HomeMy WebLinkAbout2023-12-31 Form 460 - HarnikRecipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from 07/01/2023
through 12/31/2023
1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4.
® Officeholder, Candidate Controlled Committee
O State Candidate Election Committee
p Recall
(Also Complete Part 5)
❑ General Purpose Committee
O Sponsored
Q Small Contributor Committee
p Political Party/Central Committee
3. Committee Information
❑ Primarily Formed Ballot Measure
Committee
Q Controlled
Q Sponsored
(Also Complete Part 6)
❑ Primarily Formed Candidate/
Officeholder Committee
(Also Complete Part 7)
I.D. NUMBER
1322067
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Re -Elect Jan Harnik Palm Desert City Council 2022
STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
Indian Wells CA 92210 (
COVER PAGE
Date Stamp
Date of election if applicable: page 1 of 10
(Month, Day, Year) 1 14 JAIL 29 PM 2.27
For Official Use Only
11/08/2022
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
Jan Harnik
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
Indian Wells CA 92210 (
NAME OF ASSISTANT TREASURER, IF ANY
Bryan Burch
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
West Sacramento CA 95799 West Sacramento CA 95691 (
OPTIONAL: FAX / E-MAIL ADDRESS OPTIONAL: FAX / E-MAIL ADDRESS
4. Verification
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 of the State of California that the foregoing is true and
Executed on 01/14/2024
Date
Executed on 01/14/2024
Date
Executed on
Date
Executed on
Date
-_..r..- __._
By
By
By
Signature of Controlling Officeholder, Candidate, State Measure Proponent
By
Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-31772)
www.fppc.ca.gov
Recipient Committee
Campaign Statement
Cover Page — Part 2
S. 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 Member City of Palm Desert
RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP
Indian Wells CA 92210
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 CODE/PHONE
COMMITTEENAME I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEEADDRESS STREETADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
COVER PAGE- PART 2
Page 2 of 10
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER I 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 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 (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.
Statement covers period
from 07/01/2023
SUMMARY PAGE
SEE INSTRUCTIONS ON REVERSE I through 12/31/2023 I Page 3 of 10
NAME OF FILER
I.D. NUMBER
Re -Elect Jan Harnik Palm Desert City Council 2022
1322067
Column A
Column B
Calendar Year Summary for Candidates
Contributions Received
TOTALTHISPERIDD
CALENDAR YEAR
Running in Both the State Primary and
(FROMATTACHEDSCHEDULES)
TOTALTO DATE
g
General Elections
1. Monetary Contributions ...........................................
schedule A, Line 3
$
0.00
$
0.00
1/1 through 6l30 7/1 to Date
2. Loans Received......................................................
schedule B, Line 3
0.00
2,796.08
3. SUBTOTAL CASH CONTRIBUTIONS .........................
Add Lines 1 +2
$
0.00
$
2,798.08
20. Contributions
Received $ $
4. Nonmonetary Contributions ....................................
schedule c, Line 3
0.00
0.00
21. Expenditures
5. TOTAL CONTRIBUTIONS RECEIVED•••••••••••.•••••.......•••
Add Lines 3+4
$
0.00
$
2,798.08
Made $ $
Expenditures Made
Expenditure Limit Summary for State
6. Payments Made .......................................................
schedule E, Line 4
$
1,887.85
$
6,313.15
Candidates
7. Loans Made.............................................................
Schedule H, Line 3
0.00
0.00
22. Cumulative Expenditures Made*
8. SUBTOTAL CASH PAYMENTS .................................... Add Lines 6 + 7
$
1 887 85
$
6, 313 15
(I(Subiectto Voluntary Expenditure Limit)
9. Accrued Expenses (Unpaid Bills) ............................... schedule F, Line 3 -500. 00 0 .00 1 Date of Election Total to Date
10. Nonmonetary Adjustment schedule C, Line 3 0.00 0.00 (mm/dd/yy)
11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + 10 $ 1,387.85 $ 6,313.15 - 1 $
Current Cash Statement
12. Beginning Cash Balance ....................... Previous Summary Page, Line 16 $ 7,791.38
13. Cash Receipts Column A, Line 3 above 0.00
14. Miscellaneous Increases to Cash ........................... schedule 1, Line 4 310.88
15.Cash Payments .................................................. Column A, Line 8above 1,887.85
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Line 15 $ 6,214.41
If this is a termination statement, Line 16 must be zero.
17. LOAN GUARANTEES RECEIVED ........................... schedule e, Part 2 $
0.00
Cash Equivalents and Outstanding Debts
18. Cash Equivalents see instructions on reverse $ 0.00
19. Outstanding Debts ......................... Add Line 2+Line 9 in Column B above $ 2,798.08
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).
I I $
*Amounts in this section may be different from amounts
reported in Column B.
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
SCHFDI II_F R-PART 1
Schedule B — Part 1 Amounts may be rounded
Statement covers periodFpage
_
Loans Received to whole dollars.
I • 'fromSEE
07/01/2023
INSTRUCTIONS ON REVERSE
through 12/31/2023
4 of 10
NAME OF FILER
I.D. NUMBER
Re -Elect Jan Harnik Palm Desert City Council 2022
1322067
FULL NAME, STREET ADDRESS AND ZIP CODE
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
OUTSTANDING
BALANCE
O
AMOUNT
tN
AMOUNT PAID
OUTSTANDING
BALANCE AT
a
INTEREST
f)
ORIGINAL
g
CUMULATIVE
OF LENDER
(IF SELF-EMPLOYED, ENTER
BEGINNING THIS
RECEIVED THIS
OR FORGIVEN
CLOSE OF THIS
PAID THIS
AMOUNTOF
CONTRIBUTIONS
(IFCOMMITTEE,ALSOENTERI.D.NUMBER)
NAMEOFBUSINESS)
P RO
PERIOD
THIS PERIOD*
OD
PERIOD
LOAN
TO DATE
Brian S. Harnik
Attorney
❑PAID
CALENDARYEAR
Roemer & Harnik LLP
Indian Wells, CA 92210
$ 0.00
$ 2,798.08
0.00%
$ 18,000.00
$ 0.00
PER ELECTION"
❑ FORGIVEN
RATE
$ 2,798.08
$ 0,00
$ 0.00
$ 0.00
10/01/2010
$
DATE DUE
DATE INCURRED
tg] IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
❑ PAID
CALENDARYEAR
❑ FORGIVEN
PERELECTION"
RATE
DATE DUE
DATE INCURRED
t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
❑ PAID
CALENDARYEAR
❑ FORGIVEN
RATE
PERELECTION"
DATE DUE
DATE INCURRED
tEl IND ❑ COM ❑ OTH ❑ PTY ❑ SCC
SUBTOTALS $ 0.00$ 0.00$ 2,798.08$ 0.00
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.)
3. Net change this period. (Subtract Line 2 from Line 1.) ................
Enter the net here and on the Summary Page, Column A, Line 2.
'Amounts forgiven or paid by another party also must be reported on Schedule A.
"" If required.
0.00
0.00
....................... NET $ 0.00
(May be a negative number)
Itmer Iepn
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
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule D
ecuGn If F n
Summary of txpencutures
Statement covers period
Support! a!O OSIn Other Amounts may be rounded
pp 9 pp ghto dollars.
• ' •
whole
Candidates, Measures and Committees
from 07/01/2023
SEE INSTRUCTIONS ON REVERSE
through 12/31/2023
Page 5 of 10
NAME OF FILER
I.D. NUMBER
Re -Elect Jan Harnik Palm Desert City Council 2022
1322067
DATE
NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR
TYPE OF PAYMENT
DESCRIPTION
AMOUNT THIS
CUMULATIVE TO DATE
CALENDAR YEAR
PER ELECTION
TO DATE
MEASURE NUMBER OR LETTER AND JURISDICTION,
(IF REQUIRED)
PERIOD
(JAN.1- DEC. 31)
(IF REQUIRED)
OR COMMITTEE
07/01/2023
Jose Solache
Monetary100.00
100.00
State Assembly Person
State Assembly
Contribution
District 62
❑ Nonmonetary
Contribution
❑ Independent
❑ Support ❑ Oppose
Expenditure
❑ Monetary
Contribution
❑ Nonmonetary
Contribution
❑ Independent
❑ Support ❑ Oppose
Expenditure
❑ Monetary
Contribution
❑ Nonmonetary
Contribution
❑ Independent
❑ Support ❑ Oppose
Expenditure
SUBTOTAL $ 100.00
Schedule D Summary
1. Contributions and independent expenditures made this period of $100 or more. (Include all Schedule D subtotals.) ........................................... $ 100.00
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 $
0.00
100.00
www.netfile.com 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 REVERSE
NAME OF FILER
Re -Elect Jan Harnik Palm Desert City Council 2022
Amounts may be rounded
to whole dollars.
Statement covers period
from 07/01/2023
through 12/31/2023
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
Page 6 of 10
I.D. NUMBER
1322067
E
CW
campaign paraphernalia/misc.
MBR
member communications
RAID
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
M
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
OFCOMMrrTEE,ALSO ENTER I.D.NUMBER)
CODE OR
DESCRIPTION OF PAYMENT
AMOUNTPAID
CitiBank Card
lCredit Card Charges -See
Sch. G
100.00
PO Box 6500
Sioux Falls, SD 57117
Think Right Compliance, Inc. I PRO 1 1 623.75
PO Box 981415
West Sacramento, CA 95799
Think Right Compliance, Inc. I PRO I I 500.00
PO Box 981415
West Sacramento, CA 95799
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 1,223.75
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.).............................................................................................................. $ 1,887.85
2. Unitemized payments made this period of under $100.......................................................................................................................................... $ 0.00
3. Total interest paid this period on loans. Enter amount from Schedule B, Part 1, Column a 0.00
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ 1,887.85
FPPC Form 460 (Jan/2016)
FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275-3772)
www.fppc.ca.gov
Schedule E
(Continuation Sheet)
Payments Made
ON REVERSE
NAME OF
Re -Elect Jan Harnik Palm Desert City Council 2022
Amounts may be rounded
to whole dollars.
Statement covers period
from 07/01/2023
through 12/31/2023
SCHEDULE E
Page 7 of 10
I.D. NUMBER
1322067
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CM'
campaign paraphernalia/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
ND
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
AMOUNT PAID
�itiBank Card
WEB, MTG
447.17
PO Box 6500
Sioux Falls, SD 57117
CitiBank Card
OFC, WEB
143.76
PO Box 6500
Sioux Falls, SD 57117
CitiBank Card
OFC
23.17
PO Box 6500
Sioux Falls, SD 57117
Secretary of State
FIL
50.00
1500 llth St., Ste. 495
Sacramento, CA 95814
* Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 664.10
FPPC Form 460 (Jan/2016)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)
SCHEDULEF
Schedule F Amounts may be rounded Statement covers period CALIFORNIA• '
Accrued Expenses (Unpaid Bills) to whole dollars. from 07/01/2023 • -
through 12/31/2023
SEE INSTRUCTIONS ON REVERSE Page 8 of 10
NAME OF FILER I.D. NUMBER
Re -Elect Jan Harnik Palm Desert City Council 2022 1322067
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CMP
campaign paraphernalia/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
LIT
campaign literature and mailings
PRT
print ads
WEB
information technology costs (Internet, e-mail)
NAME AND ADDRESS OF CREDITOR
CODE OR
(a)
OUTSTANDING
(b)
AMOUNT INCURRED
(c)
AMOUNTPAID
(d)
OUTSTANDING
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
DESCRIPTION OF PAYMENT
BALANCE BEGINNING
THIS PERIOD
THIS PERIOD
BALANCE AT CLOSE
OF THIS PERIOD
(ALSO REPORT ON E)
OF THIS PERIOD
Think Right Compliance, Inc.
PRO
500.00
0.00
500.00
0.00
PC Box 981415
West Sacramento, CA 95799
* Payments that are contributions or independent expenditures must also be SUBTOTALS $ 500.00$ 0.00 $ 500.00$ 0.00
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 $ 0.00
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 $ 500.00
3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and
on the Summary Page, a Column A Line 9.)................................................................................................................. NET $-500.00 May be a negative number
FPPC Form 460 (Jan/2016)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275-3772)
Schedule G
Payments Made by an Agent or Independent
Contractor (on Behalf of This Committee)
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Re -Elect Jan Harnik Palm Desert City Council 2022
NAME OF AGENT OR INDEPENDENT CONTRACTOR
CitiBank Card
Amounts may be rounded
to whole dollars.
covers
from 07/01/2023
through 12/31/2023
SCH
Page 9 of 10
I.D. NUMBER
1322067
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CW
campaign paraphemalia/misc.
MBR
member communications
RAO
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
M
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
Lrr
campaign literature and mailings
PRT
print ads
WEB
information technology costs (internet, e-mail)
* Payments that are contributions or independent expenditures must also be summarized on Schedule D.
NAME AND ADDRESS OF PAYEE OR CREDITOR
(IF COMMITTEE. ALSO ENTER 1.0. NUMBER)
CODE OR DESCRIPTION OF PAYMENT
AMOUNT PAID
Friends of Solache for Assembly 2024 (ID# 1443410)
CTB
100.00
12501 Imperial Hwy. Ste. 200
Norwalk, CA 90650
Palm Desert Chamber of Commerce
MTG
425.00
72559 CA-111
Palm Desert, CA 92260
Attach additional information on appropriately labeled continuation sheets.
* 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.
TOTAL* $ 525.00
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule I
SCHEDULEI
Miscellaneous Increases
to Cash
Amounts may be rounded
Statement covers periodFPage
to whole dollars.
'from
07/01/2023
-
through 12/31/2023
10 of 10
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
I.D. NUMBER
Re -Elect Jan Harnik Palm Desert
City Council 2022
1322067
DATE
FULL NAME AND ADDRESS OF SOURCE
DESCRIPTION OF RECEIPT
AMOUNT OF
RECEIVED
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
INCREASE TO CASH
09/01/2023
City of Palm Desert
Refund -Overpayment
310.88
73510 Fred Waring
Drive
Palm Desert, CA 92260
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 $ 310.88
310.88
0.00
0.00
310.88
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov