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Home My WebLink About2016-06-30 Form 460 - HarnikCOVER PAGE Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 0110i12016 through 06/30/2016 4-L L=•{ .LM CiERKI'S 0 CE DESER-T • Date of election if ap 4pM 5: 53 (Month, Day, Yea 11 /04/2014 Page 1 of 4 For Official Use Only 1. Type of Recipient Committee: All Commile es - Complete Parts 1, 2.3. and 4. 2. Type of Statement: ® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement 0 State Candidate Election Committee Committee ® Semi-annual Statement ❑ Special Odd -Year Report 0 Recall 0 Controlled ❑ Termination Statement l^kaG""pWeP&I51 0 Sponsored (Also file a Form 410 Termination) 416a Cmpkfe Part W ElGeneral Purpose Committee ❑ Amendment (Explain below) 0 Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee — 0 Political Party/Central Committee JAI- ea r) 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 STREETADDRESS (NO P.O. BOXI CITY STATE ZIP CODE AREACODEIPHONE Palm Desert CA 92260 ( MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR RO BOX CITY STATE ZIP CODE AREACODEIPHONE Treasurer(s) NAME OF TREASURER Dr. William Kroonen MAILING ADDRESS CITY STATE ZIP CODE AREACODElPHONE Palm Desert CA 92260 ( NAME OF ASSISTANT TREASURER, IF ANY Elizabeth Lopez MAILING ADDRESS CITY gtATE ZIP CODE AREACOOE/PHONE India CA 92203 ( OPTIONAL. FAX t E-MAIL ADDRESS OPTIONAL FAX I E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowled a the information contained herein and in the attached schedules is true and complete 1 certify under penally of perjury under the laws of the State of California that the foregoin 071 Erewted on BY pile y,raafTreasureror ismrdTreasurer �4. t..�Ca r Executed on ExectAed Dale By • ._ Candhdaie. fete Mpe n[ a Responsihte O[ficer of Sponsor uate By Signature of ControWtg Oftehoider Candidate. State Measure Proponent Executed pale By Signature of Contra" OfBmhaider Candidate State Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 6. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Jan Hamik OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council / City of Palm Desert RESIDENTIALBUSINESS ADDRESS INO AND STREET) CITY STATE ZIP Palm Desert, CA 92260 Related Committees Not Included in this Statement: t.istanycommiuees 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 OF TREASURER I ❑ YES ❑ NO P.O. BOX) CITY STATE ZIP CODE AREACODEIPHONE COMMITTEE NAME I I.D. NUMBER NAME OF TREASURER I ❑ YES ❑ NO ! O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE COVER PAGE - PART 2 Page 2 of 4 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 List names of officeholder(s) or canddate(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.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded Summary Page to whole dollars. ON REVERSE NAME OF FILER Re-elect Jan Hamik Palm Desert City Council 2014 Contributions Received 1. Monetary Contributions................................................... Schedule A, Una S 2. Loans Received................................................................ schedule 8, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines +2 $ 4. Nonmonetary Contributions ............................................ Schedule C. Line 3 5. TOTAL CONTRIBUTIONS RECEIVED ................................... Add Lines 3 + 4 S Statement covers period from_ 01/01/2016 through Column A Column B TOTALTKS PERIOD CALENDAR YEAR "QU ATTACFED SCMEDIAES) TOTAL TO DATE 00.00 00.00 $ 00.00 -2798.08 00,00 00.00 $ 00.00 00.00 00.00 $ -2798.08 Expenditures Made 6. Payments Made................................................................ Sdxm*#te E, Line 4 $ 00.00 7. Loans Made ...................... .......... Schedule H, Line 3 00.00 S. SUBTOTAL CASH PAYMENTS .......................................... Ada Lines 6+7 $ 00.00 9. Accrued Expenses (Unpaid Bills) .................................. Schedule Una 00.00 10. Nonmonetary Adjustment ......................................................... schedule C, Line 3 00.00 11. TOTAL EXPENDITURES MADE ........................................ Add Lines 8 + 9 + 10 $ 00,00 Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 S 13, Cash Receipts........................................................... Column A, tine 3 above 14. Miscellaneous Increases to Cash .................................. schedule 1, Una 4 15. Cash Payments......................................................... Column A, Line a above 16. ENDING CASH BALANCE~ ..................Add Lines 12 + 13 + 14, then subtrad Line 15 $ !f this is a termination statement. Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule8, Part $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ see insrn chons orr reverse $ 19. Outstanding Debts .............................. Add Line 2+Una 9 in Column a above S 9796.04 00.00 00.00 00.00 9796.04 00.00 00.00 2798.08 s 00.00 00.00 S 00.00 00.00 00.00 S 00.00 To calculate 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 first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). 06/30/2016 SUMMARY PAGE Page 3 of 4 1322067 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 $ $ IExpenditure limit Summary for State Candidates 22. Cumulative Expenditures Made* III[ subiact to Voluntary EgwndMura Una) Date of Election Total to Rate (mmlddlyy) I I $ � 1 $ 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 Amnnfn may be rounded SCHEDULE B - PART 1 Schedule — Part I to whole dollars. Statement covers period Loans Received 01/01/2016 . - • from SEE INSTRUCTIONS ON REVERSE through 06/30/2016 Page 4 of 4 NAME OF FILER I D_ NUMBER Re-elect Jan Hamik Palm Desert City Council 2014 1322067 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OUTSTANDING AMOUNT (cI AMOUNT PAID OUTSTANDING a INTE REST ORIGINAL si CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER (F SELF.E MPLOVEn ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCE AT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS IFLOL11AfTTE:E. ALSO ENTER ID. NUMBER) �EOFOUSINESSI PERIOD PERIOD THIS PERIOD' PERIOD PERIOD LOAN TO DATE Brian S. Hamik Self ❑ PAID CALENDAR YEAR ❑ FORGIVEN RATE PER ELECTION- 2798.08 S 00.00 10/01/10 S S S S DATE DUE 110 IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED ❑ PAID CALENDAR YEAR S S X S S PER ELECTION" ❑ FORGIVEN RATE f S S S S DATE DUE t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED ❑ PAID CALENDARYEAR FORGIVEN RATE RATE❑ ELECTION" f f $ S $ DATE DUE fi❑ IND ❑ com ❑ OTH ❑ PTY ❑ SCC DATE INCURRED SUBTOTALS $ 00.00 $ 00.00 $ 2798.08 $ 00.001. Schedule B Summary 1. Loans received this period....................................................................................................................$ nn nn (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period.........................................................................................................$ no nn (Total Column (c) plus bans 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 $ nn nn Enter the net here and on the Summary Page, Column A, Line 2. (M"be•mgahw 'Amounts forgiven or paid by another party also must be reported on Schedule A. " If required. (Enter (e) on SdwmkAe E, Una 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 (Jan/2026) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov