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Home My WebLink About2015-06-30 Form 460 - HarnikCOVER PAGE Recipient Committee Campaign Statement Cover Page (Government Code Sections 8420D-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Lkor-1 OFF�iCE C1T Y LERK PAL DESERT. CA e Statement covers period Date of election If appjk�lei L `z$ i M 2• 27 n1m11gn, (Month, Day, Yea .1 from through 06/30/2015 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. ® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall Q Controlled (Also com*hlPart 5) Q Sponsored (Also CW0*fe PartQ ❑ General Purpose Committee i. ; Sponsored IJ Primarily Formed Candidate! Q Small Contributor Committee Officeholder Committee Q Political PartylCentral Committee ("fte Cwpbf °Pa`( 7) 3. Committee information I.D NUMBER 1322067 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Re-elect Jan Hamik Palm Desert City Council 2014 STREET ADDRESS (NO P.O. BOX) 73- STATE ZIP CODE AREA CODEIPHONE 11 /04/2014 1 2. Type of Statement: ❑ Preelection Statement ® Semi-annual Statement LY Termination Statement (Also file a Form 410 Termination) Amendment (Explain below) Treasurer(s) Page ... __ 1— of For Official Use O, y ❑ Quarterly Statement {3 Special Odd -Year Report ❑ Supplemental Preelection Statement -Attach Form 495 NAME OF TREASURER Dr. William Kroonen MAILING ADDRESS 73575 STATE ZIP CODE AREA CODEIPHONE Palm Desert, CA 92260 (760) OF ASSISTANT TREASURER. IF ANY Palm Desert, CA 92260 (76) Lopez MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS 41621 Michelle Place CITY STATE ZIP CODE AREA CODEIPHONE CITY STATE ZIP CODE AREA CODEIPHONE Indio, CA 92203 (760) FAX I E-MAIL ADDRESS OPTIONAL FAX I E-MAIL ADDRESS jan@jancan. com 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the bes of m knowledge the information contained herein and in the attached schedules is true and complete. I certify under penalty of perjury un er the la of the /Stale of California that the foregoing is 1 Executed on 8y Dale Signature of Controra<g Offoeh wer, CarA dale. Slate Meawre Proponent Executed on By SynanaeafCmuoa Oftehdder.rarre�dale.Stale Mean" Pmp0rWTI Dale FPPC Form 460 (January105) FPPC Toll -Free Helpline: 86WASK-FPPC 18661275-37721 state of Callfomla Type or print In ink. COVERPAGE-PART2 Recipient Committee CALIFORNIA Campaign Statement FORM Cover Page— Part2 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 1 City of Palm Desert RESIDENTIALIBUSINESS ADDRESS (NO AND STREET] CITY STATE ZIP 73- Desert, CA 92260 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. COMMrrrEENAME ID NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? YES NO COMMITTEEADDRESS STREETADDRESS (NO PO BOX) CITY STATE ZIP CODE AREA CODE(PHONE COMMITTEENAME G.D NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? 1 YES _ NO COMMITTEE ADDRESS STREETADDRESS (NO PO BOX) CITY STATE ZIP CODE AREA CODEIPHONE Page 2 of 17 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO OR LETTER I 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 Listnames of officeholder(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 (Januaryl06) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661276-3772) State of California Campaign Disclosure Statement Type or print in ink Amounts may be rounded Summary Page to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Re-elect Jan Hamik Palm Desert City Council 2014 Statement covers period from 01/01/2015 through 06/30/2015 SUMMARYPAGE Page 3 of 7 I.D. NUMBER ColumnA Column B Calendar Year Summary for Candidates Contributions Received TOTALTHISPERIOD cALENOMYEAR Primary Runningin Both the State Prima and (FRWATTACHMSC+�1LESj TOT&TODATE General Elections 1. Monetary Contributions ........................................... Schedule A, Line 3 100.00 $ $ 100.D0 -9,000.00 -2,798.00 111 through 6130 7r1 to Data 2. Loans Received...................................................... schedule S. Line 3 •••• 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add $ -8.900.00 $ -2,698.00 20.Receivutions Received $ $ 4. Nonmonetary Contributions .................................... Schedule C. Line 3 00.00 00.00 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED .........................add Lines 3+4 $ -8,900.00 $ -2.698.00 Made $ $ Expenditures Made 6. Payments Made ....................................................... Schedule E. tine 4 S 7. Loans Made............................................................. schedule H, tine 3 8. SUBTOTAL CASH PAYMENTS .................................... add Lines 6+7 5 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F. Line 3 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + 10 $ 250.00 $ 250,00 00.00 00.00 250.00 $ 250.00 00.00 00,00 00.00 00.00 250.00 $ 250.00 Current Cash Statement 12.Beginning Cash Balance ....................... Previous summary Page, Line 16 S 19,181.38 13. Cash Receipts ................................................... Column A. Line 3 above-8,900.00 14. Miscellaneous Increases to Cash ........................... schedule 1. Line 4 134.66 15.Cash Payments .................................................. Column A, Line 6above 250.00 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 10,166.04 1f this is a fennination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... schedule B, Part 2 S 00.00 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See instructions on reverse $ OO.DO To calcuiale Column B, add amounts in Column A to 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 fast report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' IN Subject to voluntary EMpondltun Limn) Date of Election Total to Date (mmfddlyy) I $ 'Amounts in this section may be different from amounts reported in Column B. 19. Outstanding Debts ......................... Add Line 2+ Line 9 in Column 9 above $ 2,798.00 I I FPPC Form 460 (Januaryl05) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772) Schedule A Type or print In Ink. Amounts may be rounded Monetary Contributions Received to whole dollars. Statement covers period from 01/01/2015 SCHEDULE A 06/30/2015 4 7 through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER ID NUMBER Re-elect Jan Hamik Palm Desert City Council 2014 1322067 DATE FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL. ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVETO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (FCOMMfTiEE ALSOENfERID MJIAHERj CODE • OF SELF-EMPLOYM ENTER NAME PERIOD (JAN 1 -DEC 31) (IF REQUIRED) oFa mowssl MIND 6119/15 Robert Roark ❑COM Real Estate Developer $100.00 $100.00 ❑PTY ❑SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑SCC ❑ IND ❑COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑COM ❑OTH ❑ PTY ❑ SCC ❑IND ❑COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 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 $ 100.00 00.00 100.00 FPPC Form 460 (January106) FPPC Toll -Free Helpline: 8661ASK-FPPC (86612751772) 'Contributor Codes IND— Individual COM—Recipient Committee Bother than PTY or SCC) OTH — Other (e.g.. business entity) PTY— Political Party SCC — Small Contributor Committee SCHEDULEB-PARTI �m may b - un Schedule B — Part 1 Amounts Amounts may be rounded Statement covers period P Loans Received to whole dollars. 01/01/2015FPage OF Pramthrall 06/30/2015 5 SEE INSTRUCTIONS ON REVERSE 8 h of NAME OF FILER 1.1) NUMBER Re-elect Jan Hamik Palm Desert City Council 2014 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL. ENTER lot OUTSTANDING id) AMOUNT let AMOUNT PAID Idt OUTSTANDING tel INTEREST III ORIGINAL III) CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER IIFSELF-EMPLOYED ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCEAT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMMME. ALSO EWER ID. NUMBER] NAMEOFBU5INE&% PERIOD THIS PERIOD" PERIOD LOAN TO DATE Brian S. Hamik Self ®PAID CALENDARYEAR ❑ POROVEN PERELECTM— s 11798.08 s 00.00 10/01/10 , s DATEINCURRED t® INC) ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE ❑ PAID CALENDARYEAR s s x s s ❑ FORGIVEN RATE PERELECTION" s s s S s DATE DUE t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATEINCURRED ❑ PAID CAL£NDARYEAR ❑ FORGIVEN RATE PER ELECTION" S S S f S DATE DUE DATEINCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ 00.00 $ 9,000.00 $ 2,798.08 $ Schedule B Summary 1. Loans received this period....................................................................---............................................. $ (Total Column (b) plus unitemized loans of less than $100.) 00.00 2. Loans paid or forgiven this period..................................................................................... ................... $ 9,000.00 (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 $-9,000.00 Enter the net here and on the Summary Page, Column A, Line 2. ""ybeanegab"nrmW *Amounts forgiven or paid by another party also must be reported on Schedule A. — If required, IEnter(e)- SchedAe E. LW4 31 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 (January105) FPPC Toll -Free Helpline: 8661ASK-FPPC (866I275-3772) Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE Re-elect Jan Harnik Palm Desert City Council 2014 Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period From 01101/2015 through 06/3012015 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. Page 6 of r ID NUMBER CUP campaign paraphemakalmisc. N113R member communications RAD radio airtime and production costs CNS campaign consultants MfG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)' OFC office expenses SAL campaign workers' salaries CVC civic donations FEr petition circulating TE L t.% or cable airtime and production costs FIL candidate filinglballot fees PM phone banks TRC candidate travel, lodging, and meals FPD fundraising events POL polling and survey research TRS slafflspouse travel, lodging, and meals IPD independent expenditure supportinglopposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the some candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internal, e-mail) NAME AND ADDRESS OF PAYEE (EFccMµnT.u.sOEWERr.o_nanaBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID Palm Desert Area Chamber of Commerce 72-559 Highway 111 Palm Desert, CA 92260 MTG 200.00 ' Payments that are contributions or independent expenditures must also be summarized on Schedule D. Schedule E Summary SUBTOTAL$ 1. Itemized payments made this period. (Include all Schedule E subtotals.).............................................................................................................. $ 2 Unitemized payments made this period of under $100 .......................................................................................................................................... $ 200.00 50,00 3, Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column a 00.00 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A. tine 6.) ............................. TOTAL $ 250,00 FPPC Fonn 460 (JanuaryMS) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772) Sr_horh ilp I V..__ __ _a_. I- SCHEDULF 1 Miscellaneous Increases to Cash Amounts may be rounded Statement covers period . to whole dollars. 01 /01 /2015 • ' from F 06/30/2015 7 through Page of SEE INSTRUCTIONS ON REVERSE NAME OF FILER D NUMBER Re-elect Jan Harnik Palm Desert City Council 2014 RECEIVEED FUOFCOW Ate". ALSO �R i OF µ SOURCE DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH City of Palm Desert Refund of balance of deposit paid for the 01/20/15 73-510 Fred Waring Drive Candidate Statement. 134.66 Palm Desert, CA 92260 Attach additional information on appropriately labeled continuation sheets. SUBTOTAL- $ 134.66 Schedule 1 Summary 1. Itemized increases to cash this period. .. $ 134.6fi 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 Summary Page, Line 14.) .... TOTAL $ 134.fifi .............................. FPPC Form 460 (Januaryl05) FPPC Toll -Free Helpline: 8661ASK-FPPC (8661275-3772)