
CALENDAR VEAR
TOTAL TO DATE
To calculate Column B,
add amounts in Column
A to the corresponding
amounts from Column B
of your last report. Some
amounts in Column A may
be negative figures that
should be subtracted from
previous period amounts. If
1.D. NUMBER
1248897
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
1/1 through 6/30 7/1 to Dale
20. Contributions
Received $ ____ _ $ ____ _
21. Expenditures
Made $ ____ _ $ ____ _
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made"
Ill Subject to Voluntary Expenditure Limit)
Date of Election
(mm/dd/yy)
__J___j __
__J___J __
Total lo Date
$ _____ _
$ ___ _
"Amounts in this section may be different from amounts
reported in Column B.
-------------------------------------11 this is the first report being
17. LOAN GUARANTEES RECEIVED................................ Schedule B. Part 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents................................................ See inslnlctions on reverse $
19. Outstanding Debts.............................. Add Line 2 + Line 9 in Column B above $
filed for this calendar year,
only carry over the amounts
from Lines 2, 7, and 9 flf
any).
FPPC Form 460 (Jan/2016)
FPPC Advice: ad11ice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule I
Miscellaneous Increases to Cash
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Palm Springs Fire Management Association
DATE
RECEIVED
FULL NAME AND ADDRESS OF SOURCE
(IF COMMITTEE. ALSO ENTER I.C. NUMBER)
Attach additional information on appropriately labeled continuation sheets.
Schedule I Summary
Amounts may be rounded
to whole dollars. Statement covers period
from __ 1_0_/2_1_/2_0_1_7 __
lhrough __ 1_2/_3_1/_2_01_7 __
DESCRIPTION OF RECEIPT
SUBTOTAL$
1. Itemized increases to cash this period ............................................................................................................................ $ _____ 0_._0_6
2. Unitemized increases to cash of under $100 this period ................................................................................................. $ _____ _
3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ....................................... $ _____ _
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
Summary Page, Line 14.) ............................................................................................................................. TOTAL $ ____ 0_.0_6_
SCHEDULE I
CALIFORNIA 460
FORM
Page ___ of __ _
1.0. NUMBER
1248897
AMOUNT OF
INCREASE TO CASH
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
• • .VER PAGE Recipient Committee
·campaign Statement
Cover Page
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from ___ 0_9_/2_4_/2_0_1_7 __
10/21/2017 through ________ _
1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4.
D Officeholder, Candidate Controlled Committee
0 State Candidate Election Committee
0 Recall
(Nm Comp/ol!J -5)
liZI General Purpose Committee
~ Sponsored
0 Small Contributor Committee
0 Polilical Party/Central Commiltee
3. Committee Information
D Primarily Formed Ballot Measure
Committee
0 Controlled
0 Sponsored
/Also ea...,. ,,.,, 6J
D · Primarily Formed Candidate/
Officeholder Committee
,,.,.. CGmp/ol8 Pait 71
LO.NUMBER
1248897
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Palm Springs Fire Management Association
STREET ADDRESS (NO P.O. BOX)
300 N El Cielo Rd
CITY
Palm Springs
STATE ZIPCOOE
CA 92262
MAILING ADDRESS (IF DIFFERENTI NO. AND STREET OR P.O. BOX
PO Box 1761
CITY STATE ZIP CODE
Palm Springs CA 92263
OPTIONAL: FAX/ E-MAIL ADDRESS
4. Verification
AREA CODE/PHONE
(760) 323-8181
AREA CODE/PHONE
Date stamp
R EC E \ \/ E_D U'
::: I l '( 0 F p Al M SF' R I h ,~
CALIFORNIA 460
FORM
Date of election If. applicable~ 17 OCT 2 6
(Month, Day, Year) ,
~M II: 2 ~P_a_ge __________ ot,::_-_-__ _
For Official Use Only
11/07/2017
,1r,:::-o·•,:7 ~11...1 1E CITY CLE :L iJf u.-
2. Type of Statement:
l2l Preelection Statement
D Semi-annual Statement
D Termination Statement
(Also file a Form 410 Termination)
D Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
Ron Beverly
MAILING ADDRESS
1453 E Gem Cir
CITY
Palm Springs
NAME OF ASSISTANT TREASURER, IF ~V
MAILING ADDRESS
CITY
OPTIONAL: FAX I E-MAIL ADDRESS
D Quarterly Statement
D Special Odd-Year Report
STATE ZIP CODE
CA 92262
STATE ZIP CODE
AREA CODE/PHONE
(760) 218-7103
AREA CODE/PHONE
t have used all reasonable diligence in preparing and reviewing this statement and lo the best of my knowledge lhe information contained herein and in the attached schedules is true and complete.
certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on 10/26/2017
Date
E,ceculed on
Date
Executed on
Date
· Executed on
Date
BY-----...,,..---,.-..,....-,-..,.....,,.,,,....,...,....-,,,.---.,.,..,......,..,....,....--.,,.---,------s;gnalure of Canlrollln9 Officeholder, Candidate, Slale Measure Proponent
By_·-------,S"'"ig_na...,.lu-re-of-==Cllf\-,-tro""'lli_ng...,Qffi=-oe..-h...,.olde..--~..-Ca-n""dida.,..,..le...,,S,.,..la.,..le...,.M.,...ee-su-r-e-=-Pr-oP-•-ne-nt,-------
fpp( Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov 1866/275-3772)
www.fppc.ca.gov
• .Campaign Disclosure Statement·
Summary Page
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Palm Springs Fire Management Association
Contributions Received
1. Monetary Contributions ................................... -................ Schedule A. Une 3 $
2. Loans Received ............. -.................. :................................ Schedule B, Line 3
3. SUBTOTAL CASH CONTRIBUTIONS.............................. Add Lines 1 + 2 $
4. Nonmonetary Contributions............................................ Schedule c, Une 3
5. TOTAL CONTRIBUTIONS RECEIVED .................................... Add Lines 3 + 4 $
Expenditures Made
6. Payments Made................................................................ Schedule E. LJne 4 $
7. Loans Made ....................................................................... Schedule H, Line·a
8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6 + 7 $
9: Accrued Expenses (Unpaid Bills) .......................................... Schedule F. LJne 3
· 10. Nonmonetary Adjustment... ...................................................... Schedule c, Line 3
11. TOTAL EXPENDITURES MADE. ....................................... AddLines8+!1+10 $
Current Cash Statement
12. Beginning Cash Balance ............................ Previous Summary Page, Une 16 $
13. Cash Receipts ............... ..... ........ ................. .............. Column A, Line 3 above
14. Miscellaneous Increases to Cash.................................. Scheduler, Line 4
15. Cash Payments ......................................................... Column A, Line B above
16. ENDING CASH BALANCE .................. AddUnes 12 + 13 + 14, then subtract Line 15 $
If this is e termination statement, LJne 16 must be Z'ero.
17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Part 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ................................................ Seeinstrucfionsonreverse $
19. Outstanding Debts.............................. Add Une 2 + Line 9./n Column B above $
• Amounts may be rounded
to whole dollars.
Column A
TOTAL THIS PERIOD
(FROM ATTACHED SCHEDULES)
573.28
0.06
573.34.
• SUMMARY PAGE
Statement covers period
09/24/2017 from ________ _
I
CALIFORNIA 460
FORM
10/21/2017 through _______ _ Page ___ of __ _
$
$
$
$
$
$
Column B
CALENDAR VEAR
TOTAL TO DATE
To calculate Column B,
add amounts in Column
A to the corresponding
amounts from Column B
of your last report. Some
amounts in Column A may
be negative figures that
should be subtracted from
previous period amounts. If
this ls the first report being
filed for this calendar year,
only carry over the amounts
from Lines 2, 7, and 9 (if
any).
I.D.NUMBER
1248897
Calendar Year Summary for Candidates
Running In Both the State Primary and
General Elections
1/1 through 6/30 7/1 to Date
20. Contributions
Received $ _____ $ ____ _
21. Expenditures
Made $ ____ _ $ ____ _
Expenditure Limit Summary for.State
Candidates
22. Cumulative Expenditures Macie*
(I' SubJecl to Volunlllry Expenditure Limit!
Date of Election
(mmldd/yy)
__J__J __
__J__J __
Total to Date
$ ____ _
$----'----
*Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov 1866/275-3772)
www.fppc.ca.gov
• Schedule D
Summary of Expenditures
Supporting/Opposing Other
Candidates, Measures and Committees
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Palm Springs Fire Management Association
DATE
08/28/2017
NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR
MEASURE NUMBER OR LETTER AND JURISDICTION,
OR COMMITTEE
"Yes on Measure o·
121 Support D Oppose
D Support D Oppose
D Support D Oppose
Schedule D Summary
•
Amounts may be rounded
to whole dollars.
TYPE OF PAYMENT
'21 Monetary
Contribution
• Non monetary
Contribution
• Independent
Expenditure
• Monetary
Contribution
• No·nmone1ary
Contribution
• Independent
Expenditure
• Monetary
Contribution
• Nonmonetary
Contribution
• Independent
Expenditure .
DESCRIPTION
(IF REQUIRED)
SUBTOTAL $
• SCHEDULED
Statement covers period
from __ 0_9_/_24_/_2_0_17 __
CALIFORNIA 460
FORM
through __ 1_0_/2_1_/_2_01_7 __ Paga_. __ of __ _
AMOUNT THIS
PERIOD
0.00
I.De NUMBER
1248897
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
2,500.00
PER ELECTION
TO DATE
(IF REQUIRED)
1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) ....................................................... $ --~2=,5=0=0~.0=0-
2. Unitemized contributions and independent expenditures made this period of under $100 .................................................................................... $ _____ _
3. Totai contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) .......... TOTAL.. $ __ .....,2 .... ,5=0 .... 0....,.0...,0'-
.FPPC Form 460 (Jan/2016)
FPPC Advice: advice@)fppc.c:a.gov (866/275-3772)
www.fppc.ca.gov
• Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Palm Springs Fire Management Association
• Amounts may be rounded
to whole dollars. Statement covers period
from __ 0_9_/2_4_/2_0_1_7 __
through __ 1_0_/2_1_/2_0_17 __
-SCHEDULE E
CALIFORNIA 460
FORM
Page ___ of_. __
t.O. NUMBER
1248897
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP
CNS
CTB
eve
FIL
FND
IND
LEG
LIT
campaign paraphernalia/misc.
campaign consullants
contribution (explain nonmonelary)"
civic donations
candidate filing/ballot fees
fundraising events
independent expenditure supporting/opposing others (explain)*
· legal defense
campaign literature and maiHngs
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, Al.SO ENTER LO. NUMBER)
Deane & Company
1787 Tribute Rd, Ste K
Sacramento, CA 95815
MBR
MTG
OFC
PET
PHO
POL
POS
PRO
PRT
member comrmmicalions
meetings and appearances
office expenses
petition circulating
phone banks
polling and survey research
postage, delivery and messenger services
professional services (legal, accounting)
print ads
CODE OR
RAD
RFD
SAL
TEL
TRC
TRS
TSF
VOT
WEB
radio airtime and production costs
returned contributions
campaign workers' salaries
l.v. or cable airtime and11roduction costs
candidate travel, lodging, and meals
staff/spouse travel, lodging, and meals
transfer between committees of the same candidate/sponsor
voter registration
information technology costs (Internet, e-mail)
DESCRIPTION OF PAYMENT AMOUNT PAID
''Yes on Measure D"
CTB City of Palm Springs tax measure 2,500.00
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 2,500.00
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................................................. $ ___ 2_,_5o_o_._oo_
$ 0.00-2. Unitemized payments made this period of under $100 .................................................................................................................... :..................... _____ _
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ............................................................................. $ ____ o_.o_o_
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................... TOTAL $ ___ 2 ,_5o_o_.o_o_
FPPC Form 460 (Jan/2016)
FPPC Advice: advlce@fppc.ca.gov (866/27S-3772)
www.fppc.ca.gov
••• Schedule I
Miscellaneous Increases to Cash
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Palm Springs Fire Management Association
DATE
RECEIVED
FULL NAME AND ADDRESS OF SOURCE
~FCOMMITTEE.AL50 ENTER I.D. NUMBER)
Attach additional information on appropriately labeled continuation sheets.
Schedule I Summary
• Amounts may be rounded
to whole dollars. Statement covers period
09/24/2017 from _______ _
through __ 1_0_/2_1_/2_0_1_7 __
DESCRIPTION OF RECEIPT
SUBTOTAL$
1. Itemized increases to cash this period ............................................................................................................................ $ _____ 0_._06_
2. Unitemized increases to cash of under $100 this period ................................................................................................. $ _____ _
3. Total of_ all interest received this period on loans made to others. (Schedule H, Column (e).) ....................................... $ _____ _
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
Summary Page, Line 14.) ............................................................................................................................. TOTAL $ ____ 0_.0_6_
• SCHEDULE I
CALIFORNIA 46 0
FORM
Page __ of __
1.0. NUMBER
1248897
AMOUNT OF
.INCREASE TO CASH
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization
Recipient Committee
Statement Type D Initial
Nol yet qualified D or
121 Amendment
List I.D. number:
# 113652985
I '
D Termination -See Part S
list 1.0. number:
# _______ _
I ,_
R
in th
Dab!Stamp
EIVED AND Fn .. ZG
office of the Secretary of Stats
of 111e Stile of Catiiornia
JUL 31 2017
Ul
-<
G:r, ~~
~("')
::,0 rr, ,...._ __ _,, ,_
Dale qualified as committee Date qualified as committee
(If appllcablel
Date of Termination ~< . ,rn
1.~<Cqffiijl~¢::!nfo.t"'1.atlot1,;~;~[';C::•·· ;, .\ -c:~;{ ,,,:,.,:~<>;M;:·;,:_::::: .\, .. ,:,;,,;::,.;,r;,,~:.s,:;[t:, ; . .;;.: . :;~:,'.t:::,. 2~xrr~a'surer and;Qt~~rsPiin'clp;;al{Qffl.~,~-:~'.i,,k·J:i::EAt:•::jl~:•ff '.·,;ir·~~;~;~::~~;;'i:\">:· •: ;jfjk :ds:i
NAME OF TREASURER C';" • • NAME OF COMMITTEE
f"" -Palm Springs Fire Management Association PAC Ron Beverly r·-o
STREET ADDRESS [NO P.O. BOXI
1453 E Gem Circle
STREET ADDRESS INO P.O. 80XI CITY STATE ZlPCOOE AREA CODE/PHONE
300 N El Cielo Rd Palm Springs CA 92262 (760)218-7103
CITV STATE ZIP CODE AREA CODE/PHONE NAME Df ASSISTANT TIW\SOREII, IF ANY
Palm Springs CA 92262 (760)323-8181 nla
MAIUNG ADDRESS !IF DlffEIUNTl. STREET ADDRESS INO P.O. BOXI
P.O. Box 1761 Palm Springs, CA 92263
FAX/ E-MAIL ADDRESS CITY STATE ZIPCOl>E AREA CODE/PHONE
COUNTV OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PIUNCll'AI. OFFICER(5)
Riverside Jason Loya
STREET ADDRESS (NO P.O. IOXI
78-465 Via Sevilla
Attach additional information on appropriately labeled conttnuatfon sheets.
CITY STATE ZIP CODE
La Quinta CA 92253
AREA CODE/PHONE
(760)927-5770
penalty of perjury under the laws of the State of California that th regolng i and c ~ <?J ~ :
Executedon 07/27/2017
DATE
Executed on By
DATE
Executed on By
DATE
Executed on By
DATE
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR 51'.IITE MWURE PROPON£NT
SIGNATURE OF CONTRDLLINl'i OFFICEHOLDER, CANDIDATE, OR STATE MEIISURE PROPONENT
:::---(".7 ---,, .~-~
f"":'. ..,.-:::
___ ..!) ,.:_: ....
~::-::~ ~-_. ·,
l . , ~ '
I
-.J
FPPC Form 410 (Jan/2016)
FPPC Advice: advlce@lfppc.ca.guv (866/275-3772l
www.fppc.ca.1ov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Palm Springs Fire Management Association PAC
CALIFORNIA 410
FORM
1,D.NUMDER
113652985
• All committees must 11st the flnanclal Institution where the campaign bank account Is located.
NAME Of FINANCIAL INSTITUTION AREA CODE/PHONE BANI ACCOUNT NUMBER
Sun Community Federal Credit Union (760)327-7 47 4 50109510
ADDIESS STATE ZIPCOOE
425 N Civic Dr Palm Springs CA 92262
Controlled Com,wttet:
• 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:'
• 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) nAR OF ELECTION
P1 /fnnnly fu,med Comn'ittee Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(SJ NAME OR MEA5UREl5} FUtl TlnE (INCWDE BALLOT NO. OR LETTER) CANDIOATEjS) OFFICE SOUGHT 011 HHD OR MEASURE(S) JURISDICTION
[INCWDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
PARTY
D Nonpartisan
0 Nonpartisan
CHECK ONE
T rO§,
FPPC Form 410 (Jan/ZOl&t
FPPC Advice: advlce@lfppc.ca.gov (866/275•37nt
www.fppc.ca.1ov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON RfVERSE
COMMlmE NAME
Palm Springs Fire Management Association PAC
CALIFORNIA 410
FORM
l,D,NUMBER
113652985
General Purpose Cnmm1tlPP Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
12] CITY Committee • COUNTY COmmittee • STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITV
Sponsored Lomm,ttce List additional sponsors on an attachment.
NAME Of Sl'ONSOft INDUSTRY GROUP OR AFFILIATION OF SPONSOR
Palm Springs Fire Management Association
snEET ADDRESS NO. ANO STR~U CITY STATE ZIP CODE
P.O. Box 1761 Palm Springs CA 92263
Small Conti rbutor Comm1ttl'e •-----DIie qualfied
S;.Term.ln~tlo~!~@qijl,~!ti~lil!t~Ii:fi"'fs,~~~~:~:~®i:a~.~~t~etreasu~r,ass~~;:~.#.~~~tlf;f!DPJ!~~~f!!tigid.~f/~r·p¥j,i,nrmtci!ftl':v·~·~.(.ti!:~,<>!1~ij[~~~~?~t~~~~~:.rfa1!i;:)i/Jc":i.•···. •·
• This committee has ceased to receive contributions and make expenditures;
• This committee does not anticipate receMng 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 89511-89S18, and are
subject to Elections code Section 18680 and FPPC Regulation 18521.5.
FPPC Form 410 (Jan/2016)
FPPC Advice: advlcel!Pfppc.ca,eov (866/Z75-37n)
www.fppc.ca.gov
Recipient Committee
Campaign Statement
Cover Page RECEIVED . _____________________ ... ·• ....... ,_.__ .. .,..) F P t, L M SP R l h C ;
SEE INSTRUCTIONS ON REVERSE
Statement covera period
01/01/2017 from ________ _
06/30/2017 through _______ _
1. Type of Recipient Committee: A• Comm1tmea-eompia Parm 1, 2, 3, and 4.
D• of election if applicable:
(Mooth, Day, Year) 2111 UL 2 7 PH 2: 5 0
2. Type of Statement:
D Officeholder, Candidate Controlled Committee
0 State Candidate Election Committee
D Primarily Fonned Ballot Measure
Committee
D Preeleclion Statement
121 Semi-annual Statement
D Termination Statement
D Quarterly Statement
Q Recall 0 Controlled • Special Qdd.Year Report
~~,,.,ii!
liZI General Purpose Committee
~ Sponsored
0 SmaU ContributorConvnittee
0 Political Party/Central Committee
3. Committee Information
0 Sponsored
(A/111~,,.,8/
D Primarily Formed Candidate/
Officeholder Committee
(Also~ P1117J
1.0.NUMBER
11-3652985
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Palm Springs Fire Management Association-PAC
STREET ADDRESS (NO P.O. BOX)
300 N El Cielo Rd
CITY
Palm Springs
STATE ZIP CODE
CA 92262
WJLINGADDRESS (IF DIFFERENT) NO.ANO STREET OR P.O. BOX
P.O. Box 1761
crtv STATE ZIP CODE
Palm Springs CA 92263
OPTIONAL: FAX/ E-MAIL ADDRESS
4. Verification
AREA CODEIPttONE
(760) 323-8181
AREA CODE/PHONE
(Also file a Fonn 410 Termination)
D Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
Ron Beverly
loWUNG ADDRESS
1453 E Gem Circle
cliv
Palm Springs
NAME OF ASSISTANT'TREASURER, IF AtN
n/a
MAILING ADDRESS
CITY
OPTIONAL: FAX/ E-MAIL ADDRESS
STATE ZIP CODE
CA 92262
STATE ZIP CODE
AREA CODE/PHONE
(760) 218-7103
AREA CODE/PHONE
I have used aH reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete. I
certify under penalty of peljury under the laws of the State of Cafifomia that the foregoing is true and~ ~
Executed on 07/27/2017 Bv-------1-1------•-!'"t-.-......-. _ __....._...,..,....,._--=----------
Om& s· ori; or · T"'-
Exeamid on----......., ..... -----ay_....,.,..,..,.,.....,.,....,.....,..,...,.,.,..,.,.........,..,..,.,,..,,...,......,,..,...,.,,,....,,....,.,....-,...-,.......;;;;:::---,---,--.,............,.,,..,.....,.,,.........,..,,.......-,--Oale Slgnabn d CcnUohlg Offtceho1der, candidale, State Measure Proponent or Reaponsible OfflaK of Sponsor
Executedon-----Dala==------
Executedon-----.6~ • ..------
Bv----...... ..--......................... .,._ ...... ..,...._....,......,......, _ __,,,.........., ____ _
Signalllr8 of Coolralli1111 Ollahddllr. Candidate, stale~ PnlpQnent
Bv-------,Slplute,,......-,--'""'ol""'Conrall--.-""ing--,,,ofiicafioidai-.,,..........,...,.. __ C.,.. _ _,,.,ic1a1""'a-•, siaie.....,..""Me'""asure-'""P'""roponen--,1-----
FPPC Form 460 tJan/2016)
FPPC Advica: advlce@)fppc.ca.pv (866/275-3772)
www.fppc.ca.aov
SUMMARY PAGE Campaign Disclosure Statement
Summary Page
Amounts mil)' be rounded
to whole dolars. Statement covers period
01/01/2017 from _______ _
CALIFORNIA 460
FORM
SEE INSTRUCTIONS ON REVERSE
06/30/2017 ~rough ______ _ Page ___ of __ _
NAME OF FILER
Palm Springs Fire Management Association-PAC
Contributions Received
1. Monetary Contributions................................................... ScheduleA. Line 3 $
2. Loans Received ................................................................ Schedules, Unal
ColumnA
Ta™. 1lil8 PERIOO
(FAC-..ATTActED SCHED1Jt.ES1
3. SUBTOTAL CASH CONTRIBUTIONS .............................. Addl.ines1+2 S ------
4. Nonmonetary Contributions............................................ Schedule c, Une 3
5. TOTAL CONTRIBUTIONS RECEIVED ................................... .Add Linn 3 + 4 $
Expenditures Made
6. Payments Made................................................................ St:hedule E, L/nt!I 4 $
7. Loans Made....................................................................... Schedule H. Line 3
8. SUBTOTAL CASH PAYMENTS ......................•................... Add Lines o + 7 $
9. Accrued Expenses (Unpaid BiUs) .......................................... Schedule F. Lines
10. Nonmonetary Adjustment.. ....................................................... Schfldu/e ~ Line 3
11. TOTAL EXPENDITURES MADE. ....................................... Add Lines 8 + 9 + 10 $
Current Cash Statement
12. Beginning Cash Balance ............................ Pr9vious Summary Page, une 10 $ 573.16
13. Cash Receipts .............................................. ..... ........ Coiumn A. Line 3 above
14. Miscenaneous Increases to Cash .................................. Schewie 1, Lil9 4 .12
15. Cash Paynients .............. ..... ...................................... Column A, Linll 8 above
16. ENDING CASH BALANCE .................. Add Lines 12 + 13 + 14, then subtract Line 15 $ 573.28
If this is a tennination statement, Um 16 must be zero.
$
s
$
$
$
$
ColumnB
CALENDAR VEAR
TOTAL TO 0,1.TI:
To calallate Coloom B,
add amounts in Column
A to the corresponding
amounts from Column B
of your last report. Some
amounts in Column A may
be negative figures that
should be subtracted from
previous period amo1.11ts. If ---------------------------------1 thisisthefirstreportbeing
EES RECEIVED filed for this calendar year, 17. LOAN GUARANT ................................ Schedule B, Patt 2 $ only carry aver the amounts
_C_a_s_h_E_q_u_i_v_a-le_n_ts_a_n_d_O_u_ts_ta_n_d_i_n_g_D_e_b_ts _____________ from Lines 2, 7, alld 9 (If
any).
18. Cash Equivalents................................................ See /nstnJdions on rc,i,e,se $
19. Outstanding Debts.............................. Add une 2 + Line 9 in Column B abol/8 $
I.D.NUMBER
11-3652985
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
111 thmugh 6/30 7/1 lo Date
20. Contributions
Received $ $
21. Expendih.res
Made $ $
Expenditure Limit Summary for State
Candidates
22. Cumullltlva Expendituree Made*
llfSubfecllo~E...-.,.IJRIII)
Date of Election
(mmlddlyy) __ ....,, __ _./
I
Total to Date
$ _____ _
$ _____ _
*Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (Jan/2016)
FPPC Advice: advlce8fppc.ca.10Y (866/275-3772)
www.fppc.ca,gov
Schedule A
Monetary Contributions Received
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Palm Springs Fire Management Association-PAC
Amounts fflllJ be rounded
towhoktdollara.
DAlE
RECEIVED
FULL NAME, STREET ADDRESS ANO ZIP CODE OF CONTRIBUTOR CONTRIBUTOR
(IF COMMrTTeE. Al.SO ENTeR 1.0. NUMBER) CODE *
IF AN IN0MDUAL, ENTER
OCCUPATION AND EMPLOYER
~F SELF-BiFI..OYED, ENTER NAME
OF BIJSINE88)
Schedule A Summary
1. Amount received this period -itemized monetary contributions.
•IND •COM
DOTH •PTY •sec
•IND •COM
DOTH
0PTY •sec
DINO •COM
00TH •PTY •sec
•IND •COM
00TH
0PTY •sec
•IND •COM
DOTH
0PTY •sec
SUBTOTALS
Statament covens period
01/01/2017 from _______ _
06/30/2017 through ______ _
SCHEDULE A
CALIFORNIA 46 0
FORM
Page ___ of __ _
I.D. NUMBER
11-3652985
AMOUNT
RECEIVED THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 • DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
*Contributor Codes
IND -Individual
(Include all Schedule A subtotals.) .............•...•...•................................................................................... $------'---COM -Recipient Committee
(other than PTY or SCC)
0TH -Other (e.g., business entity)
PTY -Political Party 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.) ...................... TOTAL $ ______ o_
sec -Small Contri>utor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advlce@fppc.ca.pv (866/275-3772)
www.fppc.ca.pv
Schedule B -Part 1
Loans Received
SEE INSTRUCTIONS ON REVERSE
NAME OF FU.ER
Palm Springs Fire Management Association-PAC
Amounts may be rounded
to whole dolars. Statement covers period
01/01/2017 ~om _______ _
06/30/2017 through ______ _
SCHEDULE B -PART 1
CALIFORNIA 460
FORM
Page ___ of __ _
I.D.NUMBER
11-3652985
FULL NAME, STREET ADQRESSAND ZIP CODE
OF LENDER
IF AN INDMDUAL, ENTER
OCCUPATION AND EMPLOYER
(F SELF-EMPLOYED, ENTER
NAME OF BUSINl!SS)
Cc)
OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING
BEG~~:8'ittis RECEIVED THIS OR FORGIVEN c~~~l.Afis
• INTEREST ORIGINAL
AMOUNT OF
LOAN
CUMULATIVE
CONTRIBUTKlNS
TO DATE (IF COMMITTEE. ALSO ENTER I.D. NUUIIER) PERIOD PERIOD THIS PERIOD• PERIOD
0 PAID
$ $
D FORGIVEN
to INO O COM O 0TH O PTY O sec •----• DATE DUE
D PAID
s $
0 FORGIVEN
to IND O COM O 0TH O PTY O sec
, ___ _ , ___ _ s DATE DUE
0 PAID
s s
0 FORGIVEN
•----to IND O COM O 0TH O PTY O SCC
, ___ _ • OATEOUE
SUBTOTALS $ $ $
Schedule B Summary
1. Loans received this period .................................................................................................................... $
(Total Column (b) plus unitemized loans of less than $100.)
2. Loans paid or forgiven this period ......................................................................................................... $
(Total Column {c) plus loans under $100 paid or forgiven.)
(Include loans paid by a third party that are also itemized on Schedule A.)
3. Net change this period. (Subtract Line 2 from Line 1.) .............................................................. NET $
Enter the net here and on the Summary Page, Column A, Line 2. (May tie• 119tift ffll'nller)
'"Amounts forgiven or paid by another party also must be reported on Schedule A.
"" If required.
$
s
s
$
PAID THIS
PERIOD
--"' RAlE
--"' RATE
--"' Rl\lE
(Enter (eJ on
CALENDAR YEAR
s s
PER ELECTION"
s
DATE INCURRED
CALENDAR VEAR
$ •
PER ELSCTlON ..
• DA"llo INCURRED
CALENDAR YEAR
s s
PER ELECTION ..
s
DATE INCURRED
SchadlAe E, Line 3)
tContributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY or SCC)
0TH -Other (e.g., business entity)
PTY -Political Party
SCC -SmaU Contributor Convnittee
FPPC Form 460 tJan/2016)
FPPC Advice: advlcel!Pfppc.ca.gov (866/275-3772)
www.fppc.ca.gov
SCHEDULEE
Schedule E
Payments Made
Amounts may be rounded
to whole dollars. Stalament covers period
01/01/2017 from _______ _
CALIFORNIA 460
FORM
SEE INSTRUCTIONS ON REVERSE
06/30/2017 through ______ _ Page __ of __
NAME OF FILER
Palm Springs Fire Management Association-PAC
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
1.0.NUMBER
11-3652985
CMP campaign paraphernalia/misc. MBR member commooications RAD radio airtime and production costs
CNS campaign consultan1s MTG meetings and appearances RFD returned contributions
CTB contl1bution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries
eve civic donations PET petition circulating TEL t.v. or cable airtime and production costs
FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals
FND fwtdraising events POL poling and sun,ey research TRS staff/spouse travel, lodging, and meals
IND Independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor
LEG legal defense PRO prote&Sional services (legal, accounting) VOT voter registration
LIT campaign literature and mailings PRT print ads VI/EB information lechnology costs (intamet, e-mail)
NAME AND ADDRESS OF PAYEE
(F COMMITTEE.ALSO EN11:R 1.0. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
• Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL$
Schedule E Summary
0 1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................................................. $ _____ _
0 2. Unitemized payments made this period of under $100 .......................................................................................................................................... $ _____ _
0 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ............................................................................. $ _____ _
0 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................... TOTAL $ _____ _
FPPC Form 460 (Jan/20161
FPPC Advice: advlce.,ppc.ca.gov (B66/275-3nzt
www.fppc.ca.gov
Schedule I
Miscellaneous Increases to Cash
SEE INSTR TIONS ON REVERSE
NAMEOFRLER
Palm Springs Fire Management Association-PAC
DATE
RECEIVED
FULL NAME ANO ADDRESS OF SOURCE
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER)
Attach additional information on appropriately labeled continuation sheets.
Schedule I Summary
Amounts may be rounded
to whole dollars. Statement covers period
01/01/2017 from _______ _
06/30/2017 through ______ _
DESCRIPTION OF RECEIPT
SUBTOTAL$
1. Itemized increases to cash this period ............................................................................................................................ $ _____ ._12_
2. Unitemized increases to cash of under $100 this period •................................................................................................ $ _____ _
3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ....................................... $ _____ _
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
Summary Page, Line 14.) ............................................................................................................................. TOTAL $ _____ ._12_
SCHEDULE I
CALIFORNIA 460
FORM
Page __ of __
I.D. NUMBER
11-3652985
AMOUNT OF
INCREASE TO CASH
FPPC Form 460 (Jan/2016)
FPPC Advice: acMce@fppc.ca.pv (866/275-3772)
www.fppc.c:a.gov
.
Recipient Committee
Campaign Statement
Cover Page -Af"'\enc1ed
SEE INSTRUCTIONS ON REVERSE
Statament coven period
07/01/2016 from ________ _
12/31/2016 ~rough _______ _
1. lype of Recipient Committee: AH Comm111Ns-Comp1ete Patti 1, 2, l, 1111d 4.
D Officeholder, Candidate Controlled Committee
0 State Candidate Election Committee
D Primarly Formed Balot Measure
Committee
Q Recall
(A/lo ~Ari 5}
liZI General Purpose Committee e Sponsored
0 SrnaD Contributor Committee
0 Political Party/Central Committee
3. Committee lnfonnatlon
0 Controled
0 Sponsored
(Allo~l'Mf)
• Primarily Formed Candidate/
Officeholder Committee
(Alla eom,,ille Plrl 1)
I.D.NUMBER
11-3652985
COMMITTI::E NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Palm Springs Fire Management Association
STREET ADORESS (NO P.O. BOX)
300 N El Cielo Rd
CITY
Palm Springs
STATE ZIP CODE
CA 92262
MAILING ADDRESS (IF 01FFERENT) NO. AND STREET OR P.O. BOX
P.O. Box 1761
CITY STATE ZIP CODE
Palm Springs CA 92263
OPTIONAL: FAX I E-MAllADORESS
4. Verification
AREA CODE/PHONE
(760) 323-8181
AREA CODE/PHONE
Date Stamp
Date of •IIICtion if applicable:
(Month, Day, Year)
2. Type of Statement:
D Preelection Statement
121 Semi-annual Statement
D Termination Statement
(Also file a Form 410 Termination)
D Amendment (Explain below)
Treasurer(s)
NAME OF mEASURER
Cory Gorospe
MXILINdAbbREss
68070 Madrid Rd
CllY
Cathedral City
NAME OF ASSISTANT TREASURER, IF ANY
n/a
MAILING ADDRESS
CITY
OPTIONAL: FAX I E-MAIL ADDRESS
For Official Use Only
0 9. _,, ~ ~ • Quarterty s~ --<
0 Special Odd-~r Ra,IIQrt O ?,:>
0 ~ -.;~
I I ?fi\
--r--rn ~.c:.
S ~ o,11'
STATE ZIP CODE AREA CODE/PHONE
CA 92234 (760) 673-1896
STATE ZIP CODE AREA CODE/PHONE
I have used au reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the i ormati contained herein and in the attached schedules is true and complete. I
certify under penalty of perjury under the laws of the Slate of California that the foregoing is true anm~rP.d
Execullld on
Executed on
Executed on
Execu1edon
01/2412017
Date
biiie
Date
Da1lt
ey _____ Signafu""'·=""'re""or""c""'o"'niroiing=""'0111""1101""'""110kler=~, c""'~==c-, ""s-,,..,....,Ma=asu""re,,...P""ra""ponen1=,,......----
By _____ S""'igna=1ur~e""or""c..,.o.~,b~Ol~ing,-Office=-.-holdet-.~. C:,o,llncldale~-,-, ""st111e,,..,....,MNIUB=~Pr""op=0nen1~-----
fPPC Form 460 (Jan/2016)
FPPC Advice: advlcet!Pfppc.ca.gov (866/275-3772)
www.fppc.ca.gov
-•·
Campaign Disclosure Statement
Summary Page
see INSTRUCTIONS ON REVERSE
NAME OF FILER
Palm Springs Fire Management Association
Contributions Received
1. Monetary Contributions................................................... ScheduleA, Line 3 $
2. Loans Received................................................................ Sdledule s. Line 3
3. SUBTOTAL CASH CONTRIBUTIONS.............................. Add lines 1 + 2 $
4. Nonmonetary Contributions............................................ Schedule C, Line 3
5. TOTAL CONTRIBUTIONS RECEIVED ................................... .Adc/Unes3+4 $
Expenditures Made
6. Payments Made................................................................ SchedlJle E, Lm 4 $
7. Loans Made....................................................................... Schedule H, LN 3
B. SUBTOTAL CASH PAYMENTS.......................................... Add Unes 6 + 7 $
9. Accrued Expenses (Unpaid BiHs) .......................................... Schedule F, Une 3
10. Nonmonetary Adjustment.. ....................................................... Schedule c, Line 3
11. TOTAL EXPENDITURES MADE. ....................................... AddLinesB+9+ 10 $
Current Cash Statement
12. Beginning Cash Balance ............................ Ptellfous SUmma,y Page, Line 16 $
13. Cash Receipts ........................................................... Column A, Une J above
14. Miscellaneous Increases to Cash .............. .................... Schedule 1, Line 4
15. Cash Payments......................................................... Column A, Lines above
16. ENDING CASH BALANCE .................. Add Lines 12 + 13 + 14, then subtract Line 15 $
ff this is a tennination statement, LJne 16 must be zero.
17. LOAN GUARANTEES RECENED ................................ ScheduleB,Part2 $
Cash Equivalents and Outstanding Debts
Amounts may be rounded
to whole dolars.
ColumnA
TOTAL THIS PEAIOO
(FROMATTACIED SCHEDULESI
573.04
.12
573.16
18. Cash Equivalents ................................................ Seeinstruc:liansoon,11111.rse $
19. Outstanding Debts .............................. AddL.ine2+L.ine9inColumnBabove $
SUMMARY PAGE
Statement covers period
07/01/2016 kom ________ _
CALIFORNIA 460
FORM
12/31/2016 through _______ _ Page ___ of __ _
$
Columns
CALENDAR YEAR
TOTAL TC DATE
$ -------
$
$
$
$
To calculate Column B,
add amounts in Column
A to the con-esponding
amounts from Column B
of your last report. Some
amounts in Column A may
be negative figures tha1
should be subtracted from
previous period amounts. If
this is the first report being
filed for this calendar year,
only cany over the amounts
from Lines 2, 7, end 9 (if
any).
1.0.NUMBER
11·3652985
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Electlona
1/1 through 6130 7/1 to Date
20. Conbibutions Received $ ____ _ S-----
21. Expencll1ures Made $ ____ _ $ ____ _
Expenditure Limit Summary for State
Candidates
22. Cumulative Expendituree Made•
pr SU111«t fill VDllntuy Eiipandlln Lllllltl
Date of Election
(mm/dd/yy)
I
__ _.I, __ _,/
Total to Date
$ _____ _
$ _____ _
"'Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 {Jan/2016,
FPPC Advice: advice@fppc.ca.gov (866/27S-3772,
www.fppc.ca.gov
-·
Schedule A
Monetary Contributions Received
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Palm Springs Fire Management Association
Amounts may be rounded
to whole dollan..
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR
OF COMMITTEE, ALSO ENTER LD. NUMBER) CODE *
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SEL.F-EliFLOYED, ENTER NAME
OF BUSINESS)
Schedule A Summary
1. Amount received this period -itemized monetary contributions.
•IND •COM
00TH
OPTY •sec
•IND •COM
DOTH
OPTY •sec
•IND •COM
DOTH •PTY •sec
DINO •COM
00TH
OPTY •sec
•IND •COM
00TH •PTY •sec
SUBTOTAL$
SCHEDULE A
Statement covers period
07/01/2016 from ________ _ CALIFORNIA 460
FORM
ttlrough __ 1_21_3_1_12_0_1_6 __ Page ___ of __ _
AMOUNT
RECEIVED THIS
PERIOD
1.0.NUMBER
11-3652985
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
*Contributor Codes
IND-Individual
(Include all Schedule A subtotals.) ......................................................................................................... $ _____ _ COM -Recipient Committee
(other than PTY or SCC)
0TH -Other (e.g., business entity)
PTY -Political Party 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.) ...................... TOTAL $ ______ o_
sec -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advlce@fppc.ca,gov (866/275-3772)
www.fppc.ca.gov
Schedule B -Part 1
Loans Received
SEE INSTRUCTIONS ON REVERSE
NAME Of FILER
Palm Springs Fire Management Association
Amounts may be rounded
to whole dollars. Statement covera period
07/01/2016 from _______ _
12/31/2016 through ______ _
SCHEDULE B -PART 1
CALIFORNIA 460
FORM
Page___ of __ _
I.D. NUMBER
11-3652985
FULL NAME, STREET ADDRESS AND ZIP CODE
OF LENDER
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
~FSELF-EMPLOVED,ENTER
NAME OF l!USINESS)
(CJ
OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING
BALANCE RECENED THIS OR FORGIVEN BALANCE AT
• INTEREST ORIGINAL
AMOUNT OF
LOAN
II
CUMULATIVE
CONTRIBUTIONS
TO DATE (F COMMITTEE, ALSO ENTER 1.0. NUMBER) BEG~:~io THIS PERIOD THIS PERIOD• CLO~iR?iJHIS
0 PAID
$ •
0 FORGIVEN
to IND O COM O 0TH O PTY O sec
•----•----• DATE DUE
•PAID
$ s
0 FORGIVEN
to IND O COM O 0TH O PTY O sec
$ ___ _
$
DATEOUE
0 PAID
$ s
0 FORGIVEN
to IND • COM • 0TH • PTY O sec
, ___ _ , ___ _
$
DATE DUE
SUBTOTALS $ $ $
Schedule B Summary
1. Loans received this period .................................................................................................................... $
(Total Column (b) plus unitemized loans of less than $100.)
2. Loans paid or forgiven this period ......................................................................................................... $
(Total Column (c) plus loans under $100 paid or forgiven.)
(Include loans paid by a third party that are also itemized on Schedule A)
3. Net change this period. (Subtract Line 2 from line 1.) .............................................................. NET $
Enter the net here and on the Summary Page, Column A, Line 2. (M9y 11e • ~ ninberl
*Amounts forgiven or paid by another party also must be reported on Schedule A.
,... If required.
$
$
$
s
PAIOTHIS
PERIOD
--" RATE
--" RAlE
--" RATE
(Enler(e)oo
CALENDAR VEAR
$ I
PER ELECTION ..
s
DATE INCURRED
CALENDAR VEAR
$ •
PER ELECTION ..
$
DATE INCURRED
CALENDAR YEAR
$ $
PER ELECTION.,.
$
DATE INCURRED
Schedla E, Line 31
tcontributor Codes
IND -Individual
COM -Recipient Convnittee
(other than PTY or SCC)
0TH -Other (e.g., business entity)
PTY -Po&tical Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advlce@Pfppc.ca.sav 1866/275-3772)
www.fppc.ca.gov
-. .
SCHEDULEE Schedule E
Payments Made
Amounts may be rounded
to whole dollars. Statement covers period
07/01/2016 wom _______ _
CALIFORNIA 460
FORM
SEE INSTRUCTIONS ON REVERSE
through __ 1_2/_3_1/2_01_6 __ Paga ___ of __ _
NAME OF FILER
Palm Springs Fire Management Association
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
1.0. NUMBER
11-3652985
CMP campaign paraphemalia/misc. MBR member communications RAD radio airtime and production costs
CNS campaign consultants MTG meetings and appearancies RFD returned contributions
CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries
CVC civic donations PET petition c:i-cuating TEL l.v. or cable airtime and production costs
FIL candidate fillng/balot fees PHO phone banks TRC candidate travel, lodging, and meals
FND funclraising events POL poHing and survey research TRS staff/spouse travel, lodging, and meals
IND independent expenditure supporting/opposing others (explain)* POS postage, deivery and messenger services TSF transfer between committees of the same candidate/sponsor
LEG legal defense PRO professional services (legal, accounting) VOT voter registration
UT campaign literature and mailings PRT print ads WEB infonnation technology costs (internet, a-mail)
NAMEANDADDRESS OF PAYEE
Clf CO!Affl"Tee, Al.SO eNTl:R I.D. NUM81!R} CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$
Schedule E Summary
0 1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................................................. $ _____ _
0 2. Unitemized payments made this period of under $100 .......................................................................................................................................... $ _____ _
0 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).} ............................................................................. $ _____ _
0 4. TotaJ payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................... TOTAL $ _____ _
FPPC Form 460 (Jan/2016)
FP9C Advice: advlceOfppc.ca.gov {866/275-3772)
-.fppc.ca.gov
.. . .
Schedule I
Miscellaneous Increases to Cash
SEE INSTRUCTIONS ON REVERSE
NAME OF ALER
Palm Springs Fire Management Association
DATE
RECEIVED
RJLL NAME AND ADDRESS OF SOURCE
~F COMMITTEE, ALSO ENTER 1.0. NUMBER)
Attach additional information on appropriately labeled continuation sheets.
Schedule I Summary
Amounts may be rounded
to whole dollar... Statement covers period
07/01/2016 from _______ _
through __ 1_2/_3_1/2_01_6 __
DESCRIPTION OF RECEIPT
SUBTOTAL$
1. Itemized increases to cash this period ............................................................................................................................ $ _____ ._12_
2. Unitemized increases to cash of under $100 this period ................................................................................................. $ _____ _
3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ....................................... $ _____ _
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
Summary Page, Line 14.) ............................................................................................................................. TOTAL $ _____ ._12_
SCHEDULE I
CALIFORNIA 460
FORM
Paga __ of __
LO.NUMBER
11-3652985
AMOUNT OF
INCREASE TO CASH
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
,. R,ecipient Committee
Campaign Statement
Cover Page
SEE INSTRUCTIONS ON REVERSE
ent covers period
06/30/2016 from----~;::::~.::::.::::.::::::::::=:=
1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4.
D Officeholder, Candidate Controlled Committee
0 State Candidate Election Committee
D Primarily Formed Ballot Measure
Committee
0 Recall
(Also Coo,p/ele Pall SJ
liZI General Purpose Committee
® Sponsored
0 Small Contributor Committee
0 Political Party/Central Committee
3. Committee Information
0 Controlled
0 Sponsored
(Also Complete Parl 6)
D Primarily Formed candidate/
Officeholder Committee
/Also C01111Jleli> Par! 7)
1.0.NUMBER
11-3652985
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Palm Springs Fire Management PAC
STREET ADDRESS (NO P.O. BOX)
300 N El Cielo Rd
CITY
Palm Springs
STATE ZIP CODE
CA 92262
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
P.O. Box 1761
CITY STATE ZIP CODE
Palm Springs CA 92263
OPTIONAL: FAX/ E-MAIL ADDRESS
4. Verification
AREA CODE/PHONE
760-323-8181
AREA CODE/PHONE
...
Date Stamp ~
c.Ct.lV ED ur-.:. F p~LH SPRlnv•-
CALIFORNIA 460
FORM
Date of election If appllcabl~
(Month, Day, Year) ti\ I ~N 24 AM\\: 09
Page ___ of __ _
For Official Use Only
2. Type of Statement:
D Preelection Statement
1121 Semi-annual Statement
D Termination Statement
(Also file a Form 410 Termination)
D Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
Cory Gorospe
MAILING ADDRESS
68070 Madrid Rd
CITY
Cathedral City
NAME OF ASSISTANT TREASURER, IF ANY
n/a
MAILING ADDRESS
CITY
OPTIONAL: FAX I E-MAIL ADDRESS
D Quarterly Statement • Special Odd-Year Report
STATE ZIP CODE
CA 92234
STATE ZIP CODE
AREA CODE/PHONE
(760) 673-1896
AREA CODE/PHONE
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete.
certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
E~ecutedoo _____ \ __ l L_4+-l.__l'"\-__
Date
Executed llll-----,,,_oa..,.te _____ _
Executed on-----,,,-08..,.te _____ _
Executed on _____ ,,,,08..,.te _____ _
BY-----....,,,---,-..,.,,,....,....,,,......,,.,....,....,.,.....,,,.....,,.,..,.....,,.,...,...,.,..--.,,....---,------signalure of Conlrolling Officellolder, Gandidale, Stale Measure Proponenl
BY------,S"'°ig-na-.-tu-,e-o.,,.fC"'"o-nt,-ro""'lli-ng-=om=-cet,=01de.,.-~.,..Ca--nd""'ida=1e-=,s,.,.1a.,..1e-,M.,..ees=-u,-e""Pr ... opo"="ne"""nt,-------
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
.. ..
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
NAME Of FILER
Palm Springs Fire Management Association PAC
Contributions Received
1. Monetary Contributions................................................... Schedule A, Line 3 $
2. Loans Received................................................................ Schedule B, Line 3
3. SUBTOTAL CASH CONTRIBUTIONS.............................. Add Lines 1 + 2 $
4. Nonmonetary Contributions............................................ Schedule c. Line 3
5. TOTAL CONTRIBUTIONS RECEIVED ................................... AddUnes3+4 $
Expenditures Made
6. Payments Made................................................................ Schedule E. Line 4 $
7. Loans Made....................................................................... Schedule H. Line 3
8. SUBTOTAL CASH PAYMENTS.......................................... Add Lines 6 + 7 $
9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F. Line 3
10. Nonmonetary Adjustment... ...................................................... Schedule c, Line 3
11. TOTAL EXPENDITURES MADE. ....................................... Add lines 8 + 9 + 10 $
Current Cash Statement
12. Beginning Cash Balance ............................ Previous Summa,y Page, Line 16 $
13. Cash Receipts ...... .............. ...................... ................. Column A, Line 3 above
14. Miscellaneous Increases to Cash.................................. Schedule/, Line 4
15. Cash Payments......................................................... Column A, Line 8 above
16. ENDING CASH BALANCE .................. Add Lines 12 + 13 + 14, then subtract Line 15 $
If this Is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED................................ Schedule B, Part 2 $
Cash Equivalents and Outstanding Debts
Amounts may be rounded
to whole dollars.
Column A
TOTAL THIS PERIOD
(FROM ATTACHED SCHEOUL£S)
573.04
.12
573.16
18. Cash Equivalents................................................ See instructions on reverse $
19. Outstanding Debts.............................. Add Line 2 + Line 9 in Column B above $
$
$
$
$
$
$
Columns
CALENDAR YEAR
TOTAL TO DATE
To calculate Column B,
add amounts in Column
A to the oorresponding
amounts from Column B
of your last report. Some
amounts in Column A may
be negative figures that
should be subtracted from
previous period amounts. If
this is the first report being
filed for this calendar year.
only carry over the amounts
from Lines 2, 7, and 9 (if
any).
11-3652985
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
1 /1 through 6/30 711 to Date
20. Contributions
Received $ ____ _ $ ____ _
21. Expenditures
Made $-----$ ____ _
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made*
(If Subject to Voluntary Expenditure Limit)
Date of Election
(mm/dd/yy)
__j__j __
__J__J __
Total to Date
$ _____ _
$ ___ _
•Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@lfppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A
Monetary Contributions Received
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Palm Springs Fire Management Association PAC
Amounts may be rounded
to whole dollars.
DATE
RECEIVED
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR
(IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE *
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER NAME
OF BUSINESS)
Schedule A Summary
1. Amount received this period -itemized monetary contributions.
•IND •COM
00TH
OPTY •sec
•IND •COM
DOTH
0PTY •sec
•IND •COM
DOTH •PTY •sec
•IND •COM
DOTH •PTY •sec
•IND •COM
00TH •PTY •sec
SUBTOTAL$
SCHEDULE A
Statement covers period
06/30/2016
from ___ ----::::=====:::...
CALIFORNIA 460
FORM
AMOUNT
RECEIVED THIS
PERIOD
Page ___ of __ _
I.D. NUMBER
11~3652985
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 • DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
-"Contributor Codes
IND -Individual
(Include all Schedule A subtotals.) ......................................................................................................... $ _____ _ COM -Recipient Committee
(other than PTY or SCC)
0TH -Other (e.g., business entity)
PTY -Political Party 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.) ...................... TOTAL $ _____ ,J_
sec -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov 1866/275-3772)
www.fppc.ca,gov
SCHEDULE B -PART 1
Schedule B -Part 1
Loans Received
Amounts may be rounded
to whole dollars. Statement covers period
CALIFORNIA 460
FORM
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Palm Springs Fire Management Association PAC
FULL NAME. STREET ADDRESS AND ZIP CODE
OF LENDER
(IF COMMITTEE, ALSO ENTER 1.0. NUMBER)
t • IND O COM O 0TH O PTY O SCC
to IND • COM • 0TH • PTY • SCC
to IND O COM O 0TH O PTY O sec
Schedule B Summary
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF·EMPLOYEO, ENTER
NAME OF BUSINESS)
a
OUTSTANDING
BALANCE
BEGINNING THIS
PERIOD
$ ___ _
$ ___ _
$ ___ _
SUBTOTALS $
(c)
AMOUNT AMOUNT PAID OUTSTANDING
RECEIVED THIS BALANCE AT OR FORGIVEN CLOSE OF THIS
PERIOD THIS PERIOD • PERIOD
0 PAID
$ $
0 FORGIVEN
$----$
DATE DUE
0 PAID
$ $
0 FORGIVEN
$
DATE DUE
D PAID
$ $
0 FORGIVEN
$ ___ _ $
DATE DUE
$ $
Page of
I.D.NUMBER
11-3652985
• 8
INTEREST ORIGINAL CUMULATIVE
PAID THIS AMOUNT OF CONTRIBUTIONS
PERIOD LOAN TO DATE
CALENDAR YEAR
__ % $ $
Rl'TE PER B.ECTION"'
$
DATE INCURRED
CALENDAR YEAR
--% $ $
R<ITE
PER ELECTION ..
$ s
DATE INCURREO
CALENDAR YEAR
__ % $ $
RATE
PER EUECTION**
$ $
DATE INCURRED
$ -(Enter (e) on
Schedule E, Line 3)
1. Loans received this period .................................................................................................................... $ ---------'-._
(Total Column (b) plus unitemized loans of less than $100.)
2. Loans paid or forgiven this period ......................................................................................................... $
(Total Column (c) plus loans under $100 paid or forgiven.)
(Include loans paid by a third party that are also itemized on Schedule A.)
3. Net change this period. (Subtract Line 2 from Line 1.) .............................................................. NET $
Enter the net here and on the Summary Page, Column A, Line 2. (Mayboanogalivenumber)
'Amounts forgiven or paid by another party also must be reported on Schedule A.
•• If required.
tContributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY or SCC)
0TH -Other (e.g., business entity)
PTY -Polillcal Party
sec -Small Contributor Committee
FPPC Form 460 {Jan/2016)
FPPC Advice: advlce@fppc.ca.gov (866/27S-3772)
www.fppc.ca.gov
SeHEDULEE Schedule E
Payments Made
Amounts may be rounded
to whole dollars.
Statement covers period CALIFORNIA 460
FORM
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Palm Springs Fire Management Association PAC
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
Page of
1.0. NUMBER
11-3652985
CMP campaign paraphernalia/misc. MBR member oommunications RAD radio airtime and production costs
CNS campaign consultants MTG meetings and appearances RFD returned contributions
CTB oontribulion (explain nonmonetary)' OFC office expenses SAL campaign workers' salaries
eve civic donations PET petition circulatlng TEL t.v. or cable airtime and production costs
FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals
FND fundralslng events POL polling and survey research TRS staff/spouse travel, lodging, and meals
IND independent expenditure supportingtopposing others (explain)• POS postage. delivery and messenger services TSF transfer between committees of the same candidate/sponsor
LEG legal defense PRO professional services (legal, accounting) VOT voter registration
LIT campaign literature and mailings PRT print ads WEB information technology casts (internet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, AlSO ENTI:R l,D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
• Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$
Schedule E Summary
0 1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................................................. $ _____ _
0 2. Unitemized payments made this period of under $100 .......................................................................................................................................... $ _____ _
0 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (0).) ............................................................................. $ _____ _
0 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ........................... TOTAL$ _____ _
FPPC Form 460 (Jan/2016)
FPPC Advice: advlce@lfppc.ca.gov (866/275-3772)
www.fppc.ca.gov
.
Schedule I
Miscellaneous Increases to Cash
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Palm Springs Fire Management Association PAC
DATE
RECEIVED
FULL NAME AND ADDRESS OF SOURCE
(IF COMMITTEE. ALSO ENTER I.D. NUMBER)
Attach additional information on appropriately labeled continuation sheets.
Schedule I Summary
Amounts may be rounded
to whole dollars. Statement cavers period
DESCRIPTION OF RECEIPT
SUBTOTAL$
1. Itemized increases to cash this period ............................................................................................................................ $ _____ ._1_2
2. Unitemized increases to cash of under $100 this period ................................................................................................. $ _____ _
3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ....................................... $ _____ _
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
Summary Page, Line 14.) ............................................................................................................................. TOTAL $ _____ ._12_
I.D.NUMBER
11-3652985
of __ _
AMOUNT OF
INCREASE TO CASH
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@lfppc.ca.gov (866/275-3n2)
www.fppc.ca.gov