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Home My WebLink About2018-09-22 Form 460 - HarnikCOVER PAGE Recipient Committee Campaign Statement Cover Page from Statement covers period Date of election if applicable: 07/01/2018 (Month, Day, Year) 91!6'M ED CITY CLERK'S OFF PALM DESERT. r 2010 SEP 26 AM 10: Page 1 of 6 For Olficial Use Only SEE INSTRUCTIONS ON REVERSE through 09/22/2018 11/06/2018 1. Type of Recipient Committee: All committees -complete parts 1, 2, 3, and 4. 2. Type of Statement: Officeholder, Candidate Controlled Committee ❑ Primarily Farmed Ballot Measure m Preelection Statement ❑ Quarterly Statement O State Candidate Election Committee Committee ❑ Semi-annual Statement ❑ Special Odd -Year Report Q Recall O Controlled ❑ Termination Statement f4w FW15) O Sponsored (Also file a Form 410 Termination) fA4o Ca+pkAe Ptrt tiJ ❑ General Purpose Committee ❑ Amendment (Explain belovii) • Sponsored ❑ Primarily Formed Candidate) • Small Contnbutor Committee Officeholder Committee • Political PartylCentral Committee (Also cuwWePot 7) 3. Committee Information I.D. NUMBER 1322067 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Re -Elect Jan Hamik for Palm Desert City Council 2018 STREET ADDRESS (NO P.O. BOX) 45- STATE ZIP CODE AREACODEIPHONE Indian Wells CA 92210 (760) ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX P. STATE ZIP CODE AREACODEIPHONE Palm Desert CA 92262 OPTIONAL. FAX/ E•MAILADDRESS Treasurer(s) NAME OF TREASURER Dr. William Kroonen MAILINGADDRESS 73575 Juniper ZIP CODE AREACODE/PHONE Palm Desert CA 92260 (760) 568- ASSISTANT TREASURER, IF ANY Elizabeth Lopez MAILING ADDRESS 41-621 ZIP CODE AREACOOEMHONE Indio CA 92203 (760) 578- 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 of perjury under the laws of the State of Califomla that the fore ' is true and Exewted on , } � 1e By Sig tiY. awiv a \ Tre �'ar - al Executed on — 2'2&Date B Y 5 ControAarg . Canaoate, State Measure P-b5v Responsible Ofter of Sponsor Executed an Date Executed on Dale BY Signawre at Contrdlutg Offaceiwlder, CenWdate, State Measure P-r—t FPPC Form 460 (!an/20161 FPPC Advice: advice@fppc.ca.gov (866/275-37721 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 RESIDENTIALlBUSINESSADDRESS (NO.AND STREET) CITY STATE ZIP 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. I.D. NUMBER Jan Harnik for County Supervisor 2018 1 1395155 NAME OF TREASURER CONTROLLED COMMITTEE? David Bauer 1 ® YES ❑ NO CITY STATE ZIP CODE AREA CODEIPHONE Palm Desert CA 92260 ( COMMITTEE NAME I I.D. NUMBER NAME OF STREET ❑ YES ❑ NO CITY STATE ZIP CODE AREACODElPHONE COVER PAGE - PART 2 Page 2 of 6 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER I JURISDICTION I ElSUPPORT ❑ 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 List names of officeholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD m SUPPDRT Jan Hamik Held ❑ 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 (966/275-3772) www.fppc-ca.gov Campaign Disclosure Statement Amounts may be rounded to whole dollars. Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Re -Elect ,fan Harnik for Palm Desert City Council 2018 from Statement covers period m 07/01/2018 SUMMARY PAGE through 09/22/2018 I page 3 of 6 Column A Column B Contributions Received TOTAL THIS PERIOD CALENOARYEAR (FROM ATTACHED SCHEDULES) TOTAL TO DATE 15750.00 15750.00 1. Monetary Contributions ................................................... Schedule A. Line 3 $ S 00.00 00,00 2. Loans Received--- . ........... Schedule 8, Line 3 15750.00 15750.00 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Was 1 +2 S $ 0.00 00.00 4. Nonmonetary Contributions ....................... ..................... schedule C, Line 3 1575 50.00 $ 15750.00 5. TOTAL CONTRIBUTIONS RECEIVED ................. ..._......_. . Add Lines 3 +4 S Expenditures Made 6. Payments Made................................................................ Schedule E. Line 4 S 1800.00 7. Loans Made....................................................................... Schedule H. Line 3 00.00 8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6 + 7 S 1800.00 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3 10. Nonmonetary Adjustment ............................... ......... Schedule C, Line 3 00.00 11. TOTAL EXPENDITURES MADE ........................................ Add Lines a +9 + 10 S 1800.00 Current Cash Statement 12. Beginning Cash Balance ............................ Previous summary Page, Line 16 S 13. Cash Receipts........................................................... Column A. Line 3 above 14. Miscellaneous Increases to Cash .................................. Schedule 1. Line 4 15. Cash Payments......................................................... Column A, Line a above 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 S Lf this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ schedule S. Part 2 S Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See instructions on reverse $ 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column Li above S 3490.40 15750.00 1800.00 17440.40 00.00 00.00 00.00 5 S 5 To calculale Column B, add amounts in Column Ato the corresponding amounts from 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). 11322067 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 111 through 6130 711 to Date 20. Contributions Received $ S 21. Expenditures Made S S Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' (If Subject to Voluntary Expenditure Limit) Dale of Election Total to Date (mmlddlyy) -� $ "Amounts in this section may be different from amounts reported in Column B. 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 I 60 from 0710112018 • - through 09/22/2018 Page 4 of 6 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Re -Elect Jan Harnik for Palm Desert City Council 2018 1322067 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED OF COMMITTEE, ALSO ENTER I.O. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) IND 8/1/2018 Barbara Spencer p 0 coM Retired 5000.00 5000.00 73290 ❑ SCC ❑ IND 8/28/2018 Chrislel Prokay ❑ COM Retired 500.00 500.00 73- ❑ SCC 1Z IND 9/6/2018 Harold Hopp ❑COM Judge of the California 100.00 100.00 73187 ❑ ScC I� IND 9/6/2018 Robert Rivkin ❑ coM Retired 100.00 100.00 P. ❑ SCC ❑ IND 9/17/2018 Harold Matzner P. ❑ SCC SUBTOTAL. $ 15700.00 Schedule A Summary I 'Contributor Codes 1. Amount received this period — itemized monetary contributions. (Include all Schedule 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 $ 15700.00 50.00 15750.00 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 A SCHEDULE 8 - PART 1 � IVMIIMYM Schedule B -- Part 1 to n�uarwhollee dollars. to wlars. Statement covers period s _ Loans Received 07/01/2018 from through 09/22/2018 Page 5 of 6 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 AMOUNT {N AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE OF !ENDER OGCUPATIONANDEMPLOYER (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCEAT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE,ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) PERIOD PERIOD THIS PERIOD' PERIOD PERIOD LOAN TO DATE ❑ Pao CALENDAR YEAR Brian S. Hamik Self 45- RATE PER ELECTION- 2798.08 00.00 10/01/10 3 S s s s DATE DUE t @ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED ❑ PAID CALENDAR YEAR S S ❑ FORGIVEN RATE PER ELECTION" S S S S S DATE DUE T ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED ❑ PAID CALENDAR YEAR ❑ FORGIVEN RATE PER ELECTION" 3 S S S S DATE DUE t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED SUBTOTALS $ 00.00 $ $ 2798.08 $ Schedule B Summary 1. Loans received this period....................................................................................................................$ nn nn (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period.........................................................................................................$ nn 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 $ Enter the net here and on the Summary Page, Column A, Line 2. (May 6e a neptive number} (Enter (e) on Schedule E. Una 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 'Amounts forgiven or paid by another party also must be reported on Schedule A. FPPC Form 460 (Jan/2016) if required. FPPC Advice: advice@fppc.ca.gov (866/27S-3772) www.fppc-ca.gov SCHEDULE E Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Amounts may be rounded to whole dollars. Statement covers period CALIFORNIA irom 07/01 /2018 FORM through 09/22/2018 Page 6 of 6 Re -Elect Jan Harnik for Palm Desert City Council 2018 11322067 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphematialmisc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonelary)' OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL Lv or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staH/spouse travel, lodging, and meals IND independent expenditure support(nglopposing others (explain)' POS postage, delivery and messenger services TSF transfer between committees of the same candidale/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (Internet, a -mail) NAME AND ADDRESS OF PAYEE (IF COMf1IMF-ALSO ENTER I.U. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID City of Palm Desert 73-510 Fred Waring Drive FIL 550.00 Palm Desert, CA 92260 California Latino Voters' Guide 930 Colorado Blvd., Building 2 LIT 250.00 Los Angeles, CA 90041 Michael Williams Michael Williams Company POS 1000.00 3711 A Arlington Avenue, Riverside, CA 92506 R Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................................................. $ 1800.00 2. Unitemized payments made this period of under $100..................... $ 00.00 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ................ $ 00.00 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.)........................... TOTAL $ 1800.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov