2019-01-09 Form 460 - PS Fire Safetyr Recipient Committee
Campaign Statement
Cover Page
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from __ O_c_t_o_be_r_2_1_,_2_0_1_8_
December 31, 2018
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
(JIJso Complete Pert 5)
liZl General Purpose Committee
® Sponsored
0 Small Contributor Committee
0 Political Party/Central Committee
3. Committee Information
0 Controlled
0 Sponsored
(Also Complete Pert 6)
D Primarily Formed Candidate/
Officeholder Committee
(Also Complete Pert 7)
I.D. NUMBER
881536
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Palm Springs Fire Safety Association PAC
STREET ADDRESS (NO P.O. BOX)
CITY
Yucaipa
STATE ZIP CODE
CA 92262
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE
OPTIONAL: FAX I E-MAIL ADDRESS
4. Verification
AREA CODE/PHONE
(
AREA CODE/PHONE
Date Stamp
: !
Date of election if applicable:
CALIFORNIA
FORM
Page _ __;__
•
460
of 3
(Month, Day, Year) 20 JhH -9 Pll 2: 16 For Official Use Only
I
j -· November 6, 2018
2. Type of Statement:
D Preelection Statement
!;ll Semi-annual Statement
D Termination Statement
I, 1 ....
(Also file a Form 410 Termination)
D Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
Brandon Wright
MAILING ADDRESS
CITY
Yucaipa
NAME OF ASSISTANT TREASURER, IF ANY
Damien Myers
MAILING ADDRESS
CITY
Temecula
OPTIONAL: FAX I E-MAIL ADDRESS
D Quarterly Statement
D Special Odd-Year Report
STATE ZIP CODE
CA 92262
STATE
CA
ZIP CODE
92592
AREA CODE/PHONE
(
AREA CODE/PHONE
(
I have used all reasonable diligence in preparing and reviewing this statement and to the best of
Executed on 1/8/2019
Date
Executed on
Date
Executed on
Date
Executed on
Date
By
By
By
By
Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor
Signature of Controlling Officeholder. Candidate. State Measure Proponent
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
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Palm Springs Fire Safety 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 .................................... Add Lines 3 + 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
1 0. Nonmonetary Adjustment.. ....................................................... Schedule c. Line 3
11. TOTAL EXPENDITURES MADE. ....................................... AddLinesB+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 B 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
18. Cash Equivalents................................................ See instructions on reverse $
19. Outstanding Debts.............................. Add Line 2 +Line 9 in Column B above $
Amounts may be rounded
to whole dollars.
Column A
TOTAL THIS PERIOD
(FROM ATIACHED SCHEDULES)
3360
3360
3360
5361.85
3360
8721.85
SUMMARY PAGE
Statement covers period
from __ o_c_t_o_b_e_r 2_1_,_2_0_1_8_
CALIFORNIA 460
FORM
through December 31,2018 Page __ 2_ 01 __ 3_
$
$
$
$
$
$
Column B
CALENDAR YEAR
TOTAL TO DATE
9944.69
9944.69
9944.69
2196.81
2196.81
2196.81
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).
1.0. NUMBER
881536
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 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@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
• Schedule A SCHEDULE A
Monetary Contributions Received
Amounts may be rounded
to whole dollars. Statement covers period CALIFORNIA 460
FORM from __ o_c_t_o_be_r_2_1_,_2_0_1_8_
SEE INSTRUCTIONS ON REVERSE
through December 31, 2018 Page_3 __ of __ 3_
NAME OF FILER
Palm Springs Fire Safety Association PAC
DATE
RECEIVED
11/23/18
12/23/18
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR
(IF COMMITIEE. ALSO ENTER 1.0. NUMBER) CODE *
Palm Springs Fire Safety Association
180 N Luring Dr.
Palm Springs, CA 92262 #881536
Palm Springs Fire Safety Association
180 N Luring Dr.
Palm Springs, CA 92262 #881536
DIND
0COM
DOTH
0PTY
Osee
OIND
OCOM
DOTH
DPTY
Osee
DIND
DcoM
DOTH
DPTY
Osee
OIND
0COM
DOTH
DPTY
Osee
DIND
0COM
DOTH
DPTY
Osee
Schedule A Summary
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED. ENTER NAME
OF BUSINESS)
AMOUNT
RECEIVED THIS
PERIOD
$1680
$1680
SUBTOTAL $ 3360
1. Amount received this period -itemized monetary contributions.
(Include all Schedule A subtotals.) ......................................................................................................... $ _____ 3_3_6_0
2. Amount received this period -unitemized monetary contributions of less than $100 ........................... $ _______ o
3. Total monetary contributions received this period.
(Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ...................... TOTAL $ _____ 3_3_6_0
I.D. NUMBER
881536
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
PER ELECTION
TO DATE
(IF REQUIRED)
*Contributor Codes
IND -Individual
COM -Recipient Committee
(other than PTY or SCC)
OTH-Other (e.g., business entity)
PTY-Political Party
SCC -Small Contributor Committee
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov