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Home My WebLink About2016-12-31 Form 460 - HarnikRecipient Committee Campaign Statement Cover Page Statement covers period from 07/01/2016 p CITY C PALI Date of election if aplJ (Month, Day, Ye' DESERT, CA 23 PM 2-- 23 COVER PAGE CALIFORNIA• 1 .- Page 1 of 5 For Official Use Only SEE INSTRUCTIONS ON REVERSE through 12/31/2016 11/04/2014 1. Type of Recipient Committee: All Committees — 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 Ia Semi-annual Statement ❑ Special Odd -Year Report 0 Recall 0 Controlled ❑ Termination Statement (Abacarfk*Prts) 0 Sponsored (Also file a Form 410 Termination) ❑ General Purpose Committee ❑ Amendment (Explain below) 0 Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee W-C-ObbPW7) 3. Committee Information I.D. NUMBER 1322067 Re-elect Jan Harnik Palm Desert City Council 2014 STREETADDRESS (NO P.O. BOX) 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 FAX I E-MAIL ADDRESS Treasurer(s) NAME OF TREASURER Dr. William Kroonen MAILING ADDRESS CITY STATE ZIP CODE AREACODEIPHONE Palm Desert CA 92260 ( NAME OF ASSISTANT TREASURER, IF ANY Elizabeth Lopez MAILING ADDRESS CITY STATE ZIP CODE AREACODEIPHONE Indio OPTIONAL_ FAX I E-MAIL ADDRESS 4. Verification CA 92203 ( 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 offtthe / State of California that the foregoir�y41 Executed on 1 6 r� ! J 1 I By Dale 0 of OffKer m Sponsor Executed on Date Executed on Date By By Signature o1 Corttrotlug Officeholeer, Caneioate, State Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppLca.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 and Mayor of the 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 I.D. NUMBER NAME OF TREASURER I CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODEWHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODEIPHONE COVER PAGE - PART 2 Page 2 of 5 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 ustnames of officeholder(sJ 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 (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. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Re-elect Jan Hamik Palm Desert City Council 2014 Contributions Received Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) 1. Monetary Contributions ................................................... schedule A, Line 3 00.00 S S ....................................... 2. Loans Received ....................... .. schedule B, line 3 00.00 00.00 3. SUBTOTAL CASH CONTRIBUTIONS ................... ........... Add fines 1 + 2 S S 4. Nonmonetary Contributions ............................................ schedule C. Line 3 00.00 5. TOTAL CONTRIBUTIONS RECEIVED ........................... .Add Lines 3+4 S 00,00 $ Expenditures Made 6. Payments Made .................. .... schedule E tine 4 $ 422.88 7. Loans Made .................. .... Schedule H. Line 3 00.00 8. SUBTOTAL CASH PAYMENTS .......................... Add Lines 6+7 $ 422.88 9. Accrued Expenses (Unpaid Bills) .......................................... schedule F Line 3 00.00 10. Nonmonetary Adjustment......................................................... Schedule C, true 3 00.00 11. TOTAL EXPENDITURES MADE ........................................ Add Unes8+9+10 $ 422.88 Current Cash Statement 12. Beginning Cash Balance ............................ Previous summary Page, fine 16 S 13. Cash Receipts........................................................... column A, Line 3above 14. Miscellaneous Increases to Cash .................................. Schedule r tine 4 15_ Cash Payments... _......._...-................................... column A. fine 8above 16_ ENDING CASH BALANCE __-___...Add 12 + 13 + 14, then subtract Line 15 S If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED Schedule B. Part 2 S Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ see instructions on reverse S 19. Outstanding Debts .............................. Add Line 2 + Line gin Column 8 above $ 9796.04 00.00 00.00 422.88 9373.16 00.00 00,00 -2798.08 Statement covers period from 07/01/2016 through 12/31/2016 Page Column B CALENDAR YEAR TOTAL TO DATE 00.00 -2798.08 00.00 00.00 -2798.08 S 422.88 00.00 g 422,88 00.00 00.00 s 422.88 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). SUMMARY PAGE 3 of 5 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 S 21, Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made• IN Subject to voluntary Expendltum Limn) Date of Election Total to Date (mmlddlyy) I I I $ 'Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (!an/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Amcunfm m-v he roundeA SCHEDULE B - PART 1 Schedule — Part 1 to whole dollars. Statement covers period e . ! Loans Received 07/01/2016 ' - from • SEE INSTRUCTIONS ON REVERSE through 12131 /2016 Page 4 of 5 NAME OF FILER I.O. NUMBER Re-elect Jan Harnik Palm Desert City Council 2014 1322067 FULL NAME, STREETADDRESS AND ZJP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER ' OUTSTANDING AMOUNT tit AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE OF LENDER (IF COMINIMM ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS PERIOD OR FORGIVEN BALANCE AT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS ,AL50 NAME OF BUSINESS) PERIOD THIS PERIOD PERIOD PERIOD LOAN TO DATE Brian S. Hamik Self ❑ PAID CALENDAR YEAR 45-025 PER ELECTION" 2798.08 00.00 10/01/10 t la IND ❑ COM ❑ OTH ❑ PTY ❑ SCC f s s s DATE INCURRED S DATE DUE ❑ PAID CALENDAR YEAR ❑ FORGIVEN RATE PER ELECTION S f f f f DATE DUE t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE INCURRED ❑ PAID CALENDAR YEAR f S % f s ❑ FORGIVEN RATE PER ELECTION" t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC f S S S DATE INCURRED f DATE DUE 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 $ no nn Enter the net here and on the Summary Page, Column A, Line 2. (May be a mgatin nwrber) 'Amounts forgiven or paid by another party also must be reported on Schedule A. If required. (Erder (e) on Sdreddde E. Lure 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 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON Re-elect Jan Hamik Palm Desert City Council 2014 Amounts may be rounded to whole dollars. SCHEDULE E Statement covers period from 07/01 /2016 through 12/31/2016 page 5 of 5 I.D. NUMBER 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 Lv. or cable airtime and production costs FIL candidate filingfballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staflspouse travel, lodging, and meals IND independent expenditure supportinglopposing 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 OF COMMITTEE, ALSO ENTER I.O. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID US Postal Service LISPS Portola OFC 160.00 Palm Desert, CA 92260 Buzz Factory 1801 East Tahquitz Canyon Way, Suite 101 WEB 262.88 Palm Springs, CA 92262 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 422.88 Schedule E Summary 1. Itemized payments made this period. Include all Schedule E subtotals. ......... $ 422.88 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 $ 422.88 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov