2022-01-25 Form 425 - Palm Springs ForwardType or print in ink. STATEMENT OF NO ACTIVITY
Semi -Annual Statement of No Activity Date Stamp -
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
1399524
COMMITTEE NAME
Palm Springs Forward
STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREACODE/PHONE
Palm Springs CA 92262
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET
CITY STATE ZIP CODE AREACODE/PHONE
OPTIONAL: FAX / E-MAIL ADDRESS
2. Period of No Activity
Treasurer(s)
NAME OF TREASURER
John Shay
MAILINGADDRESS
RECEIVED
IAN 3 1 2022
of the City Clerk
CITY
Palm Springs
NAME OF ASSISTANT TREASURER, IF ANY
For Official Use Only
STATE ZIP CODE AREA CODE/PHONE
CA 92262
Chris Lucker
MAILINGADDRESS
CITY STATE ZIP CODE AREA CODE/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. El January 1, through June 30, 20 ® July 1, through December 31, 20 21
3. Verification
I have used all reasonable diligence in preparing this statement. I have reviewed
FPPC Form 425 (Jan/01)
FPPC Toll -Free Helpline: 866/ASK-FPPC
866/275-3772
Type or print in ink. STATEMENT OF NO ACTIVITY
Semi -Annual Statement of No Activity Date Stamp
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
NAME
Palm Springs Forward
STREET ADDRESS (NO P.O. BOX)
CITY
1399524
STATE ZIP CODE AREA CODE/PHONE
Palm Springs CA 92262
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET
CITY
OPTIONAL: FAX / E-MAIL ADDRESS
STATE ZIP CODE AREACODE/PHONE
Treasurer(s)
NAME OF TREASURER
John Shay
MAILING ADDRESS
STATE ZIP CODE
AREACODE/PHONE
Palm Springs
CA 92262
310 489 1605
NAME OF ASSISTANT TREASURER, IF ANY
Chris Lucker
MAILING ADDRESS
CITY
STATE ZIP CODE
AREA CODE/PHONE
Palm Springs,
CA 92262
310 489 1605
OPTIONAL: FAX / E-MAIL ADDRESS
2. Period of No Activity
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 ® July 1, through December 31, 20 21
3. Verification
I have used all reasonable diligence in preparing this statement. I have reviewed the statement
FPPC Form 425 (Jan/01)
FPPC Toll -Free Helpline: 866/ASK-FPPC
866/275-3772
Type or print in ink. STATEMENT OF NO ACTIVITY
Semi -Annual Statement of No Activity Date Stamp I _
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 310 489 1605
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET
CITY
OPTIONAL: FAX / E-MAIL ADDRESS
2. Period of No Activity
STATE ZIP CODE AREACODE/PHONE
Treasurer(s)
NAME OF TREASURER
John Shay
MAILINGADDRESS
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
AREA CODE/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 21
3. Verification
have used all reasonable diligence in preparing this statement. I have reviewed
Form 425 (Jan/01)
FPPC Toll -Free Helpline: 866/ASK-FPPC
866/275-3772