2022-01-31 Form 460 - MiddletonRecipient Committee
COVER PAGE
Campaign Statement
F p
Cover Page
e
Stater. covers plod
Date of election If appllcable:
�� LZ BAN 31
W/01/2021
(Month, Day, Year)
PN�al;�. 1
of 16
from
-
Ur'FlC"
()f
For omcw
use only
through 12/31/2021
fi�iC
1. Type of Recipient Committeean committees- Complete Penes 1, 2, 9. and 4
2. Type of Statement:
Q Officeholder, Candidate Controlled Committee
❑ Primarily Formed Ballot Measure
❑ Preelection Statement
❑ Quanery Statement
❑ State CandWare Eledlon Committee
committee
❑X Semi-armual Statement
❑ Speolel Odd -Year Report
❑ Recall
❑ controlled
❑ Temdnatien Statement
(Also GoffpWe P&I5)
❑ Sponsored
(Also me a Fans 410 Termination)
❑ General Purpose Commllree
(Also Com�ar Part B)
❑ Amendment (Exgxleln Be"
❑ Sponsored
❑ Primarily Formed Candidate/
❑ Small Contributor Committee
Omceholder Committee
(Aiso lo Parr7)
❑ Poill el Party/Central Cummmee
3. Committee Information
I I.D. NUMBER 13W65
Treasurers)
COMMITTEE NAME (OR CANDIDATES NAME IF NO COMMITTEE)
NAME OF TREASURER
Lisa Middleton For Palm Springs City Council DistriCt 5, 2020
Kathleen Wermluk
MAILING ADDRESS
STREET ADDRESS (NO P.O. BO))
CITY
STATE ZIP CODE
AREA CODE/PHONE
Palm Springs, CA M62
CITY
STATE ZIP CODE AREA CODEIPHONE
NAME OF ASSISTANT TREASURER, IF ANY
Palm Springs, CA 92264
Joshua Friedes
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
MAILING ADDRESS
CITY
STATE ZIP CODE AREA CODE/PHONE
CITY
STATE ZIP CODE
AREA CODE/PHONE
Palm Springs, CA 92263
Palm Springs, CA 92282
OPTIONAL: FAX / E-MAIL ADDRESS
OPTIONAL: FAX / E-MAIL ADDRESS
Mlddieton2020Compliame@gmail.com
Kathy.werrniukUverizon.net
4. Verlfication
I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained erein and in the attached schedules is true and complete. I
certify under penalty of perjury under the laws of the State of California that the foregoing
DATE Signature of ling Omcehoider, Candidate, State Measure Proponent or Responsible Officer or Sponsor
Executed on By
DATE Signature of Controlling omcehoidar, Candidate, Slate Measure Proponent
Executed on BY
DATE Signature of Corprdihxg Of loehdder, candidate, State Measure Proponent
FPPC Form 460 (Jan12016
FPPC Advice: advice ftpc.ca.gov (86602754M)
WWW.fppc.cagov
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Recipient Committee
Campaign Statement
Cover Page - Part 2
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Lisa Middleton
OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE)
City Coundl Member #5
RESIDENTIAIJBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP
Palm Springs, CA 92264
Related Committees Not Included In this Statement: Lwanyoamewan
nwf/nabdadfn"xMimm rlVWwvva""PAdbyyrwarmwpr/msdyfb nod1omgW*oanb9wilowor
naks arperr AWM an ba+ l of yaw ewn 1*w
COMMITTEE NAME
I.D. NUMBER
NAME OF TREASURER
CONTROLLED COMMITTEES
❑ YES ❑ NO
COMMITTEE ADDRESS
STREET ADDRESS (NO P.O. BOX)
CITY
STATE ZIP CODE
AREA CODEPHONE
COMMITTEE NAME
ID. NUMBER
NAME OF TREASURER
CONTROLLED COMMITTEES
❑ YES ❑ NO
COMMITTEE ADDRESS
STREET ADDRESS (NO P.O. BOX)
CITY
STATE ZIP CODE
AREA
COVER PAGE - PART 2
Page 2 of 16
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT
❑ OPPOSE
Identify the controlling officeholder, candidate, or state measure proponent, If
any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
OFFICE SOUGHT OR HELD I DISTRICT NO. IF ANY
7. Primarily Formed Candidate(Officeholder Committee LJst names of
o o ) or candldate(s) for whkh th/s commHtee Is primarily tbnned.
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
FPPC Form 4W (Jan/2016
FPPC Advice: advlc"fppc-ca-90v (866r2753772
www.fppc.ca.gov
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Campaign Disclosure Statement Amounts my, be rounded
Summary Page to whole dollars.
Statement covers peioo
from 07/01/2021
through
12/31/2021 page 3 of 16
SEE INSTRUCTIONS ON REVERSE
I.D. NUMBER
Use Middleton For Palm Springs City Council District 5, 2020
1394265
Contributions Received
Column A
Column a
CALENDAR YEAR
Calendar Year Summary for Candidates
TOTAL TM PERIOD
(FROM ATTACHED SOKEDULES)
TOTAL TO DATE
Running in Both the State Primary and
General Elections
1. Monetary Contributions
AL#w3 $
268.35 $
268.35
2. Loans Received .................................................
s B, Lye 3
0.00
0.00
1/1 through 6W 711 to Dale
3. SUBTOTAL CASH CONTRIBUTIONS ........................
AddLkws f+2 $
268.35 $
268.35
20. contributions $ 0.00 $ 0.00
Received
4. Nonmonetary Contributions ..................................
Sd*oubaLine 3
0.00
0.00
D 5. TOTAL CONTRIBUTIONS RECEIVE ......................
AddLhVS3+4 $
268.35 $
268.35
21. Expenditures $ 0.00 $ 0.00
Made
6. Payments Made ................................................
soaa"E, LIne4 $
15,250.82
$ 19,021.06
7. Loans Made .....................................................
sdreaureH LAW
0.00
0.00
8. SUBTOTAL CASH PAYMENTS ...............................
AWLbies6+7 $
15,250.82
$ 19,021.06
9. Accrued Expenses (Unpaid Bills) ..........................
s F cue3
0.00
40.00
10. Nonmonetary Adjustment ..................................
$0041bc,the3
0.00
0.00
11. TOTAL EXPENDITURES MADE ........................
aotrLOW 8+s+10 $
15,250.82
$ 19,061.06
Current Cash Statement
12. Beginning Cash Balance ..................... Pimlow &mmmy Pop, Line fe $
13. Cash Receipts ............................................. CWunmA Lhne 3above
14. Miscellaneous Increases to Cash ......................... Sd*dnfei fhe4
15. Cash Payments ........................................... CohaimALhw8above
16. ENDING CASH BALANCE AddLhw 12+ f3+ f4 axeeaubnamLine 15 $
dOls is a tamltnal%on statement, Line 16 must be 2vro
17. LOAN GUARANTEES RECEIVER ........................ &A bll,ALbre2 $
0.00
15,250.82
1,948.36
0.00
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ............................ see InWrudons on reverse $ 0.00
19. Outstanding Debts ............... Add line 2+ Une 9 to Column B above $ 40•00
Po.rered by laporracat.com
To calmlate Column B,
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
Mad for this calendar year,
only carry over the amounts
from lines 2, 7, and 9 (If any).
Expenditures
Candidates
22. Cumulative Expenditures Made
of Sub►sd to vdun" ExrpendR m Llm10
Date of Election
(mmtddtyy)
Total to Date
Amounts In this section may be different from amounts
reported In Column B.
FPPC Form 460 (Jant2016
FPPC Advice: advice ftpe.ea gov (86612753774
www.fppc fagov
Schedule A Amounts may be rounded SCHEDULE A
munuuitry rruntnouiruns nuumvwu
""'•""-"`"'" "
Statement covers period
6 -
07/0112021 6 -
from
12/91/2021
4 16
through Page
of
SEE INSTRUCTIONS ON REVERSE
I.D. NUMBER
Lisa Middleton For Palm Springs City Council District 5, 2020
F1394265
DATE
FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CONTRIBUTOR
U INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
AMOUNT RECEIVED
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION TO DATE
RECEIVED
CODE
(IF SELF- EMPLOYED, ENTER NAME
BUSINESS)
THIS PERIOD
THIS
-DEC.31)
( IF REQUIRED)
Kathy Weremluk
® IND
Retired
268.35
268.35
COM
Retired
368.35 G-2020
11/29/2021
OTH
Palm Springs, CA 92262
PTY
O SCC
Schedule A Summary
1. Amount received this period - itemized monetary contributions.
(Include all Schedule A subtotals.) — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — $
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, Column A, Line 1.)
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----- - - - - -- - TOTAL $
SUBTOTAL$
268.35
0.00
268.35
20M
Contributor Codes
IND - Individual
COM - Recipient Committee
(other then PTY or SCC)
OTH - Other (e.g., business entity)
PTY - Political Party
SCC - Small Contributor Committee
FPPC Form
FPPC Advice: advice@fppc.ca.gov
NAME OF MER LM NUMBFA
Lisa Middleton For Palm Springs City Council District 5, 2020 1394265
FORM REFERENCE NOTES
A-241 Additional Contribution Information:
F460 Sch A Kathy weremiuk This was to correct error for use of credit card —see expense Carter Animal Shelter 10/15
11/29/2021
FPPC Form 460 JamI2016
FPPC Advke: advIw@fppc.ea.gov (866T2754M)
Powered by ISPOIMIael.mn W W WAPPeC mgov
Schedule B - Part 1 Amounts may be rounded
to �� dollera SCHEDULE B -PART 1
Loans Received
Statement covers period
AIRLI• -
,
07/01/2021
•
e
from
12/31/2021
6
16
through
page
of
SEE INSTRUCTIONS ON REVERSE
I.D. NUMBER
Use Middleton For Palm Springs City Council District 5, 2020
1394265
IF INDIVIDUAL, ENTER
(a) OUTSTANDING
(b) AMOUNT
(c) AMOUNT PAID OR
(d) OUTSTANDING
(a) INTEREST
(I) ORIGINAL
(g) CUMULATIVE
FULL NAME, STREET ADDRESS AND
OCCUPATION AND EMPLOYER
BALANCE
RECEIVEDTHIS
FORGIVEN THIS
BALANCE AT CLOSE
PAID THIS
AMOUNTOF
CONTRIBUTIONS TO
ZIP CODE OF LENDER
(IF SELF. EMPLOYED, ENTER NAME
BEGINNING THIS
PERIOD
PERIOD "
OF THIS PERIOD
PERIOD
LOAN
DATE
IF COMMITTEE, ALSO ENTER I.D. NUMBER)
OF BUSINESS)
PERIOD
OPAID
CALENDAR YEAR
$
$
%
$
PER ELECTION'
FORGIVEN
RATE
$
$
$
$
'❑ IND ❑ COM 00TH ❑ PTY❑ SCC
DATE DUE
DATE INCURRED
Schedule B Summary
1. Loans received this period —————————————————————————— — — — — —— $
(Total Column (b) plus unitemized loans of less than $100.)
0.00
2. Loans paid or forgiven this period — — — — — $ 0.00
(Total Column (c) plus loans under $1Wp 1cf-or-Tongf n)— — — — — — — — — — — — — — — —
(Include loans paid by a third parry that are also itemized on Schedule A.)
3. Net change this period. (Subtract Line 2 from Line 1.)— — — — — — — — — — — — — — — — — — — — NET $
Enter the net here and on the Summary Page, Column A, Line 2
SUBTOTALS $
'Amounts forgiven or paid by another party also must be reported on Schedule A
If required.
Power by ISP01111caLcom
0.00
(May be a nega0ve number)
Contributor Codes
IND - Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business enft
PTY - Politics] Party
SCC - Small Contributor Committee
(Enter (e) on
Schedule E, une 3) FPPC Form 460 Janr2018
FPPC Advice: advloe@fppc.cs.gov (8661275-Vn)
www.fppe.ea.gov
Schedule B - Part 2
Loan Guarantors
Use Middleton For Palm Springs City Council District 5, 2020
AmnurKe maybe rounded
to while doi
Statement covers period
from 07/01/2021
through 12/31/2021
B -PART 2
Page 7 of 16
I.D. NUMBER
1394265
FULL NAME, STREET ADDRESS AND
CONTRIBUTOR
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
LOAN
AMOUNT
CUMULATIVE TO
BALANCE
OUTSTANDING
ZIP CODE OF GUARANTOR
CODE
(IF SELF-EMPLOYED, ENTER NAME
C'UARTHIS
DATE
TO DATE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
OF BUSINESS)
PERIM
PERIOD
LENDER
CALENDAR DATE
❑ IND
$
PER ELECTION
0 comODH
(IF REQUIRED)
PTY
DATE
0 SCC
Enter on Summary
SUBTOTAL $
Page. Line 17 only.
FPPC Form 460 (Jan/1D16
FPPC Advice: advice@fppc.ce.gov (866127537721
Powarau by WPOIMMLeom www.fppr-mgov
Schedule C
Amounts my be rounded
SCHEDULE C
Nononetary Contributions Received
m
to whole dollars.
Statement
covers period
•
.
07/01/2021
•
from
12/31/2021
a
16
through
Page
of
SEE INSTRUCTIONS ON REVERSE
I.D. NUMBER
Use Middleton For Palm Springs City Council District 5, 2020
1394M
DATE
FULL NAME, STREET ADDRESS
IF INDIVIDUAL, ENTER
OCCUPATION /DUD EMPLOYER
AMOUNT/ FAIR
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
RECEIVED
AND ZIP CODE OF CONTRIBUTOR
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CONTRIBUTOR
CODE
(� SFI.F- EMPLOYED, ENTER NAME
DESCRIPTION OF
GOODS OR SERVICES
VALUE
(JAN. 1 -DEC. 311
TO DATE
(IF REQUIRED)
OF BUSINESS)
IND
COIN
p OTH
PTY
SCC
IND
p COIN
O OTH
PTY
a SCC
O IND
O COIN
O OTH
PTY
O SCC
1. Amount received this period - itemized nonmonetary contributions. 0.00
(Include all Schedule C subtotals.) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ $
2. Amount received this period - unitemized nonmonetary contributions of less than $100 _ _ _ _ _ _ _ _ _ _ _ _ $ 0.00
3. Total nonmonetary contributions received this period.
(add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) TOTAL $ 0.00
Contributor Codes
IND - Individual
COM - Recipient Committee
(other than PTY or SCC)
OTH - Other (e.g., business entity)
PTY - Political Party
SCC - Small Contributor Committee
SUBTOTAL=
FPPC Form 460 (Jan/2016
FPPC Advice: advlceQfppc-eagov (6661275,TM1
Powered by ISPolhkal cwn www.fppe.eagov
Schedule D .. Amounts may be rounded
SCHEDULE D
Summary Of Expenditures
Supporting/Opposing Other
w VRw B 0011am
Statement covers period
•
I i
Candidates, measures, and Committees
07/01/2021
_ •
from
through 12/31/2021
9 Of 16
ILD.
BER
Lisa Middleton For Palm Springs City Council District 5, 2020
1394265
DATE
NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR
MEASURE NUMBER OR LETTER AND JURISDICTION,
DE3cRIPnON
AMOUNT
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION TO DATE
(IF REQUIRED)
OR COMMITTEE
TYPE OF PAYMENT
(IF REQUIRED)
THIS PERIOD
(JAN. 1 . DEC. 31)
Monetary
Contributlon
❑Nonmonetary
CoWbutlon
DIndependent
E�endiWre
❑ gyp«+ ❑ QvpMe
SCHEDULE D SUMMARY
1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ $ 0.00
2. Unitemized contributions and independent expenditures made this period of under $100 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ $ 0•00
3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) _ _ _ _ _ _ _ _ _TOTAL $ 0.00
SUBTOTAL $
FPPC Form 460 Jaru=6
FPPC Advice: advkeetppe_ca.gov ( S- 72;
Power by ISPotaleel.com tlYw1Al.tppC.Ca.gOV
Schedule E
Amounts may be rounded
SgiEDULE E
Payments Made
s
to whole dollars.
Statement covers period
07/01/2021
from
through 12/31/2021 Page 10 of 16
SEE INSTRUCTIONS ON REVERSE
I.D. NUMBER
Use Middleton For Palm Springs City Council District 5, 2020
1394265
CODES: if one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphemalla/misc.
MBR member communications
RAID radio airtime and production costs
CNS campaign consultants
MTG meetings and appearances
RFD returned contributions
CTB contribution (explain nonmonetary)'
OFC office expenses
SAL campaign workers' salaries
CVC civic donations
PET petition circulating
TEL t.v. or cable airtime and production costs
FIL candidate filing/ballot fees
PHO phone banks
TRC candidate travel, lodging, and meals
FND fundraising events
POL polling and survey research
TRS staff/spouse travel, lodging, and meals
IND Independent expenditure supporting/opposing others (explain)*
POS postage, delivery and messenger services
TSF transfer between committees of the same candidate/sponsor
LEG legal defense
PRO professional services (legal, accounting)
VOT voter registration
LIT campaign literature and mailings
PRT print ads
WEB information technology costs (Internet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
Carter Animal Hospital
Credit Card accidently used for Personal expense. See reversal on 11/29 when mistake
Cathedral City, CA 92234
realized
268.35
Integrated Solutions: Political
Accounting and reporting software
San Diego, CA 92118
WEB
219.99
Integrated Solutions: Political
Accounting and reporting software
San Diego, CA 92116
WEB
219.99
Integrated Solutions: Political
Accounting and reporting software
San Diego, CA 92116
WEB
219.99
• Payments that are corMAbuilim or Independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 928.32
FPPC Form 460 ((JanI2016
FPPC Advice: advh aMppc.ca.gov (88612753772;
POmerad by ISPoIPoeal.com www.fppc--gov
Schedule E Amourda may be rounded SCHEDULE E
Payments Made to whole dollars. Statement covers period . 0 from
07/01/2021 0 -
through 12/31/2021 Page 11 of 16
SEE INSTRUCTIONS ON REVERSE
ID. NUMBER
Lisa Middleton For Palm Springs City Council District 5, 2020 1394265
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphemalla/misc.
MBR member communications
RAD radio airtime and production costs
CNS campaign consultants
MTG meetings and appearances
RFD returned contributions
CTB contribution (explain nonmonetary)•
OFC office expenses
SAL campaign workers' salaries
CVC civic donations
PET petition Circulating
TEL t.v. or cable airtime and production costs
FIL candidate fliing/bellot fees
PHO phone banks
TRC candidate travel, lodging, and meals
FND fundraising events
POL polling and survey research
TRS staff/spouse travel, lodging, and meals
IND Independent expenditure supportinglopposing others (explain)*
POS postage, delivery and messenger services
TSF transfer between committees of the same candidate/sponsor
LEG legal defense
PRO professional services pegal, accounting)
VOT voter registration
LIT campaign literature and mailings
PRT printads
WEB information technology costs (Internet, a -mall)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
Integrated Solutions: Political
4142
and reporting software
San Diego, CA 92118
WEB
219.99
Integrated Solutions: Political
4142
and reporting software
San Diego, CA 92118
WEB
219.99
Integrated Solutions: Political
4142
and reporting software
San Diego, CA 92118
WEB
219.99
Lisa Middleton for State Senate
840
to State Senate Account
Palm Springs, CA 92264
CTB
13,450.00
ID: 1441458
• Payments that are comrlbuilons or Independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 14,109.97
FPPC Form 4160 (Jan=6
FPPC Advice: advke®fppe.cmgov (6667275-3772�
Powered by lgPoltdcal.corn
Schedule E
Payments Made
Lisa Middleton For Palm Springs City Council District 5, 2020
Amournts may be rounded
to whole dollars.
bZatement covers perio
from 07/01/2021
through 12/31/2021
SCHEDULEE
Kilo I • - , 110*11
Page 12 of 16
I.D. NUMBER
1394265
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphemalle/misc.
MBR member communications
RAD radio airtime and production costs
CNS campaign consultants
MTG meetings and appearances
RFD returned contributions
CTB contribution (explain nonmonetary)•
OFC office expenses
SAL campaign workers' salaries
CVC civic donations
PET petition circulating
TEL t.v. or cable alrtime and production costs
FIL candidate filing/ballot fees
PHO phone banks
TRC candidate travel, lodging, and meals
FND fundraising events
POL polling and survey research
TRS staff/spouse travel, lodging, and meals
IND Independent expenditure supportinglopposing others (evleln)'
POS postage, delivery and messenger services
TSF transfer between committees of the same candidate/sponsor
LEG legal defense
PRO professional services gegal, accounting)
VOT voter registration
LIT campaign literature and mailings
PRT print ads
WEB Information technology costs (Internet, a -mall)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
Zoom
teleconferencing
San Jose, CA 95113
WEB
31.33
Zoom
teleconferencing
San Jose, CA 95113
WEB
31.33
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.) — — — — — —$ 15,100.95
2. Unitemized payments made this period of under $100 — — — — _ — — — — — — $ 149.87
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (a).)
4. Total payments made this Period. (Add Lines 1, 2, and 3. Enter here and on the Summary Paae, Column A, Line 6.)
_______________ TOTAL $ 15,250.82
0.00
• Payments that are contributions or Independent expenditures must also be summarized on schedule D. SUBTOTAL $ I 62.66
FII Form 400 (Jan02016))
FPPC Advice_ adviceMppc.ce gov, (8660275.3774)
Powered by ISPotMlcal.com
Schedule F
Accrued Expenses (Unpaid Bills)
INSTRUCTIONS
Lisa Middleton For Palm Springs City Council District 5, 2020
Amounts msy be rounded
to tahae dalara.
siatement covers peno
from 07/01/2021
through 12/31/2021
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
".LlmlmAwjil mcolwy INU1,0111
Page 13 Of 16
I.D. NUMBER
1394265
CMP campaign paraphemalialmisc.
MBR member communications
RAD radio airtime and production costs
CNS campaign consultants
MTG meetings and appearances
RFD returned contributions
CTB contribution (explain nonmonetary)'
OFC office expenses
SAL campaign workers' salaries
CVC cMc donations
PET petition circulating
TEL Ur. or cable alydme and production costs
FIL candkate fiMg(ballot fees
PHO phone banks
TRC candidate travel, lodging, and meals
FIND fundralsing events
POL polling and survey research
TRS stafdspouse travel, lodging, and meals
IND Independent expenditure supportinglopposing others (explain)"
POS postage, delivery and messenger services
TSF transfer between committees of the same candidate/sponsor
LEG legal defense
PRO professional services (legal, accounting)
VOT voter registration
LfT campaign literature and mailings
PRT print ads
WEB Information technology costs (intemet, a -mall)
NAME AND ADDRESS OF CREDITOR
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE OR DESCRIPpON OF
(a)
OUTSTANDING BALANCE
(b)
AMOUNT INCURRED
AMOUNT PAID THIS
OUTSTANDING BALANCE AT
PAYMENT
BEGINNING OF THIS PERIOD
THIS PERIOD
PERIOD (ALSO REPORT
CLOSE OF THIS PERIOD
SCHEDULE F SUMMARY
1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for
accrued expenses of $100 or more, plus total unitemized accrued expenses under $100. INCURRED TOTALS $ 0•00
2. Total accrued expenses paid this period. (include all Schedule F, Column (c) subtotals for payments on
accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) PAID TOTALS $
- - - - - - - - - - - - - - - - - -
3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and
on the Summary Page, Column A, Line 9.)
------------------------------------ - - - - -- - NET$
Payments that are cowxdbolons or Independent expenditures must also be SUBTOTALS $ $ $ $
summarized on Schedule D.
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0.00
0.00
FPPC Form 480
FPPC Advice, advice6lppc.cagov (881
Schedule G
Payments Made by an Agent or Independent
Contractor (on Behalf of This Committee)
Amounts may be rounded
to whole dollars.
Statement covers plod
from
07/01/2021
through 1MI/2021
Page 14 of 16
3� MSTRUCTION3 ON REVERSE
t D.NUMBER
Use Middleton For Palm Springs City Council District 5, 2020
1394265
AGENTNAME OF OR INDEPENDENT C
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP campaign paraphemalla/misc.
MSR member communications
RAD radio airtime and production costs
CNS campaign consultants
MTG meetings and appearances
RFD returned contributions
CTB contribution (explain nonmonetary)*
OFC office expenses
SAL campaign workers' salaries
CVC civic donations
PET petition circulating
TEL Lv. or cable airtime and production costs
FIL candidate filing/ballot fees
PHO phone banks
TRC candidate travel, lodging, and meals
FND fundrelsing events
POL polling and survey research
TRS staff/spouse travel, lodging, and meals
IND Independent expenditure supporting/opposing others (explain)*
POS postage, delivery and messenger services
TSF transfer between committees of the same candidate/sponsor
LEG legal defense
PRO professional services (legal, accounting)
VOT voter registration
LIT campaign literature and mailings
PRT print ads
WEB Information technology costs pntemet, e-mail)
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
* Payments that are conhtbutIons or Independent expenditures must also be summarized on Sehe&le D. TOTAL * $
Do not transfer to arty offer schedule or to the Summary Page. TMe total may net equal fhe amount paid to the agentor
Independent contractor as reported on Schedule E.
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FPPC Form
FPPC Advice: edvIceQtppc ca gov
Schedule H
Loans Made to Others*
Lisa Middleton For Palm Springs City Council District 5, 2020
Amourrts may 1* r n1Qd
to while dollars
Statement covers perio
from 07/01/2021
through 12/31/2021
K9;:»•11Li*;1
Page 15 of 16
ID.NUMBER
1394265
FULL NAME, STREET ADDRESS AND
ZIP CODE OF RECIPIENT
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
IF INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF" EMPLOYED, ENTER NAME
OF BUSINESS)
(a) OUTSTANDING
BALANCE
BEGINNING THIS
PERIOD
(b) AMOUNT LOANED
THIS PERIOD
(C) REPAYMENT OR
FORGIVENESS THIS
PERIOD
(d)OUTSTANDING
BALANCE AT CLOSE
OF THIS PERIOD
(e) INTEREST
RECEIVED
(q ORIGINAL
AMOUNT OF
LOAN
(g) CUMULATIVE
LOANS TO DATE
13 PAID
CALENDAR YEAR
$
%
$
PER ELECTION"
FORGIVEN
RATE
$
$
$
$
DATEDUE
DATE INCURRED
SUBTOTALS $
that are contributions to another candidate or committee must also be
rized on Schedule D. Loans forgiven must also be reported on Schedule E
Poch by
FPPC Form 460 Jam#2016
FPPC Advice: advice@fppc_ca.gov (8665275.37721
www.fppa —gov
Schedule I
Miscellaneous Increases to Cash
Amounts may be rounded
to whole dollars.
Statement covers period
from 07/0112021
SCHEDULEI
! � 1
through 12/31/2021 Page 16 of 16
SEE M13TRUCTIONS ON REVERSE
FILEM LD. NUMBER
Lisa Middleton For Palm Springs City Council District 5, 2020 1394M
DATE FULL NAME AND ADDRESS OF SOURCE AMOUNT OF
RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF RECEIPT INCREASE TO CASH
Schedule I Summary
1. Itemized increases tocash this period -————————————————————————————— — — — —.$
2. Unitemized increases to cash of under $100 this period. — — _ — — — — — — — — _$
— — — — — — — — — — — — — — — —
3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).)
4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the
Summary Page, Line 14.)
-
----------------------------------TOTAL$
0.00
0.00
0.00
0.00
SUBTOTAL $
FPPC Form 460 {Janf201
FPPC Advice: adviceMpliar-mgov (88=75-9772
Poara by ISPolfteLewn www fpPc-Csgov