2021-01-27 Form 460 - PS Fire ManagementRecipient Committee
Campaign Statement
Cover Page
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from 74
/ 2 o
through Z 3/ Z
1. Type of Recipient Committee: All committees — complete Parts 1, 2, 3, and 4.
❑ Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure
0 State Candidate Election Committee Committee
0 Recall 0 Controlled
(Also Complete Part 5) 0 Sponsored
(Also Complete Part 6)
❑ General Purpose Committee
Sponsored ❑ Primarily Formed Candidate/
Small Contributor Committee Officeholder Committee
0 Political Party/Central Committee (Also Complete Part7)
3. Committee Information
I.D. NUMBER
1zLi i
70W9
PA/41 �pi-i i file /1/11Rne)IAA.�- —1ASe<<wAa-1
STREET ADDRESS (NO P.O. BOX)
300
STATE ZIP CODE AREA CODE/PHONE
p�c So,2/,+rv5 CA 9224,2- (?600307-(
ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
rib &
nn STATE ZIP CODE AREA CODE/PHONE
r_/O'er`- �'A i,? Z6, 3
OPTIONAL: FAX / E-MAIL'ADDRESS
Date of election if applicable:
COVER PAGE
Date Stamp
RECEIVED
OF PALM SPR1UGS Page � of 3
(Month, Day, Year) 2021 WAN 27 PM 12: 4 5
iMCF OF THE CITY CL
2. Type of Statement:
For Official Use Only
❑ Preelection Statement ❑ Quarterly Statement
® Semi-annual Statement ❑ Special Odd -Year Report
❑ Termination Statement
(Also file a Form 410 Termination)
❑ Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
6e-
MAILING ADDRES
STATE ZIP CODE AREA
ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
4. Verification
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the
on By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor
Executed on By
Date Signature of Controlling Officeholder, Candidate, Stale Measure Proponent
Executed on By
Date Signature of Controlling Officeholder, Candidate, State Measure Proponent
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Campaign Disclosure Statement
Summary Page
Amounts may be rounded
to whole dollars.
Statement co ers period
from Z v
SUMMARY PAGE
SEE INSTRUCTIONS ON REVERSE through 1 L,; 2 Page z of
NAME OF FILER I.D. NUMBER
Q /Lt Si�21RJC�; %l�E �i�.t�ifG t nrr Sc � / ZYf t:'f
Column A Column B Calendar Year Summary for Candidates
Contributions Received TOTAL THIS PERIOD CALENDAR YEAR
(FROM ATTACHED SCHEDULES) TOTAL TO DATE Running in Both the State Primary and
General Elections
1. Monetary Contributions................................................... Schedule A, Line 3 $ $ 1/1 through 6/30 7/1 to Date
2. Loans Received................................................................ Schedule a, Line 3
3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 + 2 $ $ 20. Contributions
Received $ $
4. Nonmonetary Contributions ............................................ Schedule C, Line 3 21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED................................Add Lines 3+4 $ $ Made $ $
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 Summary Page, Line 16
13. Cash Receipts........................................................... column A, Line 3 above
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, then subtract Line 15
if this is a termination statement, Line 16 must be zero.
8 � S
$ _ 577 - °7-
,IL
$ SN_ /y
17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Part 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ................................................ See instructions on reverse $
19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $
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 is the first report being
filed for this calendar year,
only carry over the amounts
from Lines 2, 7, and 9 (if
any).
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made"
(If Subject to Voluntary Expenditure Limit)
Date of Election Total to Date
(mm/dd/yy)
�J $
1� $
Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule I „, „tie--A-A Sr.Hpnin F I
Miscellaneous Increases to Cash to whole dollars.
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from �'
through %o�
CALIFORNIA
FORM .1
Page 7 of .3
NAME OF FILER
P 41, sWIZ s � ass .
I.D. NUMBER
izZI/ '�-k17'?
DATE
RECEIVED
FULL NAME AND ADDRESS OF SOURCE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
DESCRIPTION OF RECEIPT
AMOUNT OF
INCREASE TO CASH
Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $
Schedule
1. Itemized increases to cash this period . ........................................................................................................................... $
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
SummaryPage, Line 14.)............................................................................................................................. TOTAL $
�z
FPPC Form 460 (Jan/2016))
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov