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Home My WebLink About2015-12-31 Form 460 - Harnik.v COVER PAGE Recipient Committee Date Slamp Campaign Statement , - Cover Page - JAN 22 AM 11: 23Page 1 of 6 Statement covers period Date of election If appi,zOlf 07/01 /2015 (Month, Day, Year) For Oruaal Use Only from SEE INSTRUCTIONS ON REVERSE through 12/31/2015 11/04/2014 1. Type of Recipient Committee: All committees -complete Parts 1, 2.3. and 4. 2. Type of Statement: 11 Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement O Slate Candidate Election Committee Committee Semi-annual Statement ❑ Special Odd -Year Report O Recall O Controlled ❑ Termination Statement (weca*ePAd5) O Sponsored (Also file a Form 410 Termination) ElGeneral Purpose Committee (A)m Compel. Pad W ❑ Amendment (Explain below) O Sponsored ❑ Primarily Formed Candidate/ O Small Contributor Committee Officeholder Committee w O Political Party/Central Committee Ima cWPWe Pad A 3. Committee Information LD. NUMBER 1322067 Re-elect Jan Hamik Palm Desert City Council 2014 STREETADDRESS IND P.O. BOXI CITY STATE ZIP CODE AREACODEIPHONE Palm Desert CA 92260 ( MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREACODEIPHONE Treasurer(s) NAME OF TREASURER Dr, William Kroonen MAILING ADDRES CITY STATE ZIP CODE AREACODEIPHONE Palm Desert CA 92260 ( NAME OF ASSIvTANT TREASURER. IF ANY Elizabeth Lopez MAILING ADDRESS CITY STATE ZIP CODE AREA CODEIPHONE Indio CA 92203 ( OPTIONAL FAX I E-MAIL ADDRESS up i IONAL FAX I E-MAIL ADDRESS jan@jancan.Org 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the 1 of my knowledge the information contained herein and in the attached schedules is tree and complete. I cerlify under penalty of perjury, nnde�r the laws of the Stale of California that the to Responsible ME@ of Sponsor Date Executed on By Date 41 Signature at Conwlmp Officeholder CarxNdala State Measure PraponeM Executed on Dale By Signature of n"Ing Officeholder Cana "e Stale Measure Pwponenl FPPC Form 460 (3an/2016) FPPC Advice: advice@fppc.ca.gov (666/275-3772) 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 RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Palm Desert, CA 92260 Related Committees Not Included In this Statement: ustanycomMmees not included In this statement that are controlled by you or are primal ly formed to receive contributions or make expenditures on behalf of your candidacy. NAME OF TREASURER BOX) ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODEIPHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODEIPHONE COVER PAGE - PART 2 Page 2 of 6 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 SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee ustnames of officeholderfs) or candidateis) 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 Aftach continuation sheets M necessary FPPC Form 460 (fan/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. Summary Page Statement covers period , - • from 07/01 /2015 through 12/31/2015 Page 3 of 6 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I D. NUMBER Re-elect Jan Hamik Palm Desert City Council 2014 1322067 Column A Column B Calendar Year Summary for Candidates Contributions Received TOTAL TMS PERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTAL TO DATE Running in Both the State Primary and General Elections 1 100.00 200.00 1. Monetary Contributions................................................... Schedule A. tine 3 $ S 111 +hrough 6130 711 to Date 00.00 -2798.0$ 2. Loans Received................................................................ Scti xkde B, tine 3 100.00 -2598.0g 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines i+2 $ S Received $ $ 00.00 00.00 4. Nonmonetary Contributions ............................................ Schedue C, tine 3 21 Expenditures 100.00 -2598.08 Made $ $ 5. TOTAL CONTRiBUTIONS RECEIVED...................................Add Lines 3+4 $ S Expenditures Made 6. Payments Made .................. ......,....... ___ ............ .,...... Schedule F, We 4 $ 470.00 7_ Loans Made .......................... -..... .................................... schedule N, tine 3 00.00 8. SUBTOTAL CASH PAYMENTS .......................................... Add Lines 6 + 7 $ 470.00 9. Accrued Expenses (Unpaid Bills schedule F. Line 3 00.00 10. Nonmonelary Adjustment ..... ,,,,,,,,,,,,,,,schedule C, Line 3 00.00 11. TOTAL EXPENDITURES MADE ..................... ..AddLt41#e+9+fo $ 470.00 Current Cash Statement 12_ Beginning Cash Balance _........................ PrempusSummeryPage. tine 16 S 13. Cash Receipts + ............................... ,........ -......... column A. We 3 above 14. Miscellaneous Increases to Cash .................................. Schedule t, Line 4 15. Cash Payments......................................................... CclurmA. Line 8above 16. ENDING CASH BALANCE ..................AddLines 12 + 13 + 14, then subtract tine 15 $ If this is a termination statement, tine 16 must be zero. 10166.04 100.00 00.00 470.00 9796.04 17. LOAN GUARANTEES RECEIVED ................................ schedule B, Part 2 $ 00.00 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ Seeinsincoans on reverse $ 19. Outstanding Debts .............................. Add Line 2 + tine 9 in Column B above S 00.00 2798.08 $ 720.00 00,00 S 720.00 00.00 00.00 $ 720.00 To calculate Column B. add amounts in Column A to the corresponding amounts from Column 13 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 (it any). Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' IN Subject to Voluntary Expenditure Limit) Date of Election Total to pate (mm/ddfyy) I I $ Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 ()an/2016) FPPC Advice: advice@Pfppc.ra.gov (866/275-3772) www,fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A Ito whole dollars. Statement covers period CALIFMonetary Contributions Received ORNIA` • 07/01/2015 FORM from through 12131/2015 page 4 of 6 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER Re-elect Jan Hamik Palm Desert City Council 2014 1322067 IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED PFCOuunTEE.ALSO ENTER I.D.NUMBER) CODE • ((FSELF-EMPLOYED. ENTER NAME PERIOD (JAN.1- DEC. 31) (IF REQUIRED) OF eUSINE581 91 IND Robert Roark El COM Real Estate Developer $100 $200 10/11/15 179 Desert Lakes Drive ❑ OTH On ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ Schedule A Summary 100.00 1. Amount received this period — itemized monetary contributions. 100.00 (Include all Schedule A subtotals.).........................................................................................................$ 2. Amount received this period — unitemized monetary contributions of less than $100 .................... 00.00 3. Total monetary contributions received this period. 100.00 (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................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 (Jan/2016) FPPC Advice: adviceLibfppc.ca.gov 1866/275-3772) wvwv.fppc.ca.gov Schedule B — Part 1 Loans Received Amounts may be rounded to whole dollars. Statement covers period from 07/01/2015 SCHEDULE B - PART 1 SEE INSTRUCTIONS ON REVERSE through 12/31/2015 Page 5 NAME OF FILER I.D. NUMBEI R 1 M J Hamik Palm Desert City Council 2014 1322067 e-e ec an IF AN INDIVIDUAL, ENTER imp OUTSTANDING AM(b) FULL NAME, STREETADDRESS AND ZIP CODE UPATION EMPLOYER OCCBALANCE NCERECEIVED (cl AMOUNT PAID OUTSTANDING AT OF LENDER SELF�PLoOYED ENTE THIS BEGBIN4NING THlS PERIOD pFcoNwIIrTEE,ALsiOENTER ro.NslYeER) NAMEOFOUSINESS) OR FORGIVEN 7HISPERIOp CLOSE OF THIS PERIOD PERIOD ❑ PAID Brian S. Hamik Self 2798.08 ❑ FORGIVEN 2,798.08 00.00 to IND ❑ COM ❑ OTH Pw ❑ SCC s s s I DATE DUE I of 6 INTEREST ORIGINAL CUMULATIVE PAID THIS AMOUNT OF CONTRIBUTIONS PERIOD LOAN TO DATE CALENDAR YEAR x $180go.0 s RATE PER ELECTION- 1 .10101/10 1 _ DATE INCURRED ❑ PAID CALENDAR YEAR s s x s s FORGIVEN RATE PER ELECTION" ❑ t ❑ IND [ICOM ❑ OTH ❑ PTY ❑ SCC DATE DUE PATE INCURRED ❑ PAID CALENDAR YEAR 11s x s s ❑ FORGIVEN RITE PER ELECTION" t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ 00.00 $ 00.00 $ 2798.08 $ 00.00 Schedule B Summary 1. Loans received this period....................................................................................................................$ nn 00 (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period........................................................... .............................................. $ 0000 (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 $ nn nn- Enter the net here and on the Summary Page, Column A, Line 2. (May e""a9al" nw"') (Enser (a) on Schedule E Line 3) tConlributor 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/20161 •• If required. FPPC Advice: advice@fppc.ca.gov (666/275-3772) www.fppc.ca.gov SCHEDULE E Schedule E Amounts may be rounded Statement covers period - to whole dollars. A Payments Made 07/01/2015 e " from through 12/31/2015 Page 6 of 6 SEE INSTRUCTIONS ON REVERSE I.D. NUMBER NAME OF FILER Re-elect Jan Hamik 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. CMP campaign paraphemalialmisc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)' OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL l.v, or cable airtime and production costs FIL candidate filinglballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundralsing events POL polling and survey research TRS statfispouse travel, lodging, and meats IND independent expenditure supportinglopposing others (explain)' POS postage, delivery and messenger services TSF transfer between committees of the same candidatelsponsor 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 AMOUNT PAID US Postal Service USPS Portola OFC 156.00 Palm Desert, CA 92260 Palm Desert Area Chamber of Commerce 180.00 72-559 Highway 111 MTG Palm Desert, CA 92260 Buzz Factory 1801 East Tahquitz Canyon Way, Suite 101 CNS 84.00 Palm Springs, CA 92262 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL. $ 420,00 Schedule E Summary 1. itemized payments made this period. (Include all Schedule E subtotals.) ............................................................................................................. $ 420.00 50.00 2. Unitemized payments made this period of under$100 .............................. $ 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 $ 00.00 470.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov