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Home My WebLink About2013-12-31 Form 460 - HarnikRecipient Committee RECEIVED 0 Campaign Statement CITY CLERIC'S OFFICE Cover Page PALM DESEq'. (Government Code Sections 84200-84216.5) 2014 JAN 27 PM 1 Sta from _ SEE rNSTRUCTIONS ON REVERSE through Type or print in ink. covers period 07/01 /2013 12/31 /2013 1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4. ,rQ Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure p State Candidate Election Committee Committee Q Recall O Controlled (AJso Complete Pall 5) p Sponsored ❑ General Purpose Committee (Also Complete Part N Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I.D. NUMBER 1322067 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Re-elect Jan Harnik Palm Desert City Council 2014 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE ® COVER PAGE CITY C L E FP?te $IaW I' I PLht USE,% �%• Date of election if applical6p. JAN 27 PM 1: 32 Page __t_ of (Month, Day, Year) For Official Use Only 11/4/2014 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement ® Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement ❑ Supplemental Preelection (Also file a Form 410 Termination) Statement - Attach Form 495 ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Dr. William Kroonen MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE Palm Desert CA 92260 ( NAME OF ASSISTANT TREASURER, IF ANY Palm Desert CA 92260 ( Elizabeth Lopez MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE Indio CA 92203 ( OPTIONAL: FAX / E-MAIL ADDRESS OPTIONAL: FAX / E-MAIL ADDRESS ' 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 perjuryidder the laws of the State of California that the foregoing is true and co Executed on 0 -"n • �-7. F� By y�. _ ........,.._....,,......__. ___..__ — Executed oDabs Executed oDate By By Executed on Date By Signature ofContmltng Officeholder- Candidate, State Measure Pmponant FPPC Forth 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (86612753772) State of California Recipient Committee Type or print in ink. COVERPAGE-PART2 Campaign Statement CALIFORNIA Cover Page — Part 2 FORM 6. 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 RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Palm 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. COMMITTEE NAME I.D. NUMBER wnmc yr 1 RCI1J VRGR I I,UN I KULLtU UUMMI 1 1 EE7 ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO 5TREETADDRESS (NO CITY STATE ZIP CODE AREA CODEIPHONE Page of 0 3 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 UK HhLU DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee Llstnames of offlceholder(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 SOUGHT OR HELD ❑ SUPPORT r ❑ OPPOSE Attach continuation sheets if necessary FPPC Form 460 (Januaryl05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661276-3772) State of California Campaign Disclosure Statement a or print in ink. SUMMARY PAGE Summary Page RECEIVE[) CITY C L E P, s Anats may be rounded to whole dollars. Statement covers period - , K' 0 F F I C E PALM Q E :: I:. CA from 07/01/2013 •- 2014 JAN 26 PH 2: 13 through 12/31/2013 Page ✓ of SEE INSTRUCTIONS ON REVERSE 1 NAME OF FILER I.D. NUMBER Re -Elect Jan Hamik Palm Desert City Council 2014 1322067 Contributions Received ALITMIr PERIOD Column Calendar Year Summary for Candidates To (FROMATTACNEDSCHEDULES) YEAR TOTALTODATE Running in Both the State Primary and General Elections 1. Monetary Contributions ........................................... Schedule A, Linea 00 $ 37243.$ 37243.00 2. Loans Received...................................................... schedule B, Line 3 3795.02 15593.10 1/1 through 6/30 7/1 to Date 3. SUBTOTALCASH CONTRIBUTIONS ......................... Add Lines 1 +2 $ 41038.02 $ 52836+10 20. Contributions Received $ $ 4. Nonmonetary Contributions .................................... Schedule C, Line 3 - - 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Unes3+4 $ 41038.02 $ 52836.10 Made $ $ Expenditures Made 6. Payments Made ....................................................... Schedule E, Line 4 $ 4384.39 $ 4434.39 7. Loans Made............................................................. Schedule H, Line 3 - -- 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6+7 $ 4384.39 $ 4434.39 9. Accrued Expenses (Unpaid Bills) ............................... Schedule F Line 3 _ - 10. Nonmonetary Adjustment .......................................... ScheduleC. Linea - 1'.. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + 10 $ 4384.39 $ 4434.39 Current Cash Statement 12. Beginning Cash Balance ....................... Previous summary Page, Line 16 $ 1071.2E To calculate Column B, add 13. Cash Receipts ................................................... Column A, L/ne 3 above 41038.02 amounts in Column A to the 14. Miscellaneous Increases to Cash ........................... schedule ►, Linea 443.00 corresponding amounts from Column B of your last 15. Cash Payments .................................................. Column A, Line 8 above 4384.39 report. Some amounts in Column A may be negative 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 38167.89 figures that should be subtracted from previous If this is a termination statement, Line 16 must be zero. period amounts. If this is the first report being filed 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts any). 18. Cash Equivalents ........................................ See instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2 +line 9 in Column B above $ 15593.10 Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure LImR) Date of Election Total to Date (mm/dd/yy) `Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/276-3772) Schedule A Type or print in ink SCHEDULE A Monetary Contributions Received Amounts may be rounded ry to whole dollars. Statement covers period • ' from 07/01 /2013 • ' - through 12/31/2013 page SEE INSTRUCTIONS ON REVERSE of NAME OF FILER I.D. NUMBER Re -Elect Jan Harnik Palm Desert City Council 2014 1322067 FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IFCOMMn7EE,AMENTER I.D.NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE * pFSSY-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) ®IND 8-14-2013 Robert Roark 179 On -Time Performance MIND 9-13-2013 James R. Houston 345 ❑SCC ®IND 11-17-2013 Janice M. Hawkins ❑COM Director of Development 100.00 100.00 75- ❑ sCC ®IND 11-12-2013 Leonard J. Kapner ❑COM Businessman 100.00 100.00 78- ❑ SCC Shirley Nye ®IND ❑ Insurance Broker 11-17-2013 44200 ❑ SCC SUBTOTAL$ 10,450.00 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 $ 36,800.00 443.00 37243.00 '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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule A (Continuation Sheet) Type or print in ink SCHEDULE (CONT.) 1V1Vllt;Ldry Vvfltributiu"s Received Amounts may oerounaea Statement covers period - to whole dollars. • ' from 07/01 /2013 - through 12/31/2013 a3 Page of NAME OF FILER I.D. 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 AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED P UMBER) (IF CODE* OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE OF SELF-EMPLOYED. ENTER NAME OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) Sabby Jonathan ®IND ❑COM CPA 11/17/2013 ❑ PTY ❑ SCC 11/17/2013 Philip Bloom ®IND ❑❑CO Investor ❑ PTY ❑ SCC 11/17/2013 Sandra Cooper Woodson ®IND ❑coM None ❑ PTY ❑ SCC Harold Matzner ®IND Entrepreneur 11/17/2013 ❑ PTY ❑ SCC 11/17/2013 Lynn Gelman ®IND ❑coM Attorney ❑ PTY ❑ SCC SUBTOTAL$ 11,150.00 *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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (86612763772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE (CONE) monetary oninDutlonS Kece)ved Amounts may be rounded Statement covers period to whole dollars.CALIFORNIA 4' from 07/01/2013 FORM • through 12/31/2013 G Page of� NAME OF FILER I.D. NUMBER Re -Elect Jan Hamik Palm Desert City Council 2014 1322067 DATE FULL NAME, STREET ADDRESS AND ZJP CODE OF CONTRIBUTOR DE CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED OFCAMMRTEE,ALSND I.D.N CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED. ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) James Latting IND OCOM Attorney 11/12/2013 ❑ PTY ❑SCC Janice Bames ®COD IND None ' ".12/2013 ❑ PTY ❑ SCC Harold Maye IND p®COM None 11/17/2013 ❑ PTY ❑ SCC John Furbee OIND ❑COM Businessman 11/12/2013 ❑ ❑ SCC Timothy Radigan-Brophy ®IND ❑COM Investor 11/12/2013 ❑ PTY ❑ SCC SUBTOTAL$ 10,900.00 '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 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/27&4772) Schedule A (Continuation Sheet) Type or print in ink --A-SCHEDULER (CONY) ..---- � - -t- 1-- nF{l11GLQIy vV1al11YUL1V115 IRCGCIVVU m1nuum5 may oe rounaeo Statement covers period ' to whole dollars. • • from 07/01/2013 - • through 12/31/2013 Page_ of C NAME OF FILER I.D. NUMBER Re -Elect Jan Harnik Palm Desert City Council 2014 1322067 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED ALSO ENTER ID. NUMBER) (IF COMMITTEE,CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE OF SELF-EMPLOYED. ENTER NAME OFBUSINESS) PERIOD (JAN 1 - DEC. 31) (IF REQUIRED) 11/12/2013 Doug Galloway ®IND ❑ Financial Investor ❑ PTY ❑SCC 1 '12/2013 Rick Stein ®IND ❑COM Financial ❑ PTY ❑ SCC 11/12/2013 Gary Smitson ®IND ❑❑CO Jeweler ❑ PTY ❑ SCC 11/12/2013 Robert Roark ®IND COM Real Estate Development ❑ PTA. ❑ SCc 11/12/2013 Linda Garbarini ®IND ❑COM Executive Vice President ❑ PTY p SCc SUBTOTAL$ 950.00 '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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (86612754772) Schedule A (Continuation Sheet) Type or print in Ink.SCHEDULER (CONY) 1tIv111WLaly %Pv"LIINUt1v11.7 RCGCIVCU ^11muntomayverounoeu -'11111111111111111— Statement covers p@rlod to whole dollars. CALIFORNIA from 07/01 /2013 FORM • through 12/31/2013 Page of4? NAME OF FILER I.D NUMBNUMB ER Re -Elect Jan Harnik Palm Desert City Council 2014 3. 1 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED OFCOMMrrrEE,ALSO ENTER I.D.NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE OF SELF-EMPLOYED. ENTER NAME OF aUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 11/17/2013 Sheila Gilligan ®IND ❑COM None 72-885 Kenneth Huddy ®IND None 11/12/2013 45-325 11/12/2013 Larry Goodwin ❑IIND Insurance Broker 77-734 ❑ SCC 11/12/2013 Pamela Williams ®IND ❑:]CO None 110 Presidio 11/12/2013 Patricia Scully ®IND ❑COM None P.O. SUBTOTAL$ 650.00 *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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (86612753772) Schedule A (Continuation Sheet) Type or print In Ink SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period to whole dollars. from 07/01 /2013 CALIFORNIA � 6 through 12/31/2013 _ Pa9 a of� NAME OF FILER Re -Elect Jan HamI.D. NUMBERik Palm Desert City Council 2014 11322067 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE. ALSOENTER I.D. NUMBER) CODE* OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME OFBUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) Arizona Mine Management Inc. ❑IND 11/12/2013 41865 Boardwalk Avenue, Suite 204 ❑coM ® OTH 750.00 750.00 Palm Desert, CA 92211 ❑ PTY ❑ SCC i Ken Stendell Construction, Inc. ❑IND — — 11/27/2013 P.O. Box 3352 ❑COM BOTH 100.00 100.00 Palm Desert, CA 92261 C PTY ❑ SCC E. Cole Burr 12/2/2013 ®IND ❑ coM President President 35560 ❑ SCc Tracy Burr 12/2/2013 FIND ❑coM Vice President 35560 ❑ SCC I Farley Paving Stone Co., Inc. ❑IND 12/6/2013 P.C. Bcx 10946 ❑coM 250.00 250.00 Palm Desert, CA 92255 El°T I ❑ SCC SUBTOTAL$ 2,600.00 '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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (86612753772) Schedule A (Continuation Sheet) Type or print in ink SCHEDULER (CONY) Wnvllcaaly VV11U1{JUL1W11, ItCGGIVWU Annuunismay usrounded Statement covers period to whole dollars. CALIFORNIA from 07/01 /2013FORM• through 12/31/2013 Page. of NAME OF FILER I.D. NUMBER Re -Elect Jan Harnik Palm Desert City Council 2014 1322067 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMIT EE,ALSOF_NTERI.D.NUMBER) CODE * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME OFSUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 7/24/13 Robert Roark IND E)COM Real Estate Development 179 ❑ scC ❑IND ❑ COM ❑ OTH ❑ PTY ❑ SCC MIND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND ❑ COM ❑ OTH ❑ PTY ❑SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 100.00 '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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) Tunn ^r rini, in Wt SCHEDULEB-PART1 Schedule — Part 1 Amounts may be rounded Statement covers period . Loans Received to whole dollars. 07/01/2013 a _ 0 from !Page 'NSTRUCTIONS 12/31/2013 � w SEE ON REVERSE through of NAME OF FILER I.D. NUMBER Re -Elect Jan Hamik Palm Desert City Council 2014 1322067 FULL NAME, STREET ADDRESS AND ZIP CODE I I IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER e OUTSTANDING BALANCE (b) AMOUNT (c) AI AR (d) OUTSTANDING BALANCEAT (e) INTEREST M ORIGINAL (9 CUMULATIVE OF LENDER (IF SELF•EMPLOYED,ENTER BEGINNING THIS RECEIVED THIS N FORGIVEN OR FORGIVEN CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (F COMMITTEE- ALSO ENTER LID NUMBER) NAMEOFBUSINESS) PERIOD PERIOD THIS PERIOD' p PERIOD LOAN TO DATE Brian S Hamik Attorney ❑PAID CALENDAR YEAR RATE PER ELECTION— 11798.08 3795.02 10-1=10 E 0 tm IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ E s E DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR S $ R $ S ❑ FORGIVEN RATE PER ELECTION" $ S S $ $ DATE DUE t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED ❑ PAID CALENDAR YEAR E E 9i S S ❑ FORGIVEN RATE PERELEcnON" S $ E E E DATEDUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTALS $ 3795.02 $ — $ 15593.10 $ Schedule B Summary 1. Loans received this period.................................................................................................................... $ (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period......................................................................................................... $ (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) (Enter (e) on Schedule E. Line 3) 3795.02 tContributor Codes 3. Net change this period. (Subtract Line 2 from Line 1.)............................................................... NET $ 3795.02 Enter the net here and on the Summary Page, Column A, Line 2. (May be a negative numbed 'Amounts forgiven or paid by another party also must be reported on Schedule A. If required. IND—Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Parry SCC—Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) SCHEDULE B-PART 2 scneauie t3 — cart z Iype or print In InK. Statement covers periodCALIFORNIA Amounts may be rounded Loan Guarantors 466 to whole dollars. 07/01/2013 FORM from 12/31/2013 h I 9 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Re -Elect Jan Harnik Palm Desert City Council 2014 1322067 FULL NAME, STREET ADDRESS AND IF AN INDIVIDUAL, ENTER AMOUNT BALANCE ZIP CODE OF GUARANTOR CONTRIBUTOR OCCUPATION AND EMPLOYER LOAN GUARANTEED CUMULATIVE OUTSTANDING (IF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED. ENTER NAMEOFBUSINES THIS PERIOD TO DATE TO DATE []IND LENDER CALENDAR YEAR ❑COM $ DATE ❑ OTH PER ELECTION ❑ PTY (IF REQUIRED) ❑SCC s CALENDAR YEAR ❑ IND LENDER ❑ COM s ❑ OTH PER ELECTION DATE (IF REQUIRED) ❑ PTY ❑ SCC s CALENDAR YEAR ❑ IND LENDER ❑ COM s []OTH PER ELECTION DATE ❑ PTY (IF REQUIRED) ❑ SCC s [:]IND LENDER CALENDAR YEAR ❑ COM $ ❑ OTH PER ELECTION (IF REQUIRED) DAB ❑ PTY ❑ Scc s Enteron SUBTOTAL $ Summary Peg"' Line 17only. FPPC Form 460 (January/OS) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule C Type or print in ink. SCHEDULEC Nonmonetary Contributions Receivedto whole dollars. Statement covers period 07/01 /2013 from CALIFORNIA 4 • FORM 12/31/2013 103- SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER Re -Elect Jan Harnik Palm Desert City Council 2014 1322067 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR * IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT/ FAIR MARKET CUMULATIVE TO DATE PER ELECTION RECEIVED (IF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES VALUE CALENDAR YEAR TO DATE (IF REQUIRED) NAME OF BUSINESS) (JAN 1 - DEC 31) ❑IND ❑COM ❑ OTH ❑ PTY []SCC ❑ IND ❑COM ❑OTH ❑ PTY ❑SCC ❑IND ❑COM ❑OTH ❑ PTY [:]SCC ❑IND ❑COM ❑OTH ❑PTY El SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.)..................................................................................................................... $ 2. Amount received this period — unitemized 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 $ '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 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (86612753772) Schedule D S f E d"t SCHEDULED ummary o xpen I ures type or pnni in mK. Statement covers period Supporting/Opposing Other Amounts may be rounded - • Candidates, Measures and Committees to whole dollars. from 07/01/2013 • - 12/31 /2013 1 SEE NSTRUCTIONS ON REVERSE through Page NAME OF FILER I.D. NUMBER Re -Elect Jan Harnik Palm Desert City Council 2014 1322067 DATE NAME OF CANDIDATE, OFFICE. AND DISTRICT, OR MEASURE NUMBER OR LETTER AND JURISDICTION, TYPE OF PAYMENT DESCRIPTION AMOUNTTHIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE OR COMMITTEE (IF REQUIRED) PERIOD (JAN. 1- DEC. 37) (IF REQUIRED) ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.)......................................................... $ 2. Unitemized contributions and independent expenditures made this period of under $100..................................................................................... $ 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) ............ TOTAL $ FPPC Form 460 (January/06) FPPC Toll -Free Helpline: 866/ASK-FPPC (86612763772) Schedule D (Continuation Sheet) hnn nr nrins in in 1. Summary P of Expenditures Amounts may be rounded Statement covers period SCHEDULED CONT. Supporting/Opposing Other to whole dollars. • . • Candidates, Measures and Committees from 07/01/2013 . through 12/31/2013 ��]]2 Page of o`7 NAME OF FILER I.D. NUMBER Re -Elect Jan Hamik Palm Desert City Council 2014 1322067 DATE OF CANDIDATE, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LETTER AND JURISDICTION, TYPE OF PAYMENT DESCRIPTION AMOUNTTHIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE ORCOMMITTEE (IF REQUIRED) PERIOD (JAN.1-DEC.31) (IF REQUIRED) ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (86612753772) Schedule E Payments Made Type or print in ink Amounts may be rounded to whole dollars. Statement covers period from 07/01 /2013 SEE NSTRUCTIONS ON REVERSE through 12/31 /2013 _ Page AL of NAME OF FILER I.D. NUMBER Re -Elect Jan Harnik Palm Desert City Council 2014 1322067 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP campaign paraphemalia/misc. MBR 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 PET petition circulating TEL U. or cable airtime and production costs FIL candidate filingiballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)` POS postage, delivery and messenger services TSF transfer between committees of the same 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 (Internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNTPAID Palm Desert Chamber of Commerce Payment for annual membership and monthly 72559 Highway 111 chamber breakfast 440.00 Palm Desert, CA 92260 Desert Willow Golf Resort 38995 Desert Willow Drive FND 400.00 Palm Desert, CA 92260 Minuteman Press 73-660 Highway 111 LIT 668.48 Palm Desert, CA 92260 * Payments that are contributions or Independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 1,508.48 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) $ 4,384.39 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 $ 4,384.39 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (86612754772) Schedule E Type or print in ink. SCHEDULE E (CONT.) (Continuation Sheet) Amounts may be rounded Statement covers period— CALIFORNIA Payments Made to whole dollars. 07/01/2013 FORM • , from SEE INSTRUCTIONS ON REVERSE through 12/31/2013 Page 1 ofj2__0 NAME OF FILER Re -Elect Jan Harnik Palm Desert City Council 2014 I.D. NUMB NUMB ER 1322067 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CKV campaign paraphemalia/misc. CNS campaign consultants NIBR member communications RAD radio airtime and production costs CTB contribution (explain nonmonetary)' MTG OFC meetings and appearances office expenses RFD returned contributions SAL campaign workers' salaries CVC civic donations FIL candidate filing/ballot fees PET PHO petition circulating banks TEL t.v. or cable airtime and production costs FND fundraising events POL phone polling and survey research TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)' LEG legal defense POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LIT campaign literature and mailings PRO PRf professional services (legal, accounting) ads VOT voter registration print WEB information technology costs (Internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMnTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Buzz Factory 1801 East Tahquitz Canyon Way, Suite 101 CNS 2,050.00 Palm Springs, CA 92262 Buzz Factory 1801 East Tahquitz Canyon Way, Suite 101 LIT 805.51 Palm Springs, CA 92262 Deluxe Check - 1st Bank PO Box 150097 OFC 20.40 Lakewood, CO 80215-0097 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 2,875.91 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (86612763772) Schedule F Accrued Expenses (Unpaid Bills) SEE WSTRUCTI NAME OF FILER Type or print In ink. Amounts may be rounded to whole dollars. Statement covers period from 07/01 /2013 through 12/31/2013 SCHEDULE F Page. of 9-3 I.D. NUMBER Re -Elect Jan Hamik Palm Desert City Council 2014 1 1322067 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP campaign paraphemalia/misc. IVBR member communications RAD radio airtime and production costs CNS campaign consultants NrrG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v 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 staff/spouse travel, lodging, and meals W independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same 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 (intemet, e-mail) NAME AND ADDRESS OF CREDITOR (IF COMMnTEE. ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT ( OUTSTAA NDING BALANCE BEGINNING OF THIS PERIOD ( AMOUNTIN CURRED THIS PERIOD (c) AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD * Payments that are contributions or independent expenditures must also be SUBTOTALS $ 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 unitemized accrued expenses under$100.)............................................ INCURRED TOTALS $ 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on 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 onthe Summary Page, Column A, Line 9.)................................................................................................................................................ NET $ May he a negative num er FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661276-3772) Schedule F Type or print In ink. SCHEDULE F (CONT.) (Continuation Sheet) Amounts may be rounded Statement covers period - Accrued Expenses (Unpaid Bills) to whole dollars. 07/01 /2013 • - • from through 12/31/2013 Page of NAME OF FILER I.D. NUMBER1322067 Re -Elect Jan Hamik Palm Desert City Council 2014 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CIVP campaign paraphemalia/misc. CNS campaign consultants I BR member communications RAD radio airtime and production costs CTB contribution (explain nonmonetary)* MTG OFC meetings and appearances office expenses RFD returned contributions SAL campaign workers' salaries CVC civic donations RL candidate filing/ballot fees PET PHO petition circulating phone banks TEL t.v. or cable airtime and production costs FPD fundraising events POL polling and survey research TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)' LEG legal defense POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor Ltr campaign literature and mailings PRO PRT professional services (legal, accounting) print ads VOT voter registration VVEB information technology costs (Internet, e-mail) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF CREDITOR OF COMMITTEE. ALSO ENTER I.D. NUMBER CODE OR DESCRIPTION OF PAYMENT (a) OUTSTANDING BALANCE BEGINNING OF THIS PERIOD (b) AMOUNT INCURRED THIS PERIOD W AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD SUBTOTALS $ $ $ $ FPPC Form 460 (January/05) FPPC Toll -Free Helpiine: 866/ASK-FPPC (866/275-3772) Schedule G Type or print in ink. SCHEDUL Payments Made by an Agent or Independent Amounts may be rounded Statement covers period Contractor (on Behalf of This Committee) to whole dollars. from 07/01/2013 FORM CALIFORNIA SEE INSTRUCTIONS ON REVERSE through 12/31 /2013 page of NAME OF FILER Re -Elect Jan Hamik Palm Desert City Council 2014 I.D. NUMBER1322067 NAME OF AGENT OR INDEPENDENT CONTRACTOR CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CNP CNS campaign paraphemalia/misc. campaign consultants MBR member communications RAD radio airtime and production costs CTB contribution (explain nonmonetary)* MTG OFC meetings and appearances office expenses RFD SAL returned contributions CVC FIL civic donations candidate filing/ballot fees PET petition circulating TEL campaign workers' salaries t.v. or cable airtime and production costs FND M fundraising events PHO POL phone banks polling and survey research TRC TRS candidate travel, lodging, and meals staff/spouse travel, lodging, and meals LEG independent expenditure supporting/opposing others (explain)* legal defense POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LIT campaign literature and mailings PRO PRT professional services (legal, accounting) print ads VOT voter registration WEB information technology costs (Internet, e-mail) * Payments thatare contributions or independent expenditures must also be summarized on Schedule D. Aaacn aootnonat inrormarion on appropnately labeled continuation sheets. TOTAL* $ * Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or independent contractor as reported on Schedule E. FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (86612763772) SCHEDULE H 5ched ule H Type or print In ink Statement covers period Loans Made to Others* Amounts may be rounded 07/01/2013 CALIFORNIA • 1 to whole dollars. from FORM SEE INSTRUCTIONS 12/31/2013 ON REVERSE through page _2L of NAME OF FILER LD NUMBER Re -Elect Jan Harnik Palm Desert City Council 2014 1322067 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OUTSTANDING (b) AMOUNT (c) ((d OUTSTANDING (e) M (9) OF RECIPIENT OCCUPATION AND EMPLOYER BALANCE LOANED THIS REPAYMENT OR BALANCE AT INTEREST ORIGINAL CUMULATIVE OF COMMITTEE. ALSO ENTER I D NUMBER) OF SELF-EMPLOYED, ENTER NAME OF BUSINESS) BEGINNING THIS PERIOD FORGIVENESS CLOSE OF THIS RECEIVED AMOUNT OF LOANS PERIOD THIS PERIOD* PERIOD LOAN TO DATE ❑ PAID CALENDAR YEAR $ S % $ $ FORGIVEN RATE PER ELECTION— S_S S $ DATE DUE DATE INCURRED PAID CALENDAR YEAR S $ % $ S FORGIVEN WE PER ELECTION" S $ S $ S DATE DUE DATE INCURRED *Loans that are contributions to another candidate or committee must also be summarized on Schedule D. Loans forgiven must also be reported on Schedule E. SUBTOTALS $ $ $ $ (Enter (e) an Schedule I, Line 3) Schedule H Summary 1. Loans made this period.................................................................................................................................................. $ (Total Column (b) plus unitemized loans of less than $100.) 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 $ (Enter the net here and on the Summary Page, Column A, Line 7.) (May be a negative numbers **If Required FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (86612763772) Schedule I T..nn — w.4.4 11- IwL gr.wl:nl II F I Miscellaneous Increases to Cash Amounts may be rounded Statement covers period 6 to whole dollars. 07/01 /2013 1 • '' from through 12/31 /2013 � � ?, C SEE INSTRUCTIONS ON REVERSE page of f NAME OF FILER I.D. NUMBER Re -Elect Jan Harnik Palm Desert City Council 2014 1322067 DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER I D NUMBER) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH Misc. Contribution - less than $100 Check # 3105 11 /12/13 99.00 Misc. Contribution - less than $100 Check # 7096 11 /12/13 99.00 Misc. Contribution - less than $100 Cash 11 /12/13 20.00 Misc. Contribution - less than $100 Check # 1150 11 /12/13 50.00 Misc. Contribution - less than $100 Check # 1321 11 /12/13 50.00 Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 318.00 Schedule I Summary 1. Itemized increases to cash this period. $ 443.00 ................................................................................................... 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 Summary Page, Line 14.)............................................................ TOTAL $ 443.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule I (Continuation Sheet) Tvoe or print in ink. SCHEDULE I Miscellaneous Increases to Cash Amounts may be rounded Statementcovers period to whole dollars. CALIFORNIA I 1 from 07/01 /2013 • ' through 12/31 /2013 SEE INSTRUCTIONS ON REVERSE Page - of NAME OF FILER I D. NUMBE-R=� Re -Elect Jan Harnik Palm Desert City Council 2014 1322067 DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE. ALSO ENTER I.D. NUMBER) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH Misc. Contribution - less than $100 Check # 1585 ' 1/12/13 25.00 Misc. Contribution - less than $100 Check # 532 11/12/13 50.00 Misc. Contribution - less than $100 Check # 2715 12/6/13 50.00 Attach additional information on appropriately labeled continuation sheets. Schedule I Summary 1. Itemized increases to cash this period...................................................................................................................... 2. Unitemized increases to cash of under $100 this period........................................................................................... 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ............................... 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the SummaryPage, Line 14.)........................................................................................................................... TOTAL SUBTOTAL $ 125.00 FPPC Form ARn (January/OS) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)