2020-01-09 Form 460 - Palm Springs ForwardRecipient Committee
Campaign Statement
Cover Page
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from __ 7_/_1 /_1_9 ____ _
through 12/3 1 /20
1. Type of Recipient Committee: All Committees-Complete Parts 1 , 2, 3 , and 4 .
D Officeholder, Candidate Controlled Committee
0 State Candidate Election Committee
0 Recall
(Nso Ccmplete Pait 5)
Ill General Purpose Committee
0 Sponsored
0 Small Contributor Committee
0 Political Party/Central Committee
3. Committee Information
D Primarily Formed Ballot Measure
Committee
0 Controlled
0 Sponsored
(Also Ccmp/ele Po~ 6)
D Primarily Formed Candidate/
Officeholder Committee
(Nso Ccmp/el• Part 7)
1.0. NUMBER
1399524
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Palm Springs Forward
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE
Palm Springs CA 92262
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE ZIP CODE
OPTIONAL: FAX / E-MAIL ADDRESS
4 . Verification
AREA CODE/PHONE
AREA CODE/PHONE
COVER PAGE
Date Stamp
CALIFORNIA 460
FORM Cl
RECEIVE D
Y OF P.t\LH SPRIN
Pa ge __ 1__ of 2
Date of election If applicabt92 20 JAN _ g PM S: J -.----------1
(Month, Day, Year) For Official Use Only
OF ICE OF THE CITY CL E i;
2. Type of Statement:
D Preelection Statement
1;21 Semi-annual Statement
D Termination Statement
(Also fil e a Form 410 Termination )
D Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
John Shay
MAILING ADDRESS
CITY
Palm Springs
NAME OF ASSISTANT TREASURER, IF ANY
Chris Lu cker
MAILING ADDRESS
D Quarterly Statement
D Special Odd-Year Report
STATE ZIP CODE
CA 92262
AREA CODE/PHONE
CITY
Palm Springs,
OPTIONAL: FAX/ E-MAIL ADDRESS
STATE
CA
ZIP CODE
92262
AREA CODE/PHONE
I have used all reasonable diligence in preparing and reviewing this statement and to the
in the attached schedules is true and complete.
Executed on /-&j. 2,Q By
Date
Execu ted on
Oata
By
Executed on
Date
By
Executed on By
Date
Signature of Controlling Officeholder, Candidate, State Measure Proponen t or Reaponslbte Officer of Sponsor
Signature of Controlling Officeholder, Candidate, State Measure Proponent
Signature of ControU,ng Officeholder, Candidate , State Measure Proponent
FP PC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/27S-3772)
www.fppc.ca.gov
Campaign Disclosure Statement
Summary Page
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Palm Springs Forward
Contributions Received
1. Monetary Contributions................................................... Schedule A, Line 3
2. Loans Received ................................................................ Schedule 8, Lfne3
3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add unos 1 + 2
4. Nonmonetary Contributions............................................ Schedule c, Line 3
5. TOTAL CONTRIBUTIONS RECEIVEQ ____ .... , ...... Add Unes 3 + 4
Expenditures Made
$
$
$
6. Payments Made................................................................ Schedule E, Lina 4 $
7. Loans Made....................................................................... Schedule H, Una 3
8. SUBTOTAL CASH PAYMENTS .......................................... Add Unes 6 + 7 $
9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F, Una 3
10. Nonmonetary Adjustment.. ...... ---·----......... Schedule c, Une 3
11. TOTAL EXPENDITURES MADE ....................................... AddUnesB+9+ 10 $
Current Cash Statement
12. Beginning Cash Balance ............................ Previous summary Page, Line 16 $
13. Cash Receipts ........................................................... Column A, Lins 3 above
14. Miscellaneous Increases to Cash .................................. Schedule I, Line 4
15. Cash Payments ......................................................... Column A. Una a above
16. ENDING CASH BALANCE .................. Add Lines 12 + 13 + 14, than subtract Lina 15 $
If this is a termination statement, Une 16 must be zero.
17. LOAN GUARANTEES RECEIVED................................ Schedule B, Pert 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents................................................ See Instructions on reverse $
19. Outstanding Debts.............................. Add Line 2 + Lina 9 In Column B above $
Amounts may be rounded
to whole dollars.
Column A
TOTAL THIS PERIOD
(FROM ATTACHED SCHEDULES)
0
0
0
0
0
0
0
0
0
0
0
211.35
0
0
0
211.35
0
0
0
SUMMARY PAGE
Stateritent covers period
from 7/1/19
CALIFORNIA 460
FORM
through 12/31 /20 Page __ 2 __ of 2
$
$
$
$
$
$
Column B
CALENDAR YEAR
TOTAL TO DATE
0
0
0
0
0
50.00
0
50.00
0
0
50.00
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).
I.•. NUMBER
1399524
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 Expendllure Limit)
Date of Election
(mm/dd/yy)
__}__} __
__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: advlce@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov