2022-07-20 Form 410 - GarnerStatement of Organization
Recipient Committee
Date Stamp Lim
"i' ' "�
2022 JUL 20 Pi i f
CALIFORNIA
-'
t75 For ORltlal Use only
Statement Type
❑ Initial
® Amendment
❑ Termination — See Part 5
0 Not yet qualified
or
IFFICE OF THE CIi
Q Date quallfloetlon threshold met
Date qualification threshold met
Date of termination
1. Committee LD. Number latsztt2.
Treasurer and Other Principal Officers
P llmele
NAME OF COMMITTEE
NAME OF TREASURER
Grace Garner for Palm Springs City Council District 1, 2022
Terri Bruggemans
STREET ADDRESS IND P.O. BOX)
1700 S. Araby Drive, Unit B-22
STREET ADDRESS (NO P.O. BOX)
CITY STATE
ZIP CODE AREA CODE/PHONE
751 N. Los Felices Circle West, Unit M207
Palm Springs CA
92264 760-718-8741
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF ASSISTANT TREASURER, IF ANY
Palm Springs CA 92262 760-831-3818
FULL MAILING ADDRESS (IF DIFFERENT)
STREET ADDRESS (NO P.O. BOX)
EMAIL ADDRESS (REQUIRED)/FAR (OPTIONAL)
CITY STATE
ZIP 000E AREA COOE/PHONE
COUNTY OF DOMICILE
JURISDICTION WHERE COMMITTEE 15 ACTIVE
NAME OF PRINCIPAL OFFICER(S)
STREET ADDRESS (NO P.O. BOX)
Attach additional information on appropriately labeled continuation sheets.
3. Verification
CITY STATE
ZIP CODE AREACODE/PHONE
ave used al reasons e in igence in preparing t is statement an a to the best of my knowledge the information contain e erein is true and complete, 1 certi y under
penalty of perjur Unger the laws of the State of California tha foregoing is true and correct.
Executed on By
DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER
Executed on V By
DAT eau. nee ne. •enu iun neuneun.een.umn.a n...... e�.cu.....n.nu.e.
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (August/2018)
FPPC Advice: adYdce@rfonc ca•eov. (866/275-3772)
ww fPPc_ca.gov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
u,MEal rt„ NAM, LD. NUMBER
Grace Garner for Palm Springs City Council District 1, 2022 1415211
All committees must list the financial institution where the campaign bank account Is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
Sun Community Federal Credit Union (760) 337-4200
ADDRESS CITY STATE ZIP CODE
1717 East Vista Chino Rd, Suite J-10 Palm Springs CA 92262
• 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 acts jointly with another controlled committee, list the name and Identification number of the other controlled committee.
ELECTIVE OF FICE SO UG HT OR H ELD YEAR OF PARTY
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE
Nonpartisan
Partisan
(list polMcal party below)
Grace Elena Garner
Palm Springs Council Member, District 1
2022
It
onparasan
Partisan(list
poltial party below)
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S)NAME OR MEASURE(S)FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATES) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
IF A RECALL, STATE "RECALL' IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY, As APPLICABLE) CHECK ONE
SUPPORT OPPOSE
SUPPORT OPPOSE
FPPC Form 410 (August/2018)
FPPCAcMee: d8 vi5 @f8ec•Ca.:LY(866/275-3772)
www..fjpPC.0