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Home My WebLink About2014-12-31 Form 460 - HarnikRecipient Committee Campaign Statement Cover Page (Government Code Sections 8420G-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period from 10/19/2014_ through Date of election if appli (Month, Day, Year) 12/31 /2014 ( 11 /04/2014 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. Wjj Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure Q State Candidate Election Committee Committee Q Recall O Controlled (Also Complete Part 5) Q Sponsored (Also Complete Part 6) ❑ General Purpose Committee p 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 Hamik Palm Desert City Council 2014 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE CI Y CLER�K'S0 FIC ALN DESERT CA 2. Type of Statement: JAN 30 PH 4: 51 ❑ Preelection Statement Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) COVER PAGE Page �1 _ of s— For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report ❑ Supplemental Preelection Statement - Attach Form 495 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 Same 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 pedury(th under the laws of the State �of California that the foregoing pantlde011fcerofSporisw '�- Executed on By Date Signaureof Controlling Officeholder, Candidate, State Measure Proponent Executed an By Date Signature of Controlling Officeholder, Candidate, State MeasureProponent FPPC Forth 460 (January105) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772) State of Callfomla Type or print in ink. 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 / City of Palm Desert RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Palm Desert, CA 92260 Related Committees Not Included in this Statement: Ust 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 II.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE COMMITTEENAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODEIPHONE 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE COVER PAGE - PART 2 Page of /57 BALLOT NO. OR LETTER JURISDICTION I ❑ 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 ust 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 Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) State of California Campaign Disclosure Statement Type or print in ink. SUMMARYPAGE Amounts may be rounded Statement covers period - NIA Summary Page to whole dollars. . ' from 10/19/2014 CALIFOFORM 12/31/2014 � through Page of 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 TOTALTHIS PERIOD CALENDAR YEAR Running In Both the State Prima and 9 Primary (FROMATTACHED SCHEDULES) TOTALTO DATE General Elections Line 3 9,154.00 $ $ 38,463.00 1. Monetary Contributions ........................................... Schedule A, 1/1 through 6/30 7/1 to Date 00.00 11,798.00 2. Loans Received...................................................... Schedule B, Line 3 $ 9,154.00 $ 50,261.00 20. Contributions 3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 +2 Received $ $ 500.00 1,590.00 4. Nonmonetary Contributions .................................... Schedule C, Line 3 21 Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED ........................... Add Lines 3+4 $ 9,654.00 $ 51,851.00 Made $ $ Expenditures Made 6. Payments Made ....................................................... Schedule E, Line 4 $ 22,416.29 7. Loans Made Schedule H, Line 3 00.00 ............................................................. 8. SUBTOTALCASH PAYMENTS .................................... Add Lines 6+7 $ 22,416.29 9. Accrued Expenses (Unpaid Bills Schedule F, Line 3 00.00 10. Nonmonetary Adjustment ............................. Schedule C, Line 3 500.00 11. TOTAL EXPENDITURES MADE ................................Add Lines 8 + 9 + 10 $ 22,916.29 Current Cash Statement 12. Beginning Cash Balance ....................... Previous summary Page, Line 16 $ 39,4. 67 ,15 13. Cash Receipts ................................................... Column A, Line 3above 0.00 00.00 14. Miscellaneous Increases to Cash ........................... Schedule 1, Line 4 22,416.29 15. Cash Payments .................................................. Column A, Line 8 above 16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14. then subtract Line 15 $ 19,181.38 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 $ none 19. Outstanding Debts ......................... Add Line 2 +Line 9 in Column B above $ 11,798.08 $ 53,211.80 00.00 $ 53,211.80 00.00 1,590.00 $ 54,801.80 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). Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' (if Subject to Voluntary Expenditure Umit) Date of Election Total to Date (mm/dd/yy) -J_ 1 $ Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January105) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule A Type or print In Ink. SCHEDULE A Monetary Contributions Received Amounts may be rounded ry to whole dollars. Statement covers period CALIFORNIAJ from 10/19/2014 . ' . through 12/31 /2014 It SEE INSTRUCTIONS ON REVERSE 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 (COMMITTEE.ALSOENTERI.D.NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OFBUSINESS) Alan Pace OIND ❑coM Self-employed 10/20/14 ❑ PTY Petra, Inc. ❑SCC William Kroonen 01ND ❑coM Retired 10/20/14 ❑ PTY ❑ SCC Erica Harnik ®IND ❑coM Sales Assoc. 10/20/14 ❑ PTY Motorcars ❑ SCC Diane Kline BIND Artist 10/20/14 ❑ PTY []SCC Building Industry Assoc of So Calif. PAC ❑IND Restricted # 741733 10/24/14 c/o Reed & Davidson LLP poTH Com 700.00 950.00 515 S. Figueroa St., Ste, 1110, ❑0TH PTY Los Angeles, CA 90071 ❑SCC SUBTOTAL $ 1,100.00 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 $ 7,984.00 1,170.00 9,154.00 *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) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period • to whole dollars. 10/19/2014 - 'of from • IPage through 12/31/2014 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 ADDRESSZIP DE O CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED (IF COMMITTEE. ALSO ENTER .D.N CODE * (IF SELF-EMPLOYED. ENTER NAME PERIOD (JAN. 1- DEC. 31) (IF REQUIRED) OFBUSINESS) Robert A. Bernheimer RIND IND Attorney 10/24/14 ❑ PTY Bernheimer ❑ SCC Richard L. Spicer RIND Retired 10/22/14 ❑NTH El PTY ❑ SCC E. Cole Burr RIND President 10/22/14 ❑OTH ❑ PTY ❑ SCC Tracy A. Burr RIND Vice -President 10/22/14 ❑NTH ❑ PTY ❑ SCC Burke Rix Communications LLC ❑IND 11/3/14 431 S. Palm Canyon Dr., Suite 206 ❑COM 250.00 250.00 Palm Springs, CA 92262 00TH ❑ PTY ❑ SCC SUBTOTAL$ 2,100.00 '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) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE A (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period . to whole dollars. 10/16/2014 • - from through 12/31/2014 Page 1757 of NAME OF FILER I.D. NUMBER Re-elect Jan Harnik Palm Desert City Council 2014 1322067 DATE A ZIPDE O FULL NAME. STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR RE CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED IT ALSO ENTER I.D.N (IF COMMITTEE. CODE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1- DEC. 31) (IF REQUIRED) OF BUSINESS) Family Development Group Inc. ❑IND 11/13/14 73081 Fred Waring Drive ❑COM ROTH 500.00 500.00 Palm Desert, CA 92260 ❑ PTY ❑SCC Tom Noble RIND Manager 11/13/14 ❑ PTY ❑ scc Karen Barone RIND Artist 11/13/14 ❑ PT, ❑ SCC Kathi Rodriguez RIND Restaurant Owner 11/13/14 ❑OTH ❑PT, ❑ SCC Oscar G. Armijo RIND Certified Public 11/13/14 ❑❑ PTH Self-employed ❑ SCC '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 SUBTOTAL$ 1,275.00 1 1 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.) Monetary Contributions Received Amounts may be rounded Statement covers period to whole dollars. 10/19/2014 - • from FP,g� through 12/31 /2014 % of NAME OF FILER I.O. NUMBER Re-elect Jan Harnik Palm Desert City Council 2014 1322067 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IFCOMIAITTEE,ALSOENTERID.NUMBER) CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED CODE (IF SELF-EMPLOYED. ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) ' OF BUSINESS) Carolyn Williams RIND Retired 11/13/14 ❑ PTY ❑SCC Jacqueline T. Jones RIND Retired 11/13/14 ❑OTH ❑ PTY ❑ SCC Herbert R. Temple RIND Retired 11/13/14 ❑OTH ❑ PTY ❑ SCC William W. Taylor RIND Retired 11/13/14 ❑OTH ❑ PTY ❑ SCC Terrence B. Jones RIND Retired 11/13/14 ❑OTH ❑ PTY []SCC SUBTOTAL$ 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. SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 10/19/2014 • • ' from 12/31/2014 /S through page of NAME OF FILER I.D. NUMBER Re-elect Jan Harnik Palm Desert City Council 2014 1322067 DATE ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVEDCODE (E COMMITTEE.RALSAND I.D.N * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 -DEC. 31) (IF REQUIRED) OF BUSINESS) Davidi Compton jaIND Agronomist 11/13/14 ❑ PTY ❑ SCC Peggy Cravens PlIND Retired 11/13/14 ❑OTH ❑ PT ❑ SCC R. M. Hughes ®IND Retired 11/13/14 El ❑ SCC Justin C. Baldwin JaIND Real Estate Developer 11/13/14 ❑ PTY ❑ SCC Patricia Scully BIND Retired 11/13/14 ❑OTH ❑ PTY ❑ SCC 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 (Januaryl05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/2753772) Schedule A (Continuation Sheet) Type or print in ink. SCHEDULE (CONT.) Monetary Contributions Received Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. 10/19/2014 FOR from 12/31 /2014 through page of NAME OF FILER I.D. NUMBER Re-elect Jan Harnik Palm Desert City Council 2014 1322067 ZIP , STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR FULL NAME. CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED QFCOMMITTE.ALSAND I.D. NUMB CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) California Real Estate Political Action Comm. ®COM ID # 890106 11/13/14 California Assoc of Realtors (CREPAC - CAR) ❑OTH 500.00 2,500.00 525 S. Virgil Avenue ❑ PT. Los Angeles, CA 90020 []SCC Stanley Sniff, Jr. ®IND Sheriff 11/13/14 ❑OTH ❑ PTY ❑ SCC Harold Gershowitz ®IND Retired 12/7/14 ❑ El PTY ❑ SCC Stone James IV 01ND Real Estate Broker 12/7/14 El PTY Organization ❑ SCC Leslie Miller JIND Attorney 12/8/14 ❑CO El PTY []SCC SUBTOTAL$ 1,550.00 `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.) Monetary Contributions Received Amounts may be rounded to whole dollars. Statement covers period • • 10/19/2014 • • from through 12/31/2014 Page-Io of NAME OF FILER I.D. NUMBER Re-elect Jan Hamik Palm Desert City Council 2014 1322067 DATE FULL NAMESTREET ADDRESS AND ZIP CODE OF CONTRIBUTOR , CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED OF CODE * (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OFBLISINESS) Judy Vossler ®IND Senior V.P. of Admin. 11/13/14 73280 Bureau ❑SCC Premier Home Health Care Inc. ❑IND 11/13/14 75101 Sego Lane, Ste J2 ❑COM BOTH 99.00 299.00 Palm Desert, CA 92211 ❑ PTY ❑ SCC Jan Hawkins ®IND Development Director 11/13/14 75- ❑ PTY Foundation ❑ SCC Richard A. Umbenhauer O❑COM IND Attorney 11/13/14 73015 ❑ SCC Victoria Bloom OIND Retired 11/13/14 40088 ❑ SCC SUBTOTAL $ 416.00 *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.) Monetary Contributions Received Amounts may be rounded Statement covers period to whole dollars. 10/19/2014 from F through 12/31/2014 ly of NAME OF FILER I.D. NUMBER Re-elect Jan Harnik Palm Desert City Council 2014 1322067 DATE ZIPDE O FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR A RE CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION TO DATE RECEIVED IT ALSO ENTER .O.N (IF COMMITTEE. CODE * (IF SELF-EMPLOYED. ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) Farley Paving Stone Co., Inc. ❑IND 11/13/14 PO Box 10946 ❑ COM BOTH 99.00 349.00 Palm Desert, CA 92255 ❑ PTY ❑SCC Dana Reed BIND Council Member 11/13/14 ❑ OTH PTY ❑ SCC The Shepherd Group Inc. ❑IND 11/13/14 4695 Macarthur Court, FI. 11 ❑COM 99.00 198.00 Newport Beach, CA 92660 ZOTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ 293.00 *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) Type or print in ink. SCHEDULEB-PART1 Statement covers period CALIFORNIA Schedule B — Part 1 Amounts may be rounded Loans Received to whole dollars. 10/19/2014 • from 12/31/2014 Page ) a SEE INSTRUCTIONS ON REVERSE through _ of NAME OF FILER I.D. NUMBER Re-elect Jan Harnik Palm Desert City Council 2014 1322067 FULL NAME, STREET ADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OUTSTANDING AMOUNT AMOUNTPAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE OF LENDER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS OR FORGIVEN BALANCEAT CLOSE OF THIS PAID THIS AMOUNT OF CONTRIBUTIONS (IF COMMITTEE. ALSO ENTER I.D. NUMBER) NAMEOFBUSINESS) ERO PERIOD THIS PERIOD` PERIOD LOAN TO DATE Brian S. Harik Self ❑ PAID CALENDAR YEAR ❑ FORGIVEN RATE s11,798.08 s 10/01/10 $ $ s DATE DUE DATE INCURRED t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR S $ % S $ ❑ FORGIVEN RATE PER ELECTION $ S $ $ S DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDARYEAR $ S % $ S ❑ FORGIVEN RATE PERELECTION"` S S S S S t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC I DATE DUE DATE INCURRED SUBTOTALS $ $ $ 11,798.08 $ Schedule B Summary 1. Loans received this period -0 (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period -0 (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.) $ -0 9 P (............................................................... NET (May beanepadva number) Enter the net here and on the Summary Page, Column A, Line 2. 'Amounts for iven or paid by another party also must be reported on Schedule A Schedule E, Line 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 if required.9 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275.3772) Schedule C Type or print in ink. SCHEDULEC ~"iVLints towholedollars�we nueU Nonmonetary Contributions Received Statement covers period • - 10/19/2014 from - 460 through 12/31 /2014 SEE INSTRUCTIONS ON REVERSE page _a of Li.Z NAME OF FILER I.D. NUMBER Re-elect Jan Harnik Palm Desert City Council 2014 1322067 DATE FULL NAME, STREET ADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT/ FAIR MARKET CUMULATIVE TO DATE PER ELECTION TO DATE RECEIVED ZIP CODE OF CONTRIBUTOR (IF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE * (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) GOODS OR SERVICES VALUE CALENDAR YEAR (JAN 1 -DEC 31) (IF REQUIRED) Buzz Factory ❑IND Printing - print 10/30/2014 1801 E. Tahquitz Canyon Way, Ste. 101 ads 500.00 500.00 Palm Springs, CA 92262 ®OTM ❑ PTY ❑Scc ❑IND ❑COM ❑OTH ❑ PTY ❑SCC ❑IND ❑COM ❑ OTH ❑ PTY ❑SCC ❑IND ❑COM ❑ OTH ❑ PTY ❑ SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 500.00 Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. 500.00 (Include all Schedule C subtotals.)..................................................................................................................... $ 2. Amount received this period — unitemized nonmonetary contributions of less than $100.................................... $ 00.00 3. Total nonmonetary contributions received this period. 500.00 (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 (8661275-3772) SCHEDULE E Schedule E Type or print in ink. Amounts may be rounded Statement covers period • N I t Payments Made to whole dollars. 10/19/2014 • from through 12/31/2014 c Page of v SEE INSTRUCTIONS ON REVERSE 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. CKF campaign paraphemalia/misc. 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 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 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 UT campaign literature and mailings PRT print ads WEB information technology costs (intemet, e-mail) NAME AND ADDRESS OF PAYEE pF COMMITTEE. ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Buzz Factory 1801 East Tahquitz Canyon Way, Suite 101 CNS $4,250.00 Palm Springs, CA 92262 Buzz Factory 1801 E. Tahquitz Canyon Way, Suite 101 LIT $10,481.56 Palm Springs, CA 92262 Buzz Factory 1801 E. Tahquitz Canyon Way, Suite 101 PRT 3,809.01 Palm Springs, CA 92262 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ $18,540.57 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.).............................................................................................................. $ 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 $ 22,380.57 35.72 00.00 22,416.29 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule E (Continuation Sheet) Payments Made SEE INSTRUCTII NAME OF FILER ON REVERSE Re-elect Jan Harnik Palm Desert City Council 2014 Type or print in ink. Amounts may be rounded to whole dollars. CODES: If one of the following codes accurately describes the payment, CIVP campaign paraphemalia/misc. MBR CNS campaign consultants MTG CTB contribution (explain nonmonetary)' OFC CVC civic donations PET FIL candidate filingiballot fees PHO FND fundraising events POL IND independent expenditure supporting/opposing others (explain)' POS LEG legal defense PRO LIT campaign literature and mailings PRT Statement covers period from 10/19/2014 through 12/31/2014 you may enter the code. Otherwise, member communications RAD meetings and appearances RFD office expenses SAL petition circulating TEL phone banks TRC polling and survey research TRS postage, delivery and messenger services TSF professional services (legal, accounting) VOT print ads WEB SCHEDULE E (CONT.) Page ) 57 of I.D. NUMBER 1322067 describe the payment. radio airtime and production costs returned contributions campaign workers' salaries t.v. or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor voter registration 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 Bobby Mao's Chinese Kitchen & Bar 72-840 Highway 111, Suite W400 Palm Desert, CA 92260 FND $3,840.00 ' Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ $3,840.00 FPPC Forth 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772)