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2021-12-30 Form 460 - PS Fire SafetyRecipient Committee C .mpa�,gn Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 7/1/21 through 12/31/21 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. ❑ Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Patt 5) 0 Sponsored (Also Complete Part 6) m General Purpose Committee • Sponsored ❑ Primarily Formed Candidate/ Small Contributor Committee Officeholder Committee Political Party/Central Committee (Also Complete Part7) 3. Committee Information I.D. NUMBER 881536 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Palm Springs Fire Safety Association PAC STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE Palm Springs CA 92262 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREACODE/PHONE Yucaipa CA 92399 OPTIONAL: FAX I E-MAIL ADDRESS COVER PAGE Date Stamp RECEDED CITY OF PP,LN SPRI age 1 of 4 Date of election if applicable: (Month, Day, Year) 2021 DEC 30 AN 9: ' 2 For Official Use Only T"Fi+ICE CF T#'Jt CITY G 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement m Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Brandon Wright MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE Yucaipa CA 92399 NAME OF ASSISTANT TREASURER, IF ANY Damien Myers MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE Temecula CA 92592 OPTIONAL: FAX I E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the inf tion contained herein 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 Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor Executed on By Dale Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on B Date y Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded SUMMARY PAGE Summary Page to whole dollars. Statement covers period CALIFORNIA , 6 0 from 07/01/2021 • - 12/31/2021 Page 2 of 4 SEE INSTRUCTIONS ON REVERSE through NAME OF FILER I.D. NUMBER Palm Springs Fire Association PAC 881536 Contributions Received Column A Column B Calendar Year Summary for Candidates TOTAL THIS PERIOD CALENDAR YEAR (FROM ATTACHED SCHEDULES) TOTAL TO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions................................................... Schedule A, Line 3 $ 10470 $ 20790 1/1 through 6/30 7/1 to Date 2. Loans Received................................................................ Schedule e, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 $ 10470 $ 20790 20. Contributions Received $ $ 4. Nonmonetary Contributions ............................................ Schedule C, Line 3 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED...............................Add Lines 3+4 $ 10470 $ 20790 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made................................................................ Schedule E, Line 4 $ 0 $ 50 Candidates 7. Loans Made....................................................................... Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ 0 $ 50 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3 Date of Election Total to Date 10. Nonmonetary Adjustment......................................................... Schedule C, Line 3 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE....................................Add Lines 8+9+10 $ 0 $ 50J $ �_� $ Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 34737.25 To calculate Column B, 13. Cash R2C@IptS........................................................... Column A, Line 3 above 10470 add amounts in Column 14. Miscellaneous Increases to Cash .................................. Schedule /, Line 4 A to the corresponding amounts from Column B *Amounts in this section may be different from amounts reported in Column B. 15. Cash Payments......................................................... Column A, Line 8 above 0 of your last report. Some amounts in Column A may 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ . 4520725 be negative figures that should be subtracted from If this is a termination statement, Line 16 must be zero. previous period amounts. If this is the first report being 17. LOAN GUARANTEES RECEIVED ................................ Schedule e, Part 2 $ filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts any). 18. Cash Equivalents ................................................ See instructions on reverse $ —9 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIA , 6 0 from 07/01/2021 - SEE INSTRUCTIONS ON REVERSE through 12/31/2021 Page 3 of 4 NAME OF FILER I.D. NUMBER Palm Springs Fire Association PAC 881536 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED CONTRIBUTOR CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME RECEIVED THIS CALENDAR YEAR TO DATE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 07/15/21 Palm Springs Firefighters Association ❑ IND S1770 ❑ CoM Z OTH Palm Springs, CA 92262 ❑ PTY ❑ SCC 08/15/21 Palm Springs Firefighters Association ❑ IND $1740 ❑ COM (� OTH Palm Springs, CA 92262 ❑ PTY ❑ SCC 09/15/21 Palm Springs Firefighters Association ❑ IND $1740 ❑ COM m OTH Palm Springs, CA 92262 ❑ PTY ❑ SCC 10/15/21 Palm Springs Firefighters Association ❑ IND $1740 ❑ COM m OTH Palm Springs, CA 92262 ❑ PTY ❑ SCC 11/15/21 Palm Springs Firefighters Association ❑ IND $1740 ❑ COM m OTH Palm Springs, CA 92262 ❑ PTY ❑ SCC SUBTOTAL $ 8730 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.).......... 10470 ................... $ ......TOTAL $ 10470 'Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Parry SCC — Small Contributor Committee FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) Monetary Contributions Received to whole dollars. Statement covers period • . , from 07/01/2021 • - • ' through 12/31/2021 Page 4 of 4 NAME OF FILER I.D. NUMBER Palm Springs Fire Association PAC 881536 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION CONTRIBUTOR * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME) (IF COMMITTEE, ALSO ENTER I.D. NUMBER) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 12/15/21 Palm Springs Firefighters Association ❑ IND $1740 ❑ COM Z OTH Palm Springs, CA 92262 ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY SCC SUBTOTAL $ 1740 "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 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov