2021-01-27 Form 425 - Palm Springs ForwardSemi -Annual Statement of No Activity
Type or print in ink.
For use by recipient committees that have not received any contributions and have not made any expenditures
during the six-month period covered by a semi-annual statement. Candidate controlled committees formed for an
elective office may not use this form.
See the Information Manual on Campaign Disclosure Provisions of the Political Reform Act for additional information
and information required to be provided to you pursuant to the Information Practices Act of 1977.
1. Committee Information
Palm Springs Forward
1399524
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
Palm Springs CA 92262
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET
CITY
OPTIONAL: FAX/E-MAIL ADDRESS
2. Period of No Activity
STATE ZIP CODE AREA CODE/PHONE
Treasurer(s)
NAME OF TREASURER
John Shay
MAILING ADDRESS
STATEMENT OF NO ACTIVITY
;IT Y OFrPA L 1 S�PRI
2021 A14 27 AM 8: 9
TICE OF THE CITY CL
CITY STATE ZIP CODE AREA CODE/PHONE
Palm Springs CA 92262
NAME OF ASSISTANT TREASURER, IF ANY
Chris Lucker
MAILING ADDRESS
CITY STATE ZIP CODE AREACODE/PHONE
Palm Springs CA 92262
OPTIONAL: FAX/E-MAIL ADDRESS
No contributions have been received and no expenditures have been made during the period covering the dates below:
Check one of the following boxes and complete the year. ❑ January 1, through June 30, 20 m July 1, through December 31, 20 20
3. Verification
I have used all reasonable diligence in preparing this statement. I have reviewed the
TREASURER
FPPC Form 425 (Jan/01)
FPPC Toll -Free Helpline: 866/ASK-FPPC
866/275-3772
Semi -Annual Statement of No Activity Type or print in ink. Date Stamo STATEMENT OF NO ACTIVITY
For use by recipient committees that have not received any contributions and have not made any expenditures
during the six-month period covered by a semi-annual statement. Candidate controlled committees formed for an
elective office may not use this form.
See the Information Manual on Campaign Disclosure Provisions of the Political Reform Act for additional information
and information required to be provided to you pursuant to the Information Practices Act of 1977.
1. Committee Information
Palm Springs Forward
1399524
STREET ADDRESS (NO P.O. BOX)
400 East Tahquitz Canyon Way
CITY STATE ZIP CODE AREACODE/PHONE
Palm Springs
CA 92262
MAILING ADDRESS (IF DIFFERENT) NO, AND STREET
CITY
OPTIONAL: FAX/E-MAIL ADDRESS
clucker@luckeranderson.com
2. Period of No Activity
STATE ZIP CODE AREACODE/PHONE
Treasurer(s)
NAME OF TREASURER
John Shay
MAILING ADDRESS
400 East Tahqiotz Canyon Way
CITY
STATE ZIP CODE AREACODE/PHONE
Palm Springs CA 92262
NAME OF ASSISTANT TREASURER, IF ANY
Chris Lucker
MAILING ADDRESS
1801 East Tahquitz Canyon Way
CITY STATE ZIPCODE AREACODE/PHONE
Palm Springs CA 92262 310 489 1605
OPTIONAL: FAX I E-MAIL ADDRESS
No contributions have been received and no expenditures have been made during the period covering the dates below:
20
Check one of the following boxes and complete the year. ❑ January 1, through June 30, 20 m July 1, through December 31, 20 —
3. Verification _
I have used all reasonable diligence in preparing this statement. I have reviewed the statement and to the of
is true and complete. I certify under penalty of perjury under the laws of the State of California that tke foy§gbing i
Executed on
January 18, 2021
DATE
By
!dge the information contained herein
correct.
R/ASSISTANT TREASURER
FPPC Form 425 (Jan/01)
FPPC Toll -Free Helpline: 866/ASK-FPPC
866/275-3772
Semi -Annual Statement of No Activity Type or print in ink. Date Stamp STATEMENT OF NO ACTIVITY
For use by recipient committees that have not received any contributions and have not made any expenditures
during the six-month period covered by a semi-annual statement. Candidate controlled committees formed for an
elective office may not use this form.
See the Information Manual on Campaign Disclosure Provisions of the Political Reform Act for additional information
and information required to be provided to you pursuant to the Information Practices Act of 1977.
1. Committee Information
Palm Springs Forward
1399524
STREET ADDRESS (NO P.O. BOX)
400 East Tahquitz Canyon Way
CITY STATE ZIP CODE AREA CODE/PHONE
Palm Springs
CA 92262
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX/E-MAIL ADDRESS
clucker@luckeranderson.com
2. Period of No Activity
Treasurer(s)
NAME OF TREASURER
John Shay
MAILING ADDRESS
400 East Tahqiotz Canyon Way
CITY
STATE ZIP CODE AREA CODE/PHONE
Palm Springs CA 92262
NAME OF ASSISTANT TREASURER, IF ANY
Chris Lucker
MAILING ADDRESS
1801 East Tahquitz Canyon Way
CITY STATE ZIP CODE AREA CODE/PHONE
Palm Springs CA 92262 310 489 1605
OPTIONAL: FAX/E-MAIL ADDRESS
No contributions have been received and no expenditures have been made during the period covering the dates below:
Check one of the following boxes and complete the year. ❑ January 1, through June 30, 20 0 July 1, through December 31, 20 20
3. Verification /I
have used all reasonable diligence in preparing this statement. I have reviewed the statement and to
is true and complete. I certify under penalty of perjury under the laws of the State of Californiajhpyfhe
Executed on
January 18, 2021
DATE
By
t of my kp6wledge the information contained herein
ng is trA a ecorrect.
OF TREASURER/ASSISTANT TREASURER
FPPC Form 425 (Jan/01)
FPPC Toll -Free Helpline: 866/ASK-FPPC
866/275-3772
Semi -Annual Statement of No Activity
Type or print in ink.
p,AL'H SPRINGS
For use by recipient committees that have not received any contributions and have not made any expenditures A �� O O
during the six-month period covered by a semi-annual statement. Candidate controlled committees formed fokffil J W 27
elective office may not use this form.
See the Information Manual on Campaign Disclosure Provisions of the Political Reform Act for additional inform �tib� F THE CITY CLU';
and information required to be provided to you pursuant to the Information Practices Act of 1977.
1. Committee Information
Palm Springs Forward
1399524
STREET ADDRESS (NO P.O. BOX)
400 East Tahquitz Canyon Way
CITY STATE ZIP CODE AREACODE/PHONE
Palm Springs
CA 92262
MAILING ADDRESS (IF DIFFERENT) NO, AND STREET
CITY
OPTIONAL: FAX/E-MAIL ADDRESS
clucker @ luckeranderson .com
2. Period of No Activity
STATE ZIP CODE AREA CODE/PHONE
Treasurer(s)
NAME OF TREASURER
STATEMENT OF NO ACTIVITY
John Shay
MAILING ADDRESS
400 East Tahqiotz Canyon Way
CITY STATE ZIP CODE AREACODE/PHONE
Palm Springs CA 92262
NAME OF ASSISTANT TREASURER, IF ANY
Chris Lucker
MAILING ADDRESS
1801 East Tahquitz Canyon Way
CITY STATE ZIP CODE AREA CODE/PHONE
Palm Springs CA 92262 310 489 1605
OPTIONAL: FAX / E-MAILADDRESS
No contributions have been received and no expenditures have been made during the period covering the dates below:
Check one of the following boxes and complete the year. ❑ January 1, through June 30, 20 m July 1, through December 31, 20 20
3. Verification
have used all reasonable diligence in preparing this statement. I have reviewed the statement and
is true and complete. I certify under penalty of perjury under the laws of the State of California;hJt\l
Executed on January 18, 2021
DATE
By
t of rryylnowle a the information contained herein
ng i tr e arWcorrect.
E OF 11REASURERIASSISTANT TREASURER
FPPC Form 425 (Jan/01)
FPPC Toll -Free Helpline: 866/ASK-FPPC
866/275-3772