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Home My WebLink About2019-12-31 Form 460 - HarnikCOVER PAGE Recipient Committee Campaign Statement Cover Page Statement covers period from 071101 /2019 SEE INSTRUCTIONS ON REVERSE through 12/3112019 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2.3. and 4. ® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 Stale Candidate Election Committee Committee 0 Recall 0 Controlled (/J-C-plotiPW5) 0 Sponsored faro f:-V*fe f 1 e) ❑ General Purpose Committee 0 Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Abu Co OHO Pe7) 3. Committee Information I.D. NUMBER 1322067 RE-ELECT JAN HARNIK FOR PALM DESERT CITY COUNCIL 2018 STREETADDRESS (NO P.O. BOX) 45-025 MANITOU CODE AREA CODEIPHONE INDIAN WELLS CA 92210 (760) 285-7531 DIFFERENT) NO. AND STREET OR P.O. BOX P.O. BOX CODE AREACODEIPHONE PALM DESERT CA 92262 OPTIONAL: FAX I E-MAILADORESS i,'IT CLERI "I"1'MCE P LM DESEF. T- CA Date of election if appli (Month, Day, Year) 11/06/2018 2. Type of Statement: JAN 22 PM 4* 46 ❑ Preelection Statement QI Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) Page I— of For Official Use ❑ Quarterly Statement ❑ Special Odd -Year Report NAME OF TREASURER DR. WILLIAM KROONEN MAILING ADDRESS 73575 JUNIPER STREET CODE AREACODEWHONE PALM DESERT CA 92260 (760) 578-3039 TREASURER, IF ANY ELIZABETH LOPEZ MAILING ADDRESS 41621 MICHELLE PLACE CODE AREACODEIPHONE INDIO CA 92203 (760) 578-3878 E-MAILADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete. I certify under penalty or pe 'ury under the laws of the Slate of California that the foregoi d Corr Executed on • [Yale By 3^e surer a A. ;s�rl Executedon _ z BYDale Signs• Controlitng Officeholder, tiarrtliJs. . Stale easureesprxmble Otker of Sponsor Executed on Executed on CSele By Signature o1 Controlling Officeholder, CandWate. Slate Measure Proponent FPPC Form 460 (Jan/2026) FPPC Advice: advice@fppc.ca.gov (866/Z75-3772) www.fppc-ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE JAN HARNIK OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) CITY COUNCIL - CITY OF PALM DESERT RESIDENTIALIBUSINESS ADDRESS (NO.AND STREET) CITY STATE ZIP 45-025 MANITOU DRIVE INDIAN WELLS, CA 92210 Related Committees Not Included in this Statement: List any committees not included in this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. NAME NAME OF TREASURER ADDRESS STREETADDRESS I.D. NUMBER ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODEIPHONE COMMITTEE NAME NAME OF STREET ADDRESS (NO P.O. I.D. NUMBER ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODEIPHONE COVER PAGE - PART 2 Page A of 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO, OR LETTER JURISDICTION ❑ SUPPORT ❑ OPPOSE - Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER. CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee ust names of officehotder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach continuation sheets if necessary FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppr-ca.gov Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS OI Amounts may be rounded to whole dollars. NAME OF FILER RE-ELECT JAN HARNIK FOR PALM DESERT CITY COUNCIL 2018 Contributions Received Column A TOTAL THIS PERIOD {FROM ATTACHED SCHEDULES) 0000 1. Monetary Contributions................................................... Schedule A, line 3 S 00.00 2. Loans Received .......................... .................. Schedule B. tine 3 00.00 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 + 2 $ 00.00 4. Nonmonetary Contributions ....................... ..................... schedule C, Line 3 00.00 5. TOTAL CONTRIBUTIONS RECEIVED ...................... ..AddL.ines3+4 S Expenditures Made 6. Payments Made................................................................ schedule E, Line 4 S 999.26 7. Loans Made ..................................... ....... Schedule H line 3 00.00 ........................... 8, SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6 + 7 5 999.26 9. Accrued Expenses (Unpaid Bills) ............................ . Schedule F Line 3 00.00 10. Nonmonetary Adjustment ..................... ................... Schedule C, Line 3 00.00 11, TOTAL EXPENDITURES MADE........................................AddL.inese+9+10 $ 999.26 Current Cash Statement 12. Beginning Cash Balance Previous summary Page, Line 16 S 9037.29 13, Cash Receipts . column A, Line 3 above 00,00 .......................................................... 14. Miscellaneous Increases to Cash .................................. schedule 1, tine 4 00.00 15. Cash Payments....................................................... Column A, Line a above-999.26 16. ENDING CASH BALANCE ...Add Lines 12 + 13 + 14. then subtract Line 15 S 8038.03 t/ this is a termination statement, line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule s, Pad $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ see instnrcdonsonreverse S 19. Outstanding Debts .............................. Add Line 2 + Line gin Column a above S 00.00 00.00 00.00 Statement covers period from 07//01/2019 through 12/31/2019 page Column B CALENDAR YEAR TOTAL TO DATE $ 50.00 00.00 50.00 00.00 $ 50.00 S 1089.75 00.00 S 1089.75 00.00 00.00 S 1089.75 SUMMARY PAGE of 1322067 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1l1 through 6130 711 to Date 20, Contributions Received $ 21, Expenditures Made 5 S S Expenditure Limit Summary for State Candidates 22- Cumulative Expenditures Made* (N Subject to Voluntary Expenditure LIMN) Date of Election Total to Dale (mrrdddlyy) $ To calculate Column B, add amounts in Column A to the corresponding 'Amounts in this section may be different from amounts amounts from Column B reported in Column B. of your last report. Some amounts In Column A may be negative figures that should be subtracted from previous period amounts. If this is the first report being filed for this calendar year, only carry over the amounts from Lines 2.7. and 9 (if any). FPPC Form 460 (]an/2016) FPPC Advice: advice@fppc.ca.gov (666/275-3772) www.fppc.ca.gov -qr_hprtttip A Amounts may be rounded SCHEDULE A Monetary Contributions Received to whole dollars. Statement covers periodFPage e _ , I from 07110112019 12131/2019 through SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER RE-ELECT JAN HARNIK FOR PALM DESERT CITY COUNCIL 2018 1322067 , STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR FULL NAME, ETADCOMMITDEE. IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED ALSO ENTER I.D. NUMBER) (OFCODE CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 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.)......................TOTAL $ 00.00 00.00 00.00 "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: adv1ceLWfppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule B — Part 'I Loans Received SEE INSTRUCTIONS ON REVERSE Amounts may be rounded to whole dollars. NAME OF FILER RE-ELECT JAN HARNIK FOR PALM DESERT CITY COUNCIL 2018 Statement covers period from 07//01 /2019 through 12/31/2019 FULL NAME, STREETADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER AND OCC OUTSlap TANDING BALANCE Ito) AMOUNT IN AMOUNT PAID OUTSTANDING BALANCEAT OF LENDER IIF COMMrrrMALSO ENTER I.O. NUMBER) F SELF-EMPLOYED.DENTER NAME OF BUSINESS] BEGINNING THIS RECEIVED THIS PERIOD OR FORGIVEN THIS PERIOD CLOSE OFT IS PERIOD PERIOD ❑ PAID BRIAN S. HARNIK SELF �45- ❑ FORGIVEN 2798.08 00.00 t❑ IND ❑ COM ❑ OTH l7 PTY ❑ SCC s s s DATE DUE ❑ PAID S S ❑ FORGIVEN t ❑ IND [I COM [I OTH [I PTY ❑ SCC S_ S_ $ DATE DUE t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC S SUBTOTALS $ ❑ PAID S $ ❑ FORGIVEN S S GATE DUE $ $ 2798.08 $ Schedule B Summary 1. Loans received this period....................................................................................................................$ nn nn (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period.........................................................................................................$ on nn (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.).............................................................. NET $ no nn Enter the net here and on the Summary Page, Column A, Line 2. (May be a^egabw nm beq 'Amounts forgiven or paid by another party also must be reported on Schedule A. " If required. SCHEDULE B - PART 1 Page _5�_ of f4 I.D. NUMBER 1322067 INTEREST ORIGINAL CUMULATIVE PAID THIS AMOUNT OF CONTRIBUTIONS PERIOD LOAN TO DATE CALENDAR YEAR % s 118,000 S RATE PER ELECTION" s 10/01/10 S DATE INCURRED CALENDAR YEAR % S S RATE PER ELECTION" S DAS TE INCURRED CALENDAR YEAR % S S RATE PER ELECTION" S S DATE INCURRED Itnlef )e) on Schedde E, Line 3) tContributor 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 ()an/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule C Amounts may be rounded SCHEDULE C to whole dollars. Statement covers period Nonmonetary Contributions Received • - , � � from 07//01/2019 • through SEE INSTRUCTIONS ON REVERSE iomiionig RE-ELECT JAN HARNIK FOR PALM DESERT CITY COUNCIL 2018 IF AN INDIVIDUAL, ENTER AMOUNT/ DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR DESCRIPTION IOF C RECEIVED ZIP CODE OF CONTRIBUTOR CODE * OCCUPATION AND EMPLOYER,ENTER GOODS OR SERVICES FAIR MARKET OF COMMITTEE, ALSO ENTER I.D. NUMBER) IIF SELF-EMPLOYED, ENTER VALUE NAME OF BUSINESS) ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 00.00 Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.)......................................................................................................................$ 2. Amount received this period — uniternized nonmonetary contributions of less than $100..................................$ 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.).....................TOTAL $ 00.00 00.00 00.00 Page I.D. NUMBER 1322067 CUMULATIVE TO DATE CALENDAR YEAR (JAN 1 - DEC 31) of PER ELECTION TO DATE (IF REQUIRED) '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 Schedule D SCHEDULE D Summary of Expenditures Amounts may be rounded Statement covers period Supporting/OpposingSupporting/Opposing Other to whole dollars. CALIFORNIA 6 from 07110112019 Candidates, Measures and Committees 12/31/2019 �j through page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER RE-ELECT JAN HARNIK FOR PALM DESERT CITY COUNCIL 2018 1322067 DATE NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR TYPE OF PAYMENT DESCRIPTION AMOUNT THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE MEASURE NUMBER OR LETTER AND JURISDICTION, (IF REOUIREO) PERIOD (JAN.1-bEG.71) (IF REQUIRED) OR COMMITTEE ❑ Monetary Contribution ❑ Nonmonelary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonelary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonelary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ 00.00 Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) ....................................................... $ 00.00 2. Unitemized contributions and independent expenditures made this period of under$100.................................................................................... $ 00.00 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.).......... TOTAL.. $ 00.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc-ca.gov (966/275-3772) www.fppc.ca.gov SCHEDULE E Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Amounts may be rounded to whole dollars. RE-ELECT JAN HARNIK FOR PALM DESERT CITY COUNCIL 2018 CODES: If one of the following codes accurately describes the payment, you may enter the code. CMP campaign paraphemallalmisc. MBR member communications CNS campaign consultants MTG meetings and appearances CTS contribution (explain nonmonetary)' OFC office expenses CVC civic donations PET petition circulating FIL candidate filing/ballot fees PHO phone banks FND fundraising events POL polling and survey research IND independent expenditure supportinglopposing others (explain)' POS postage, delivery and messenger services LEG legal defense PRO professional services (legal, accounting) LIT camoaian literature and mailings PRT print ads NAME AND ADDRESS OF PAYEE (IF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE OR CITI CARDS P.O_ BOX 78045 WEB PHOENIX, AZ 85062-8045 BELL, McANDREWS & HILTACHK LLP 455 CAPITOL MALL, SUITE 600 PRO SACRAMENTO, CA 95814 Payments that are contributions or independent expenditures must also be summarized on Schedule D. Schedule E Summary covers period from 07/101/2019 through 12/31/2019 Otherwise, describe the payment. Page —&— of LA_ 1322067 RAID radio airtime and production costs RFD returned contributions SAL campaign workers' salaries TEL l.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidatelsponsor VOT voter registration WEB information technology costs (intemet, e-mail) DESCRIPTION OF PAYMENT AMOUNT PAID 119.76 858.33 SUBTOTAL $ 978.09 1. Itemized payments made this period. (include all Schedule E subtotals. $ 978.09 2. Unitemized payments made this period of under$100............................ __. $ 21.17 00 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column e $ . 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)........................... TOTAL $ 999.26 FPPC Form 460 ()an/2016) FPPC Advice: advice@fppc.ca.gov (866/275-37721 www.fppc.ca.gov SCHEDULE F Schedule F Accrued Expenses (Unpaid Bills) SEE INSTRUCTIONS NAME OF FILER Amounts may be rounded to whole dollars. RE-ELECT JAN HARNIK FOR PALM DESERT CITY COUNCIL 2018 Statement covers period from 07//01 /2019 through 12/31/2019 CODES: if one of the following codes accurately describes the payment, you may enter the code. Otherwise, CMP campaign paraphemalialmisc. MBR member communications RAD CNS campaign consultants MTG meetings and appearances RFD CTB contribution (explain nonmonetary)' OFC office expenses SAL CVC civic donations PET petition circulating TEL FIL candidate filingiballot fees PHO phone banks TRC FND fundraising events POL polling and survey research TRS IND independent expenditure supportinglopposing others (explain)" POS postage, delivery and messenger services TSF LEG legal defense PRO professional services (legal, accounting) VOT LIT campaign literature and mailings PRT print ads VVEB describe the payment. Page A of )A I.D. NUMBER 1322067 radio airtime and production costs returned contributions campaign workers' salaries t.v. or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidatelsponsor voter registration information technology costs (intemel, e-mail) NAME AND ADDRESS OF CREDITOR (IF COMMITTEE, ALSO ENTER I.0,NUMBER) CODE OR DESCRIPTION OF PAYMENT OUTS(NDING BALANCE BEGINNING OF THIS PERIOD { AMOUNT INNCURRED THIS PERIOD (c) AMOUNT PAID THIS PERIOD (ALSO REPORT ON Et OUTSTANDING {TAA BALANCEATCLOSE OF THIS PERIOD ' Payments that are contributions or independent expenditures must also be SUBTOTALS $ $ $ 00.00 summarized on Schedule D. Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total uniteized accrued expenses under $100.)........... ......INCURRED TOTALS $ 00.00 m 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on 00.00 accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under$100.)................................... PAID TOTALS $ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.) ........... NET $ May be OO t�O FPPC Form 460 (!an/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule G Payments Made by an Agent or Independent Contractor (on Behalf of This Committee) Amounts may be rounded to whole dollars. NAME OF FILER RE-ELECT JAN HARNIK FOR PALM DESERT CITY COUNCIL 2018 NAME OF AGENT OR INDEPENDENT CONTRACTOR from irtt covers pen 07/10112019 SCHEDULE G through 12/31/2019 I Page of i.-Z CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalialmisc. MBR member communications RAD CNS campaign consultants MTG meetings and appearances RFD CTB contribution (explain nonmonetary)' OFC office expenses SAL CVC civic donations PET petition circulating TEL FIL candidate filinglballot fees PHO phone banks TRC FND fundraising events POL polling and survey research TRS IND independent expenditure supportinglopposing others (explain)" POS postage, delivery and messenger services TSF LEG legal defense PRO professional services (legal, accounting) VOT LIT campaign literature and mailings PRT print ads WEB Payments that are contributions or independent expenditures must also be summarized on Schedule D. ID NUMBER 1322067 radio airtime and production costs returned contributions campaign workers' salaries Lv. or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor voter registration information technology costs (Internet, e-mail) Attach additional information on appropriately labeled continuation sheets. TOTAL* $ 00.0u Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or FPPC Form 460 (1an/2016) independent contractor as reported on Schedule E. FPPC Advice: advice@fppc.ca.gov (856/275-3772) www.fppc.ca.gov SCHEDULE H Schedule H Amounts may be rounded Statement covers period RNIA 460 to whole dollars. 071/0112019 Loans Made to Others from FORM 12/31/2019 I ! ' +� through Page of� SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER RE-ELECT JAN HARNIK FOR PALM DESERT CITY COUNCIL 2018 1322067 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL. ENTER (� OUTSTANDING (b) AMOUNT (c) REPAYMENT OR (d) OUTSTANDING (e) INTEREST tr) ORIGINAL (g) CUMULATIVE OF RECIPIENT OCCUPATION AND EMPLOYER IIF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS LOANED THIS FORGIVENESS BALANCE AT CLOSE OF THIS RECEIVED AMOUNT OF LOANS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) PERIOD THIS PERIOD' LOAN TO DATE ❑ PAID CALENDAR YEAR $ s x s s ❑ PATE PER ELECTION- s s S s DATE DUE s � WE INCURRED ❑ PAID CALENDAR YEAR s s x s s ❑ ft)RGIVEN -E PER ELECTION" s s s s s DATE___ DATE INCURRED "Loans that are contributions to another candidate or committee must also be summarized on Schedule D. Loans forgiven must also be SUBTOTALS $ $ $ $ reported on Schedule E. (Enter (a) on Sdodule I. Line 3) Schedule H Summary 1. Loans made this period....................................................................................................................................................$ . nn Qn (Total Column (b) plus unitemized loans of less than $100.) ..If Required 2. Payments received on loans............................................................................................................................................$ (Total Column (c) plus unitemized payments of less than $100.) 3. Net change this period. (Subtract Line 2 from Line 1.)............................................................................................ NET $ — noon (Enter the net here and on the Summary Page, Column A, Line 7.) (May be a negative number) FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ce.gov (866/275-37721 www.fppc.ca.gov Schedule I Miscellaneous Increases to Cash RE-ELECT JAN HARNIK FOR PALM DESERT CITY COUNCIL 2018 DATE FULL NAME AND ADDRESS OF SOURCE RECEIVED I OF COMMITTEE, ALSO ENTER I.D. NUMBER) Amounts may be rounded to whole dollars. Statement covers period from 07/101 /2019 through 12/31/2019 DESCRIPTION OF RECEIPT SCHEDULEI Page W-1 of I.D. NUMBER 1322067 AMOUNT OF INCREASE TO CASH Attach additional information on appropnately labeled continuation sheets. SUBTOTAL $ 00.00 Schedule 1 Summary 1. Itemized increases to cash this period. ..................$ 00.00 2. Unitemized increases to cash of under $100 this period. ___.$ 00.00 ................................. 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) .................$ 00.00 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the .... TOTAL $ 00.00 Summary Page, Line 14.) FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/27S-3772) www.fppc.ca.gov