2018-07-25 Form 460 - Palm Springs ForwardRecipient Committee
Campaign Statement
Cover Page
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from
through 6 �O ZO/ g
1. Type of Recipient Committee: All Committees— Complete Pads 1, 2,3, and 4.
❑ Officeholder, Candidate Controlled Committee
❑ Primarily Formed Ballot Measure
O State Candidate Election Committee
Committee
O Recall
O Controlled
IN=Co"rp'et°Pan s)
O Sponsored
❑ General Purpose Committee
(Afro ca"Abh Part 6)
O Sponsored
❑ Primarily Formed Candidate/
O Small Contributor Committee
Officeholder Committee
0 Political Party/Central Committee
plea C."Ie Pef 7)
3. Committee Information
I.D. NUMBER
'DALVA SP"65; FoRwAl2p l�s cK MamLAR+= V 2017
pij.K 5PRwC.s CA 92�'z �
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAILADDRESS
4. Verification
COVER PAGE
CEIY "_!0rO!fficjaI
Date of election if applicabimt JUL 25 PH 3 07 (Month, Day, Year) L
1E OF i HE CIT Y CL`:.,
2. Type of Statement:
❑ 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
Su*fJ 5 OA-(
#
fain 5pn-.taIFs �; a2w1-
NAME OF ASSISTANT TREASURER, IF ANV�
CITY STATE ZIPCODE AREACODE/PHONE
OPTIONAL: FAX/E-MAILADDRESS
I have used all reasonable diligence in preparing and reviewing this statement and to the best
Candidate, Slate Measure Proponent or Responsible Officer of Sponsor
By Signalize of Controlling Officetrolder, Candidate, Slate Measure Proponent
By
Signature of Controlling Officeholder, Candidate, State Measure Proponent
FPPC Form 460 (Ian/2016)
FPPC Advice: advice@fppc.ra.gov (866/275-3772)
www.fppc.ca.gov
Instructions for
Recipient Committee
Campaign Statement — Cover Page
Period Covered by a Statement:
The "period covered" by a campaign statement
begins the day after the closing date of the last
campaign statement filed. For example, if the
closing date of the last statement was September
30, the beginning date of the next statement will be
October 1.
If this is the committee's first campaign statement,
begin with January 1 of the current calendar year.
The closing date of the statement depends on the
type of statement you are filing.
Date of Election:
If you are filing this statement as a preelection
statement in connection with an election, enter the
date of the election.
Type of Recipient Committee:
Check one box to indicate the type of committee
filing the statement. General descriptions are
provided on the cover sheet to this form, or contact
your filing officer or the FPPC for assistance.
Following are some additional guidelines:
Controlled Committee
• A controlled committee is one that is controlled
by a candidate, officeholder or, in the case
of a state ballot measure committee, by the
proponent of the measure. A committee is
"controlled" if the candidate, officeholder,
or proponent, his or her agent, or any other
committee he or she controls, has a significant
influence on the actions or decisions of the
committee.
Sponsored Committees
Is A sponsored committee is one that has a
sponsor —a business entity, organization,
union, or other entity —that meets certain
criteria. Sponsored ballot measure committees
and general purpose committees must include
the name of the sponsor in the name of the
committee.
Small Contributor Committees
• This term is significant only if the committee
makes contributions to candidates running for
elective state office.
Type -of Statement:
Check the appropriate box(es) to indicate the type
of statement you are filing (or amending).
Amendments; If you are filing an amendment to a
previously filed statement, give a brief explanation
of the amendment and:list the schedules being
amended. Include an amended summary page, if
applicable. Be sure to enter the period covered of
the statement you are amending.
Termination: A committee must continue filing
campaign statements each year until it is eligible to
terminate and files a Form 410 Termination.
Most officeholders must continue filing campaign
statements until they have terminated all controlled
committees and have left office.
Committee I.D. Number:
If the committee has not yet received an
identification number from the Secretary of State,
enter "Not Yet Received." File Form 410 to obtain
an I.D. Number.
Verification:
The statement must be signed by the committee
treasurer or the assistant treasurer named on the
committee's Statement of Organization (Form
410). An officeholder, candidate, or state measure
proponent who controls the committee must also
sign the statement. If two or three officeholders,
candidates, or proponents control the committee,
each must sign the statement. If more than three
control the committee, one may sign on behalf of
the others.
Under certain circumstances, the responsible
officer of a sponsoring organization must sign the
statement.
Additional Important Information:
Refer to the FPPC Campaign Disclosure Manual
for your type of committee for information about:
• When, where, and what type of statements the
committee is required to file.
• Closing date of campaign statements.
• Sponsored committee criteria.
• Termination criteria.
• Recordkeeping requirements and prohibitions.
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Recipient Committee
Campaign Statement
Cover Page — Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP
Related Committees Not Included in this Statement: Ust any committees
not included in this statement that are controlled by you or are primarily formed to receive
contributions or make expenditures on behalf of your candidacy.
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
[:]YES ❑ NO
COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COMMITTEE NAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODEIPHONE
COVER PAGE - PART 2
Page of '3
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
M CA s" ste 7
BALLOT NO. OR LETTER JURISDICTION
D
������ ����SUPPORT
t4rL.A5f 1''t 15 ❑ OPPOSE
loft CCIOW'st
Identify the controlling officeholder, candidate, or state measure proponent, If any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY
7. Primarily Formed Candidate/Officeholder Committee Listnames of
officeholder(s) or candidate(s) for which this committee Is primarily formed.
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE
OFFICE SOUGHT OR HELD
❑ SUPPORT
❑ OPPOSE
Attach continuation sheets if necessary
FPPC Form 460 (1an/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Instructions for
Recipient Committee
Campaign Statement — Cover Page
Officeholder or Candidate Controlled
Committee:
Candidates must have a separate bank account
and committee to run for different elective offices.
A candidate who is required to.fiile..campaign
statements in connection with more than one
elective office but is only receiving contributions
and making expenditures for one of the offices,
may include both offices on one Form 460. In Part
5 of the cover page, enter the candidate's name
and under "Office Sought or Held," identify each
office, and state whether the candidate is seeking
or holding the office. The Form 460 must be filed
with the appropriate filing officer(s) for each office.
For example, a city councilmember is raising funds
to run for the county board of supervisors. She
has no committee and is not raising or spending
funds in connection with the city office, and has
formed a controlled committee for the county office.
To comply with the requirements to file campaign
statements for both her city office and her county
candidacy, she may complete one Form 460 each
campaign reporting period, which she will file with
the city clerk and the county elections department.
In Part 5 of the Form 460 Cover Page, under
"Office Sought or Held," she will state that she is
holding the office of city councilmember (including
the name of the city) and that she is seeking a seat
on the board of supervisors (including the name of
the county).
Ballot Measure Committee:
Part 6 of the Form 460 Cover Page must be
completed by committees that are primarily
formed to support or oppose the qualification or
passage of a single ballot measure or two or more
measures being voted on in the same city, county,
multicounty, or state election. A "general purpose"
ballot measure committee (one that supports
or opposes a variety of state and/or local ballot
measures) is not required to complete Part 6.
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Campaign Disclosure Statement Amounts may be rounded
Summary Page to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
PftM 5?1WJ&5 F-09.v A44> `M5 6t4 tAGAS%k!q.g.
SUMMARY PAGE
Statement co;vr period CALIFORNIA
from
!� 41
through 01 a Page of 3
Contributions Received
Column A
TOTAL THIS PERIOD
Column B
CALENDAR
(FROM ATTACHED SCHEDULES)
YEAR
TOTAL TO DATE
Q
O
1. Monetary Contributions...................................................
Schedule A, Line
$ $
2. Loans Received .................... ............................................
Schedule B. Line 3
O
O
3. SUBTOTAL CASH CONTRIBUTIONS ...........................
... Add Lines 1 +2
$ O $
O
4. Nonmonetary Contributions ............................................
Schedule C, Line 3
O
C:)
5. TOTAL CONTRIBUTIONS RECEIVED....................................Add Lines 3 + 4
$ O $
0
Expenditures Made
6. Payments Made................................................................ Schedule E, Line 4
$
$
7. Loans Made................................................................... Schedule H, Line 3
0
0
8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6+7
$
O
$ O
9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3
O
.....................
10. Nonmonetary Adjustment......................................................... Schedule C, Line 3
6
D
11. TOTAL EXPENDITURES MADE ........................................ Add Lines 8 + 9 + 10
$
$
Current Cash Statement
35
12. Beginning Cash Balance """""""""""""" Previous Summary Page, Line 16
$
^""' •'
To calculate Column B,
13. Cash Receipts........................................................... Column A, Line 3 above
add amounts in Column
O
Ato the corresponding
14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4
amounts from Column B
15. Cash Payments Column A, Line 8 above
Q
of your last report. Some
35
amounts in Column A may
16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract line 15
$
be negative figures that
should be subtracted from
If this is a termination statement, Line 16 must be zero.
previous period amounts. If
this is the first report being
17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Part 2
$
filed for this calendar year,
only carry over the amounts
from Lines 2, 7, and 9 (if
Cash Equivalents and Outstanding Debts
O
any)'
18. Cash Equivalents ................................................ See instructions on reverse
$
19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above
$
I.D. NUMBER
!3 q 1sz
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 Total to Date
(mm/dd/yy)
*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
Instructions for
Summary Page
Campaign Disclosure Statement
The Summary Page provides an overview of the
committee's financial activities and is completed for
each filing.
Column A reflects activities during the current
reporting period as reported on Schedules A
through H. It is not necessary to attach a blank
schedule if there has been no reportable activity
during the period, but it is necessary to enter a
zero or the word °none" on the appropriate line in
Column A of the Summary Page.
Column B figures should reflect the cumulative
total since January 1 of the current calendar
year.* Add the totals from Column B of the
committee's last campaign statement (if any) to the
corresponding amounts in Column A. If this is the
first report being filed for a calendar year, only carry
forward the amounts reported on Lines 2, 7, and
9 of Column B (if any) from the committee's last
statement. (Note: The amounts reported on Lines
2, 7, and 9 of Column B should be the same as
the total outstanding amounts disclosed in column
(d) of Schedules B, F, and H, respectively, of the
current report.)
When loans (Schedules B and H) and accrued
expenses (Schedule F) are paid, the figures to
be carried from the schedules to Lines 2, 7, and
9 of Column A may be negative numbers. In this
case, be sure to show them as negative figures on
the Summary Page (e.g., with a minus sign (-) or
in parentheses), and subtract them when totaling
Columns A and B.
*There are exceptions to the calendar year
°cumulation period" for candidate elections and
ballot measure elections held in January and early
February, and for ballot measure qualification
activities. Consult the FPPC Campaign Disclosure
Manual for your type of committee for additional
information.
Current Cash Statement:
Lines 12-16 of the Summary Page should
accurately reflect your current cash position.
Beginning and ending cash balances should
include the total amount of funds in your campaign
checking and savings accounts, plus any
investments that can be readily converted to cash,
such as certificates of deposit, money market
accounts, stocks and bonds, etc. (Officeholders
and candidates are subject to bank account
restrictions, and all committees should read the
FPPC Campaign Disclosure Manual regarding
appropriate uses of campaign funds.)
Line 12 (Beginning Cash Balance) must be the
same as the ending cash balance reported on Line
16 of your previous statement's Summary Page. If
this is your first campaign statement, enter zero on
Line 12.
Line 16 (Ending Cash Balance) is the total of Lines
12, 13, and 14, minus Line 15.
If you are filing a termination statement, Line 16
must be zero.
Cash Equivalents:
"Cash equivalents" include investments that cannot
be readily converted to cash, as well as the balance
due on all outstanding loans the committee has
made to others (from Line 7 of Column B of the
Summary Page). Investments that can be readily
converted to cash, such as certificates of deposit or
money market funds, should be included in the cash
on hand figures on Lines 12 and 16 of the Summary
Page.
Summary for Primary and General
Elections (Lines 20 and 21):
This section is only for committees that are:
• Controlled by a candidate who is being voted on
in both the state primary and general elections
(does not apply to controlled ballot measure
committees); or
• Primarily formed to support or oppose
candidates being voted on in both the state
primary and general elections.
Complete this summary on the preelection and
semi-annual statements for the general election,
covering periods during the last six months of the
year (July 1 — December 31).
Expenditure Ceiling Summary for State
Candidates (Line 22):
Candidates for elective state office who have
accepted the voluntary expenditure ceiling for a
particular election must disclose the total amount of
expenditures made through the end of the reporting
period that are subject to the expenditure ceiling
for the election. Report the date of the election
and total amount expended for that election.
Report totals for the primary and general elections
separately. This information is no longer required if
the expenditure ceiling has been lifted. (See FPPC
Campaign Disclosure Manual 1.)
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov