2019-10-24 Form 460 - PS Fire SafetyRecipient Committee
Campaign Statement
Cover Page
SEE INST RUC TIO NS ON REVERS E
St at ement cover s p er i od
from ____ 9_/2_2_/_19 __ _
10/19/19 t h r oug h ________ _
1. Type of Re cipient Committee : A ll Committees -Compl ete Parts 1, 2, 3, and 4.
D Officeholder, Candidate Controlled Committee
0 State Ca ndidate Election Committee
0 Re call
(Also Comp/olo Pllfl SJ
~ General Purpose Committee
® Sponsored
0 Small Contributor Committee
0 Political Party/Central Committee
3 . Committee Information
D P rimarily Formed Ballo t Measure
Committee
0 Controlle d
0 Sponsore d
(Also Comp/ere Part 6)
D Primarily Formed Candidate/
Officeholde r Committee
(Also ComplelO Pan 7/
I.D. NUMBER
881536
COMMITTEE NA ME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Pa lm Spring s Fir Safety Association PAC
STREET ADDRESS (NO P.O. BOX)
CITY
Pa lm Springs
STATE ZIP C ODE
CA 92262
MAILING ADDRESS (IF DIFFER ENT) NO. A ND STREET O R P.O. BOX
CITY STATE ZIP CODE
O PTIONAL: FAX / E-MAIL ADDRESS
4 . Verification
AREA CODE/PHONE
AREA CODE/PHONE
Date Stamp~
COVER PAGE
CALIFORNIA 460
FORM
Date of el ect ion if ap plicabl e:
(Mo nth, Da y, Year)
RECEI V ED
IT Y OF PI, L H SP RI ~ge -
1-of __ 5.:..__
For Official Use Only
11 /5/19
2019 OCT 21+ AM 8: 31
FFICE OF THE CITY CL :R
2. Typ e of St atement:
lt2l Preelection Statement
D Semi-annual Statem ent
D Termination Statement
(Also fil e a Form 410 Termi nation)
D Amendment (Explain be low)
Tre asurer(s)
NAME OF TREASURER
Brandon Wright
MAILING ADDRESS
CITY
Yucaipa
NAME OF A SS ISTANT TREASURER, IF ANY
Damie n Myers
MAILING ADDRESS
CITY
Temecu la
OPTIONAL: FAX / E-MAIL ADDRESS
D Quarterly Statement
D Spec ial Odd-Year Report
STATE ZIP CODE AREA CODE/PHONE
CA 92399
STATE ZIP CODE AREA CODE/PHONE
CA 92592
I have us ed all rea sonable diligence in preparing and reviewing this s tatement and to the best of my knowl edge the information contained herein and in th e attached schedules is true and com ple te.
certify under penalty of perjury under th e law s of th e State of C alifornia that th e foregoing is true and
Executed on 10/24/19
Date
Executed on
Date
Executed on
Dato
Executed on
Dato
By
By
B y
By
Signature of Controlling Offiooholder. Candidate, State Measure Proponent or Responsible Officer of Sponsor
Signature of Controlling Officeholder. Candidate , State Measure Proponen t
Signature o r Controlling Officeholder, Candidate, Stato Me as uro Proponent
FPPC Form 460 (J an/2016)
FPPC Advice: ad vi ce@f ppc.ca .go v (866/275-3772)
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, Une 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, Une 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. ....................................... AddLines8+9+10 $
Current Cash Statement
12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $
13. Cash Receipts ........................................................... Column A, Une 3 above
14. Miscellaneous Increases to Cash.................................. Schedule 1, Une 4
15. Cash Payments......................................................... Column A, Une B above
16. ENDING CASH BALANCE .................. Add Lines 12 + 13 + 14, then subtracl Line 15 $
If this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Parl 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents................................................ See instructions on reverse $
19. Outstanding Debts.............................. Add Une 2 + Line 9 in Column B above $
Amounts may be rounded
to whole dollars.
Column A
TOTAL THIS PERIOD
{FROM ATTACHED SCHEDULES)
1650
1650
1650
$
$
$
SUMMARY PAGE
Statement covers period
9/22/19 from ________ _
CALIFORNIA 460
FORM
2 5 10/19/19 through _______ _ Page ___ of __ _
Column B ·
CALENDAR YEAR
TOTAL TO DATE
16560
16560
16560
I.D. 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 $ ____ _ $ ____ _
5996.57 $ 6788.70
Expenditure Limit Summary for State
Candidates
5996.57 $ 6788.70
5996.57 $ 6788.70
20839.72
1650
5996.57
16493.15
To calculate Column 8,
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).
22. Cumulative Expenditures Made•
(ff Subject to Voluntary Expenditure Limit)
Date of Election
(mm/dd/yy)
Total to Date
$ ____ _
$ ____ _
*Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (Jan/2016)
FPPC Advic~: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule A
Monetary Contributions Received
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Palm Springs Fire Safety 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)
10/15/19
Palm Springs Firefighters Association
180 N. Luring Dr
Palm Springs, CA 92262
ID# 881536
Schedule A Summary
•IND
!!]COM
00TH •PTY •sec
•IND •COM
DOTH
OPTY •sec
•IND •COM
DOTH •PTY •sec
•IND •COM
00TH •PTY •sec
•IND •COM
00TH •PTY •sec
SUBTOTAL$
SCHEDULE A
Statement covers period
CALIFORNIA 460
FORM from ____ 9/_2_2/_1_9 __ _
th h 10/19/19 roug _______ _ Page __ 3 __ of __ 5 __
AMOUNT
RECEIVED THIS
PERIOD
$1650
I.D.NUMBER
881536
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN. 1 -DEC. 31)
16560
PER ELECTION
TO DATE
(IF REQUIRED)
*Contributor Codes
IND -Individual 1. Amount received this period -itemized monetary contributions.
(Include all Schedule A subtotals.) ......................................................................................................... $ _____ 1_6_5_0 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, C9lumn A, Line 1.) .... '. ................. TOTAL $ _____ 1_6_5_0
sec -Small Contributor Committee
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 Safety Association PAC
DATE
10/7/19
10/8/19
NAME 6F CANDIDATE, OFFICE, AND DISTRICT, OR
MEASURE NUMBER OR LETTER AND JURISDICTION,
OR COMMITTEE
Dennis Woods, City Council, District 2
D Support D Oppose
Les Young, City Council, District 1
D Support D Oppose
D Support D Oppose
Schedule D Summary
Amounts may be rounded
to whole dollars.
TYPE OF PAYMENT
iZI Monetary
Contribution
• Non monetary
Contribution
• Independent
Expenditure
iZI Monetary
Contribution
• Nonmonetary
Contribution
• lndeperident
Expenditure
• Monetary
Contribution
• Nonmonetary
Contribution
• Independent
Expenditure
DESCRIPTION
(IF REQUIRED)
SUBTOTAL $
Statement covers period
from ------'9""/2cc2/=--c1..c.9 __ _
through __ 1cc0c../1'-9"-/-'-19"----c-
SCHEDULED
CALIFORNIA 460
FORM
Page __ 4_ of __ 5_
I.D.NUMBER
881536
AMOUNT THIS
PERIOD
CUMULATIVE TO DATE
CALENDAR YEAR
(JAN.1 -DEC. 31)
PER ELECTION
TO DATE
(JF REQUIRED)
$1000 $2000
$1000 $3000
20001
1. Itemized contributions and independent expeaditures made this period. (Include all Schedule D subtotals.) ....................................................... ·$ ---~2=0=0=0~
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 .. $ ----~2~00=0~
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
r· •
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Palm .~prings Fire Safety Association PAC
Amounts may be rounded
to whole dollars.
. .
Statement covers period
from ___ 9_/2_2_/1_9 __ _
through __ 1_0_/_1_9/_1_9 __
SCHEDULE E
CALIFORNIA 460
FORM
Page_5 __ of_5 __
I.D. NUMBER
881536
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 consultants
contribution (explain nonmonetary)*
civic donations
candidate filing/ballot fees
fundralslng events
Independent expenditure supporting/opposing others (explain)*
legal defense
campaign literature and mailings
. NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
MBR member communications
MTG meetings and appearances
OFC office expenses
PET petition circulating
PHO phone banks
POL polling and survey research
POS postage, delivery and messenger services
PRO professional services (legal, accounting)
PRT print ads
CODE OR
RAD radio airtime and production costs
RFD returned contributions
SAL campaign workers' salaries
TEL t.v. or cable airtime and production costs
TRC candidate travel, lodging, and meals
TRS staff/spouse travel, lodging, and meals
TSF transfer between committees of the same candidate/sponsor
VOT voter registration
WEB information technology costs (internet, e•mail)
DESCRIPTION OF PAYMENT
.
AMOUNT PAID
UPS Store, 301 N Palm Canyon, Palm Springs, CA 92262 Overnight shipping
POS $66.24
City Clerk, 3200 Tahquitz Canyon, Palm Springs, CA 92262 Late fee for 1st 460 form
OFC $50
Firefighters Print & Design, 1780 Creekside Oaks, Sacramento, CA 95833 Mailers
PRT $3880.33
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$
Schedule E Summary
3996.57 1. Itemized payments made this period. (Include all Schedule E subtotals.) .................................................................. , .......................................... $ _____ _
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).) ............................................................................. $ _____ _
3996.57 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: advice@fppc,ca.gov (866/275-3772)
www.fppc.ca.gov