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Home My WebLink About2014-10-18 Form 460 - Harnik - AmendmentRecipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) Type or print in ink. Statement covers period from 10/01 /2014 10/18/2014 SEE INSTRUCTIONS ON REVERSE I through 1. Type of Recipient Committee: All Committees —Complete Parts 1, 2, 3, and 4. ® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee Q Recall Q Controlled (Also Complete Part5) Q Sponsored (Also Complete Part 6) ❑ General Purpose Committee Q Sponsored ❑ Primarily Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party/Central Committee (Also Complete Part7) 3. Committee Information I.D. NUMBER 1322067 :OMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Re-elect Jan Hamik Palm Desert City Council 2014 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Palm Desert CA 92260 ( MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX Same CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS Date of election if (Month, Day, 11 /04/2014 C IP A L L ER KDESIWTC CIC E 30 PM 4: 51 COVER PAGE Page 1 of 3 For Official Use Only 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) Amending type of statement filed. Should have been categorized as Preelection Statement not Semi -Annual Statement. Also oprreCAinq e0lruhft8 hAA r e%6"„ di+U-1VQ Made - Treasurer(s) NAME OF TREASURER Dr. William Kroonen MAILING ADDRESS 73575 STATE ZIP CODE AREA CODE/PHONE Palm Desert CA 92260 (760) OF ASSISTANT TREASURER, IF ANY Elizabeth Lopez MAILING ADDRESS 41621 STATE ZIP CODE AREA CODE/PHONE Indio CA 92203 (760) FAX / E-MAIL ADDRESS mrslizlopez@gmail. Verification i have used all reasonable diligence to 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 oftheState of California that the foregoing is true and t. Executed on O I'� 1 2)y 1 By Date Slgna u Date BY Signature ofControlling Officeholder. Candidate, State Measure Proponent Executed on BY Date Signature of Contrdling Othceholder, Candidate, State Measure Proponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) State of California Recipient Committee Type or print in ink. COVERPAGE-PART2 Campaign Statement CALIFORNIA 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 / City of Palm Desert RESIDENTIALBUSINESS 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 NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Page of 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 SOUGHT OR HELD I DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee List names 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 (January/05) FPPC Toil -Free Heipline: 86WASK-FPPC (8661275-3772) State of California Campaign Disclosure Statement Type or print in ink. SUMMARYPAGE Summary Page Amounts may be rounded to whole dollars. Statement covers period - , ' 10/01 /2014 • from 10/18/2014 3 SEE INSTRUCTIONS ON REVERSE I through page_ of NAME OF FILER I.D NUMBER Re-elect Jan Hamik Palm Desert City Council 2014 1322067 Contributions Received Column A Column B Calendar Year Summary for Candidates TOTALTHIS PERIOD (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTALTODATE Running in Both the State Primary and General Elections 1. Monetary Contributions ........................................... schedule A, Line 3 00 965. $ 1,$ 29,309.00 2. Loans Received...................................................... Schedule B, Line 3 00.00 11,798.08 1/1 through 6/30 711 to Date 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines t+2 $ 1,965.00 $ 41,107.08 20. Contributions 4. Nonmonetary Contributions .................................... schedule c, Line 3 00.00 1,. 00 Received $ $090 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3 + 4 $ 1,965.00 $ 42,197.08 Made $ $ Expenditures Made 6. Payments Made ....................................................... Schedule E, line 4 $ 8,612.50 7. Loans Made............................................................. Schedule H, Line 3 00.00 8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6+7 $ 8,612.50 9. Accrued Expenses (Unpaid Bills Schedule F, Line 3 00.00 10. Nonmonetary Adjustment .......................................... Schedule C, Line 3 00.00 11. TOTAL EXPENDITURES MADE ................................Add Lines 8 + 9 + 10 $ 8,612.50 Current Cash Statement 12. Beginning Cash Balance ....................... Previous Summary Page, Lane 16 $ 39,091.17 13. Cash Receipts ................................................... Column A. Line 3 above 1,965.00 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 00.00 15. Cash Payments .................................................. Column A, Line 8 above 8,612.50 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14. then subtract Line 15 $ 32,443.67 if this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ........................... Schedule B, Part 2 $ 00.00 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ........................................ See instructions on reverse $ 19. Outstanding Debts ......................... Add Line 2+Line 9 in Column B above $ 11,798.08 $ 30,795.51 00.00 $ 30,795.51 00.00 00.00 $ 30,795.51 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 cant' over the amounts from Lines 2, 7, and 9 (if any). IExpenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) -J $ 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 (8661275-3772)