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2022-07-07 - Form 410 - Nevinsstatement of vrgantzation Date Stamp CALIFORNIA Recipient Committee RECEIVED 410 Statement Type ❑Initial ® Amenment d ❑ CITY OF PALM SPRIP a Termination —See PartS For Official Use Only 0 Not yet qualified 2022 JUL —7 PH 4; cc 2 or 0 Date qualification threshold met Date qualification threshold met Date of termination OFFICE OF THE CITYCL:h',' --/--/ , 271 22 • I.D. Number i449064 .. .. • nmax NAMEfficers OF COMMITTEE NAME OF TREASURER Scott Nevins for Palm Springs City Council District 1, 2022 Scott Nevins STREET ADDRESS (NO P.O. BOX) 4426 Vantage Ln STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREACODE/PHONE 4426 Vantage Ln Palm Springs CA 92262 9176935572 CITY STATE ZIP CODE AREACODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Palm Springs CA 92262 9176935572 FULL MAILING ADDRESS (IF DIFFERENT) STREET ADDRESS (NO P.O. BOX) E-MAIL ADDRESS (REQUIRED)/FAX (OPTIONAL) CITY STATE ZIP CODE AREACODE/PHONE scott@scottnevins.com COUNTYOFDOMIOLE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICERS) Riverside Palm Springs STREET ADDRESS (NO P.O. BOX) Attach additional information on appropriately labeled continuation sheets. CITY STATE ZIPCODE AREA CODE/PHONE 3. Verification I have used all reasonable diligence in preparing this statement and to the st of my knowledge the Information contained herein Is true and complete. I certify under penalty of perjury ui der th lawnsZof the State of Caliform t for oin is true and ct. " Executed on GATE REASURER OR ASSISTANTTREASURER Executed on By D YE SIGNAjjM OF CONTROLLING OFFICEHOLDER,CANDIDATE, OR STATE MEASURE PROPONENT Executed on By DATE Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (August/2018( FPPC Advice: advicer@fnoc.ca.eov (866/27S-3772) \ M!MMfooc.ca.eov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I.D. NUMBER p Scott Nevins for Palm Springs City Council District 1, 2022 1 1+C} All committees must list the financial Institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION Wells Fargo ADDRESS 760.416-3087 CITY 1978946497 STATE ZIP CODE 543 S Palm Canyon Dr Palm Springs CA 92264 4. Type of Committee Complete the applicable sections. 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 committee ads jointly with another controlled committee, list the name and identification number of the other controlled committee. NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD YEAR OF PARTY (INCLUDE DISTRIrT NIIMRFR IF APYIRARI Ff ..'runs Scott Nevins City Council, District 2022 Nonpartisan^V t/ Partisan (list political party below) Democratic Nonpartisan Partisan (list political party below) Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S)NAME OR MEASURE(S)FULLTITLE(INCLUDE BALLOT NO. OR LETTER) CANDIDATE(SI OFFIrF sn"r.NT OR HFIn OR MFASIIRFIF) II IYIFORTI/1N IF A RECALL, STATE *RECALL! IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) OIECI(ONF SUPPORTEOPP7—O—SE— UV'O'TS FPPC Form 410 (August/2018) FPPC Advice: a dvlce60fooc.ca.eov (966/275.3772) www.fnoc.ca.ROv Instructions for Statement of Organization 2. Treasurer and Other Principal Officers: 4. Type of Committee: A committee may have only one treasurer ar?d one assistant treasurer. A candidate may be his or her own treasurer or assistant treasurer. A Controlled Committee committee may not accept a contribution or A "controlled committee" is one which is controlled make an expenditure without a treasurer. directly or indirectly by an officeholder, candidate, or state measure proponent, or which actsjointly A committee that is not controlled by a candidate or officeholder must disclose the name, street address, with an officeholder, candidate, state measure and telephone number of the committee's princlpal proponent, or another controlled committee officer(s). The principal officer(s) of a committee are in connection with making expenditures. the individual(s) primarily responsible for approving the A committee is controlled if the officeholder, political activity of the committee, including authorizing the content of communications, authorizing contributions candidate, or proponent, his/her agent, or any other and other expenditures, and determining strltegy. If committee he/she controls, has a significant influence more than three Individuals qualify as principal officers on the actions or decisions of the committee. of the committee, identify no fewer than three. "Proponents" of state measures are persons who If no individual other than the committee tre surer request the Attorney General to prepare a title and qualifies as a principal officer, identify that summary of a state initiative, referendum, or measure. individual as both the treasurer and the principal officer. An attachment may be necessary. Candidate Election Committee: Identify the candidate's last name, office, election 3. Verification/Original Ink Signature(;): year and party, if applicable. The Form 410 filed with the Secretary of State must contain an original signature(s). The committee treasurer Ballot Measure Committee Controlled by State or assistant treasurer must sign the Form Al Also, each controlling officeholder, candidate or state ballot Candidate: Identify each measure on which the0. committee has spent or anticipates spending $50,000 measure proponent must sign the Form 410.1 If more or more in the current two-year period, beginning with January 1 of an odd -numbered year. If the than three control the committee, one of them may sign ballot designation has not been assigned, describe on behalf of all controlling individuals. If a ca didate {� the purpose of the anticipated measure(s). Amend will serve as his or her own treasurer, he or she must sign as the candidate and again as the treasurer. the Form 410 when a ballot designation is assigned. Provide this information in the primarily formed or Bank Account Information general purpose section or on an attachment • Qualified committees must list the name Lnd address of the financial institution where the ca+ign bank account is located and the bank account number. • Non -qualified committees are not required to list a bank account. Legal Defense Committee: On an attachment, describe the specific legal dispute(s) for which the legal defense fund was established. The Form 410 must be amended within 10 days when legal disputes are either resolved or new disputes are initiated. Primarily Formed Committee A committee is "primarily formed" when it makes or initially plans to make more than 70% of its contributions and expenditures to support or oppose a specific candidate or measure, or a group of measures or specific local candidates all being voted upon in the same election on the same date. (FPPC Regulation 18247.5) New committees: A new committee formed within six months of a statewide regular election or within 30 days of a state special election is presumed to be primarily formed if the committee makes at least $25,000 in independent expenditures to support or oppose a state candidate or measure. Monthly review is required for other new committees that spend at least $1,000 a month and were formed within six months of an election in connection with which the committee makes contributions or expenditures. Quarterly review at the end of March, June, September and December is required for other committees. A committee controlled by a candidate for his or her own candidacy is not a primarily formed committee. State ballot measures - qualification ID number: Certain committees must list in Section 4, Primarily Formed Committee, the Attorney General's Office assigned identification number to a proposed state ballot measure: • A committee submitting the title and summary; • A committee primarily formed for the measure; or A committee that spends $100,000 or more on petition circulation for the measure. Recall Committees: A committee supporting or opposing a recall must list "Recall [Officeholder's Name]," the office held by the recall target officeholder, and mark the appropriate box to indicate whether the committee supports or opposes the recall of the officeholder. FPPC Form 410 (August/2018) FPPC Advice: adviceofooc.ca.eov (866/27S-3772) f c.ca. ov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE 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 OFACTIVITY List additional sponsors on an attachment. no. enu]I xKI mall Contributor Committee �I CRY OR AFFILIATION OF • 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 abilityto 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. ZIP CODE Page 3 — 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 may be 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 420 (August/2018) FPPC Advice: adviceldfooc.ca.eov (866/275-3772) www.fooc.ca.gov