2020-09-14 Form 410 - PS POAStatement of Organization
Recipient Committee
Statement Type ❑ initial [D Amendment ❑ Termination —'See Pate
Q Not yet qualified
or
0 Date qualification threshold met Date qualification threshold met Date of termination
Information
NAME OF COMMITTEE
JI.D. Number
(if applicable) 951841
Palm Springs Police officers Association Political Action Committee
STREET ADDRESS (NO PO. UOXI
t. I7Y SLATE 71P CODE AREA CODEJPHONF
Sacramento CA 95814 (
FULL MAILING ADDRESS IIF nIFFERFNT)
EMAIL ADURLSS IREUUIREDI / FAX IUPTIONAU
Attach additional information on appropriately labeled continuation sheets.
NAME OF TREASURER
Andreas C. Rockas
Date Stamp
&SVEb AND FILEb'720SEP
• "
office
of the State of BCaii omia' State, ( 4 or SIP � e OnISpy 17
AUG 2 8 2020 OF DICE of THE CITY CLE =,
EIRFETAODRFSS(NO PO ROXI
CITY STATE LIP CODE AREA COWPHONL
Sacramento CA 95814 (
NAME OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO PO BOX)
COY S1A1E ZIP Cook AREA COOLJPHOUE
NAME OF PRINCIPAL OFFICERI5)
Joe Cook
STREET ADDRESS INO PO BOX)
CITY STATL ZIP CODF AREA CODE;PHONF
Sacramento
CA a5814 (
Verification
I have used all reasonable diligence In preparing
TREASURER
Executed on By
OATS
SIGNATURE CF CONTROLLING Of (ICE�ICtOER, CANDIDATE OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING r, FFICEHOLDER. L ANDIDATE, OR STATE MEASURE PROPONENT
Executed on
DATF
By
SIGNATURF OF CONTROLLING OFFICEHOLDER, CANDIDATF., OR STATE MFASURF PROPONENT
FPPC Form 410(August/2018)
FPPC Advice: advice@fppc.ca.gov (866127S-3772)
www.fppc.ca.gov
netl%le.com
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Palm Springs Police Officers Association Political Action Committee
• All committees must list the financial institution where the campaign bank account Is located.
NAMF OF FINANCIAL INSTITUTION
California Bank & Trust
ADDRESS
AREA CODE/PHONE
+213)228-1'709
ITY
BANK ArCOIJNT NUMBER
5799153787
STAIE LII'COUL
D NIIMBFR
951841
2 of 4
550 S. Hope Stieet, Suite 100 Los Angeles C:A. 90071
Controlled Committee
• List the name of each controlling officeholder, candidate, or state measure proponent. if candidate or officeholder controlled, also list the elective office sought or held, and
district number, if any, and the year of the election.
• List the political party with which each officeholder or candidate Is affiliated or check "nonpartisan" Stating "No party preference" Is acceptable
• If this comm,ttee acts jointly with another controlled committee, list the name and Identification number of the other controlled committee.
NAME OI CANDIDATE/OFFICEHOLDER/51AIE MEASURE PROPONENT
ELECTIVE OFFICE SOUGHT OR HELD YEAR OF PARTY
(INCI UOE DISTRICT NUMBER IF APPLICARI E) ELECTION CIi E(KONf
FormedPrimorily Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURE(S) FULI TITLE (INCLUDE BALLOT NO OR LETTER)
IF A RECALL, STATE "RECALL IN FRONT OF THE OFFICEHOLDER'S NAME
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO, CITY OR COUNTY, AS APPLICABLE)
CIIUK ONE.
T T OPPO'F
OPPOSE
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIA
Recipient Committee FORM
INSTRUCTIONS ON REVERSE
Page 3 of 4
Palm Springs Police Officers Association Political Action Committee
Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
(] CITY Committee ❑ COUNTY Committee ❑ STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACrIVtTY
To support and oppose state and local candidates.
List additional sponsors on an attachment.
NAMF OF SPON50R
Palm Springs Police Officers Association
STREET ADDRESS NO AND STRFFT
1121 L St Ste 200
NDUSTRY GROUP OR AFFII IATION OF SPONSOR
Lain enforcement labor organization
CITY STATF 21P CODE AREA CODE/PHONE
Sacramento CA 95811 (916)556-17'76
�a�yur►a•rinuii.rrur>i.rirefrin�rre=
Date qualified
5. Torrinination Requirements d/dreandldate, officeholder, or proponi-nt certify that all of the following candinons have been met
• This committee has ceased to receive contributions and make expenditures;
• This committee does not anticipate receiving contributions or making expenditures in the future;
• This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations;
• This committee has no surplus funds; and
• This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions.
There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government
Code Section 89519.
- Leftover funds of ballot measure committees maybe used for political, legislative or governmental purposes under Government Code Sections 89511- 89518, and are
subject to Elections Code Section 18680 and FPPC Regulation 18521.5
FPPC Form 410 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Additional Comments
For Form 410
Palm Springs Police Officers Association Political Action Committee
Palm Springs Police Officers Association's mailing address: P.O. Box 1881, Palm Springs, CA 92263
Page 4 of
951841
www.nefflle.com