2019-07-31 Form 410 - PS Fire ManagementStatement of Organization . Dai:e Stamp
· Recipient Committee R ---------.--------~~~----~TY . ECELV.ED
Statement Type D Initial li2I Amendment D Termination -See Part 9F PALlf.SPRINGS
i:ALIFORNIA 410
FORM
For Official Use Only
o_ Not Y•~~ualified 2 /9 JUL 3 i · PM 5; 2 /
Q Date qualification threshold met Date qualification threshold met Date of termination
--1 ::;=::;;:::: 1---OF IC£ OF TH£ CITY CL£Rk
NAME OF COMMITTEE
I.D. Number
(if applicable)
Palm Springs Fire Management Association PAC
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE
Palm Spr_ings CA 92262
-.,FULL MAILING ADDRESS (IF DIFFERENT)
E·MAILAOORESS (REQUIRED)/ FAX (OPTIONAL)
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE
Riverside
113652985
NAME OF TREASURER
Ryan Barrier
STREET ADDRESS (NO P.O. BOX)
CITY
Morongo Valley
AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY
760-323-8181
STREET ADDRESS (NO P.O. BOX)
CITY
NAME OF PRINCIPAL OFFICER(S)
STREET ADDRESS (NO P.O. BDXI
CITY
Attach additional information on appropriately labeled continuation sheets.
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I have used all reasonable diligence in preparing this statement and_to the best of my knowledge the information
penalty of perjury under the laws of the State of Califor~ia that the foregoing
.,.. .......... --•• .. DATE
Executed on By
DATE SIGNATURE OF CONTROLUNG OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, DR STATE MEASURE PROPONENT
. Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
STATE ZIP CODE AREA CODE/PHONE
CA .92256 . --
STATE ZIP CODE AREA CODE/PHONE
STATE ZJP CODE 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
Palm Springs Fire Management Associ~tion PAC
CALIFORNIA 41 Q
FORM
l,D. NUMBER
113652985
• All.committees must list the financial institution where th~ campaign bank accOul"lt is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
Sun Community Federal Credit Union 760~327-7474 ·' 50109510
ADDRESS CITY STATE ZIP CODE
P.O. Box 4210. El Centro. CA 92244
Controlled Committee
• List the name of each controlling officeholder, candidate, or state measure proponent. If candidate or officeholder controlled; also list the elective offfce sought or held, and
district number, if any, and the year of the election. 1
• 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)
(list political party below)
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, STA!E uRECALL" IN FRONT OF THE OFFJCEHOLD.ER'S NAME.
I
CANDIDATE(S) OFFICE SOUGHT OR HELO OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
I
., .
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Palm Springs Fire Management Association PAC
~; !fype.ofComfriJl:fee ... :,Jtontinu.e,i)
CALIFORNIA 41 0
FORM
1.0.NUMBER
113652985
• General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
li2I CITY Committee O COUNTY Committee O STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
SpOnsored Committee List additional sponsors on an attachment.
NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR
Palm Springs Fire Management Association
STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE AREA CODE/PHONE
P.O. Box 1761 Palm Springs CA 92263
Small Contributor Committee •--1--I-~
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 fonds 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,