2022-08-15 Form 410 - Garner.A
Statement of Organization
Date Stamp
CALIFORNIA
Recipient Committee
RECEIVED
AND FI
� 0
Statement Type ❑ Initial ® Amendment
❑ Termination —See Part
office of the Secretary of
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of the state of Celitamia
p Not yet qualified
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AUG 15 2022
JUL 27 2022
0 Date qualification threshold met Date quallfitetlOn threshold met
Date of termination
2 1 14 2019
1 1
Office of the City Clerk
R D I., Number 1415211
B Officers
a Ikaele
NAME OF COMMITTEE
NAME OF TREASURER
Grace Garner for Palm Springs City Council District 1, 2022
Terri Bruggemans
STREETADDRESS (NO P.D. BOX)
1700 S. Araby Drive,
Unit B-22
STREET ADDRESS (NO P.O. BOX)
CITY
STATE
ZIP CODE AREACODE/PHONE
751 N. Los Felices Circle West, Unit M207
Palm Springs
CA
92264 760-718-8741
ov STATE LPCODE AREACODE/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 IREDUIRED)/FA%IOPTIONAL)
CITY
STATE
ZIPCODE AREACODE/PNONE
COUNTY Of DOMICILE
JURISDICTION WHERE COMMITTEE 15 ACTIVE
NAM E OF PRINCIPAL OFFICER(S)
STREET ADDRESS (NO RO. BOX)
Attach additional information on appropriately labeled continuation sheets.
3. Verification
CITY STATE
ZIPCODf MIEACODE/PHONE
I have used all reasonable diligence in preparing this statement ancito the best of my knowledge the intormation contained herein is true and complete.
I certify pTer
penalty of perJu nd the laws of the State of California that th or oing is true and correct.
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Executed on By
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�ATE 5 ATURE OFTREASURER OR ASSISTANT TREASURER
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Executed on By
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DATE 51U NATURE OF CONTROLLING OFFICEHOLDER, CANDI DATE, OR STATE MEASURE PROPONENT
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Executed on By
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GATE SIGNATURE Of CONTROLLING OfFICEHOLOEq, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
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DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
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FPPC Form 420 (August/2038)
FPPC Advice: mdvkv@Pfonc.ca.eov (866/275-3772)
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Statement of Organization
CALIFORNIA'
Recipient Committee
•
INSTRUCTIONS ON REVERSE
Pyei
COMMITTEE NAME
I.D. 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
—4. TVpe Of Committee Complete the applicable
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 OFFICE SOUGHT OR HELD YEAR OF PARTY
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE
Nonpartisan
Partisan
Qist pollNal parry below)
Grace Elena Garner
Palm Springs Council Member, District 1
2022
Nonpartisan
I Pert$an
I St P.Mul pen, 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) CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURES) 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)
FPPC Advice: advicv@fPPc.ca,ggv_ (866/275.3772)
wvlw.iPPc.ca. —0v_