2019-08-05 Form 410 - PS Fire Management✓
Statement of Organization Date Stamp
Recipient Committee =----------r=---------=----------1 Statement Type D Initial li2I Amendment D Termination -See Part 5
0 Not y et qualified
or
0 Date qualification threshold met Date qualifica tion threshold met Date of termination ___ , __ _,, __ _ ---,/---,•---___ , ____ , __ _
1. Committee Information 1.0. Number
(if applicable)
2. Treasurer and Other Principal Officers
NAM E OF COMMITTEE NAM E OF TR[ASUR[R
Palm Springs Fire M anagement Assoc iation PAC Ryan Barrier
STR EET ADDRESS (ND PO BOXI
STR EE T ADDRESS (NO P,0 BOX) CITY
M orongo Va ll ey
CITY STAT£ ZIP CODE ARCA CODE/PHONE NAME OF ASSISTANT TREASURER , IF ANY
Palm Spri ngs CA 92262 7 60-323-8 181
ruu MAILIN G ADDRESS (IF OlrF[R(NTI 5rREET ADDR ESS (NO PO BOXI
COU NTY OF DO M ICILE JURISDICTIO N WH ERE COMMITTEE IS ACTIVE NAME OF PR INCIPAL OFFIC ER(S)
Rivers id e
STREE, ADDRESS (NO P.O. BOXJ
CITY
Attach additional information on appro priately labeled co ntinuation sheets.
3. Verification
STATE ZIP COD[
CA 92256
SlA IE 71P CODE
STATE LIP CODE
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I have u sed all r easo nable diligence in preparing this st at ement and to the best
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SIG NArUR[ OF CONTROLLING Off ICE HOLDER , CANDI0/11[, OR STATE MEASURE PROPONENl
SIGNATUR E OF CONTROLLING Orr!CEHOLDER, CANDIDATE. OR STATE MEASURE PROPONENT
SIGtMTUR( or CONTROLLING OrFICEHOLOER. CANDIDATE , OR STATE M[ASU R[ PROPONENT
FPPC Form 410 (Au gust/2018)
FPPC Advice: a dvice@fppc .ca.gov (866/275-3772)
www.fppc.ca.gov
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Statement of Organization
Recipient Committee
··CALIFORNIA 41 Q
FORM
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Palm Springs Fire Management Association PAC
I
I
• All committees must list the financial institution where the campaign bank account is located. . . . I
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE
Sun Community Federal Credit Union 760-327-7474
ADDRESS CITY
P.O. Box 4210 El Centro
Controlled Committee
1.0. NUMBER
113652985
BANK ACCOUNT NUMBER
50109510
STATE ZIP CODE
CA 92244
. .
• List the name of each controlling officeholder, candid~te, or state measure proponent, If candidate or officeholder controlled, also list the elective office sou~ht 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
' • ' Nonpartisan
·, •
Primarily Formed Committee
I '
Primarily formed to s~pport Or oppose specific candidates or measures in-a single election. List below:
• I
• I '
CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO.·OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE{S) JURISDICTION
IF A RE_CALL, STATE "RECALL" IN FRONT OF THE OFFICEHO(DER'S NAME. (INCLUDE DISTRICT NO., ~ITV OR COUNTY, AS APPLICABLE)
' '1
'(
,{'
(
Partisan • Partisan •
(list political party below)
(list political party below)
CHECK ONE
T O•
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov {866/275-3772)
www.fppc.ca .. gov
....... ('
Statel}le.nlof Organization
Recipient Committee
INSTRIJCTIONS ON REVERSE
COMMITTEE NAME I
Palm Springs Fire Management Association PAC
CALIFORNIA 41 Q
FORM
I.D. NUMBER
113652985
iJ: TYP!L of Committee ___ _
General Purpose Committee
(Continued) r , . . . -:-. ----_--, -----~----':_:.,,·,--''-=''"---'·'---
Not formed to support or oppose specific candidates or measures m a single election·. Check only on~ box:
li2l CITY Committee l D COUNTY Committee D STATE 1 Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
Sponsored Committee List additional sponsors o~. an attachment.
NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR
Palm Springs Fire Management Association
STREET ADDRESS NO. AND STREET CITY
P.O. Box 1761 Palm Springs
Small Contributor Committee •--·,/ 1--
oate qua!ified
1
STATE
I
CA
ZIP CODE AREA CODE/PHONE
92263
s:,'T!t•JJ!ri~!!O_!!; Req~J(~~ents; , _; -BY sr!'!!!!gthe v~ri.~cati~n, the:treaSurer, asslstilnt tr_e.asUrer ~nd/o_r-iandldate, (Jfftceho14er, _ _or proporlent certify that SIi of_th_e (o]lowin!(.S~~~~~;been 'll)et:;, ,_~; .,, j
• This committee has ceased to receive contributiohs and make expenditures;
' I • This.committee does not anticipate receiving contributions or making expenditures in the future;
• This committee has eliminated or has no intentio~ or ability to discharge all debts, loans received, and qther 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 surrlus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government
Code Section 89519. 1 •
I
Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code Sections 89511-89518, and are
I
subject to Elections.Code Section 18680 and F PC Regulation 18521.5.
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov