HomeMy WebLinkAbout2024-06-30 Form 460 - HarnikRecipient Committee
Campaign Statement
Cover Page
Dale Stamp
e, . , ~,l 1:. ,-; :6 \ i
fl f , l H CES EH r. (L\ I
COVERPAGE
CALIFOR NIA 460
FORM
(Government Code Sections 84200-84216.5) ----------------------------1 Statement covers period
from ___ O_l_/_O_l_/_2_02_4 ___ _
SEE INSTRUCTIONS ON REVERSE through __ 0_6/_3_0_/_2_0_24 ___ _
1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4.
ficl Officeholder, Candidate Controlled Committee D Primarily Formed Ballot Measure
O State Candidate Election Committee Committee
0 Recall O Controlled
(AJst> Complete Par! SJ O Sponsored
(AJ$0 CMIJlltl• P8l16) O General Purpose Committee
0 Sponsored
0 Small Contributor Committee
O Political PartyfCentral Committee
D Primarily Formed Candidate/
Officeholder Committee
(AlsoCompi«BPIIJI T}
3. Committee Information I.D. NUMBER
ll22067
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Re-El ect Jan Harni k Palm Desert City Council 2022
STREET AOORESS (NO P.O. BOX)
CITY STATE ZIP CODE
Indian Wells CA 92210
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY
West Sacramento
OPTIONAL: FAX I E-MAIL ADDRESS
4. Verification
STATE
CA
ZIP CODE
9 5799
AREA CODE/PHONE
(
AREA CODE/PHONE
D ate of elec:11on If applicable:
(Month, Day, Year) ZOZ JUL 25 AH 11: ~ 3 Page ___ of _9 __
11/08 /2022
2. Type of Statement:
D Preelection Statement
O Semi-annual Statement
lx) Termination Statement
(Also file a Form 410 Termination)
D Amendment (Explain below)
Treasurer(s)
NAME OF TREASURER
Jan Harnik
MAILING ADDRESS
CITY
I ndi an Wells
NAME OF ASSISTANT TREASURER, IF ANY
Bry an Bu rch
MAILING ADDRESS
CITY
W~st Sac r ame:,to
OPTIONAL; FAX ( E-MAIL ADDRESS
STATE
CA
STATE
CA
For Official Use Only
D Quarterly Statement
D Special Odd-Year Report
O Supplemental Preelection
Statement -Attach Form 495
ZIP CODE
922 10
ZIP CODE
95691
AREA CODE/PHONE
(
AREA CODE/PHONE
(
I have used all reasonable diligence in preparing and review·ng this statement and to the best of my knowledge the in!onnatiaa contained ~ere in 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
Executed on 07/03/202-'
Date
E>Cecuted on 07/03 /2024
Data
Executed on
Date
E>Cecuted on
oate
www.netflle.com
By
BY------,,,,...-,---,,,,....,,...,.-::,,,....,,...,.,--,,,....,,.,..,.-=.,....,.,----,,,..----,-------Signalun d~ Officeholder, Candidate, S-Measln Propanenl FPPC Form 460 (Jan/2016)
FPPC Advice: aclvice@fppc.ca.gov (8661275-3772)
-.fppc.ca.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 ANO DISTRICT NUMBER IF APPLICABLE)
City Council ilember City of Palm Desert
RESIDENTIAl.JBUSINESS ADDRESS (NO. AND STREET) CITY
Indian Wells
STATE
CA
ZIP
92210
Related Committees Not Included in this Statement: Ustanycommlttees
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 ONO
COMMJTTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STAlE ZIP CODE AREA CODE/PHONE
COMMITTEE NAME I.D.NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
D YES D NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
www.netfile.com
COVERPAGE-PART2
6. Primarily Fom1ed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER JURISDICTION 0 SUPPORT
0 OPPOSE
Identify the controlllng officeholder, candidate, or state measure proponent, If any.
NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT
OFFICE SOUGHT OR HELD I DISTRICT NO. IF ""
7. Primarily Formed Candidate/Officeholder Committee Ustnames of
offlceholder(s) or candld11te(s) for which this committee Is primarily formed.
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT
0 OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT
0 OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT
0 OPPOSE
NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD 0 SUPPORT
0 OPPOSE
Attach continuation sheets If necessary
FPPC Form 460 (Jan/2016)
FPPC Advice: advlce@fppc.ca.gov (8661275-3772)
www.fppc.ca.gov
SUMMARY PAGE Campaign Disclosure Statement
Summary Page
Amounts may be rounded
to whole dollars.
Statement covers period CALIFORNIA 460
FORM
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Re-Elect Jan Harnik Palm Desert City Council 2 022
Contributions Received
1 . Monetary Contributions . . ... ......... ... .. .. ...... . ............... Schedule A, Une 3 $
2. Loans Received .. ........ .. . . ... ............ ... ........ .............. Schedule B, une 3
3. SUBTOTAL CASH CONTRIBUTIONS ......................... Add Lines 1 + 2 $
4. Nonmonetary Contributions ........ ......... ................... Schedule c. um, 3
5. TOTAL CONTRIBUTIONS RECEIVED ........................... ArJdU~s3+4 S
Expenditures Made
6. Payments Made....................................................... Schedule E, une 4 $
7. Loans Made . ........ ........................ ............................ Schedule H. u~ 3
8. SUBTOTAL CASH PAYMENTS .................................... Add Un&s 6 + 7 $
9. Accrued Expenses (Unpaid Bills) ............................... Schedule F. Line 3
1 O. Nonmonetary Adjustment .......................................... Sr:hedule c, une 3
11. TOTAL EXPENDITURES MADE ................................ Add Lines 8 + 9 + 10 $
Current Cash Statement
12. Beginning Cash Balance ................... .... Previous summery Page, Line 16 $
13. Cash Receipts ................................................... Column A. Une3above
14. Miscellaneous Increases to Cash........................... SchftduJa 1, une 4
15. Cash Payments.................................................. Column A, Une 8 ebo11e
16. ENDING CASH BALANCE .......... Add Lines 12 + 13 + 14, then subtract Lina 15 $
If this is a termination statement, Lina 16 must be zero.
from ___ O_l_/O_l_/_2_02_4 __ _
through __ 0_6/_3_0_/_2 _0 2_4 __ _ Page _...;;3 __ of 9
ColumnA
TOTAL THIS PERIOD
(FROMATTACHEOso-tEOULES)
ColumnB
CALENOARYEAA
TOTAL TOOI\TE
0.00 $ 0 .00
-2,798.08 0 .0 0
-2,798.08 $ 0 .0 0
0.00 0 .0 0
-2,798.08 $ 0.0 0
3,416.33 $
0.00
3,4 16 .33
0.00
3,416.33 $
0.0 0
3,416.33
0.00
0.00 0.00
3 ,416.33 $ 3,4 i 6 .33
6,214 .4 1
-2,798 .08
0 .00
3,416 .33
0 .00
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
I.D. NUMBER
1 3 220 67
Calendar Year Summary for Candidates
Running in Both the State Primary and
General Elections
1/1 through 613 D 7/1 to Date
20. Contributions
Received $ ____ _ $ ____ _
21. Expenditu res
Made $ ____ _ $ ____ _
Expenditure Limit Summary for State
Candidates
22. Cumulative Expenditures Made*
(If Subject to Voluntary ExSNncl"UN Umltl
Date of Election
(mm/dd/yy)
___J___j __
__j___J __
Total to Date
$ ____ _
$ ____ _
• Amounts in this section may be different from amounts
reported in Column B.
------------------------------------1 the first report being filed
17. LOAN GUARANTEES RECEIVED ....... ................. ... Sol>edule a. Pan 2 $
Cash Equivalents and Outstanding Debts
18. Cash Equivalents ............. ................. .......... See instructions on rell9rs& $
19. Outstanding Debts ............ ............. Add Une 2 + Une 9 in Column 8 above $
www.netfile.com
o.oo
0 .00
0 .00
for this calendar year, only
carry over the amounts
from L ines 2, 7 , and 9 Of
any).
FPPC Fonn 460 (Jan/2016)
FPPC Advice: advlce@fppc.ca.gov (8661275-3n2)
www.fppc.ca.gov
SCHEDULE 8-PART 1
Schedule B-Part 1
Loans Received
Amounts may be rounded
to whole dollars.
Statement covers period
CALIFORNIA 460
FORM from ___ 0_1_1_0_1_1 2_0_2_4 __
SEE INSTRUCTIONS ON REVERSE through __ o_6_/ _3 0_1_2_0_2_4 __ Page __ 4_ of_9 __
NAME OF FILER
Re-E l ect Jan Harn i k Pa l m Desert City Counci l 2022
FULL NAME, STREET ADDRESS ANO ZIP CODE
OF LENDER
1IF COMMITIU, AI..SOENTERI.D.NUMBERJ
Brian S. Harnik
tiD IND O COM O 0TH O PiY O sec
to IND O COM O 0TH O PiY O sec
to IND D COM □ OTI-I D PiY □ sec
Schedule B Summary
IF AN INDIVIDUAL. ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED. ENTER
NAME DF BUSINESS/
At t o r ney
Roemer & Harnik LLP
• (bl (C)
OUTSTANDING AMOUNT AMOUNT PAID
BALANCE C I IS BEGINNING THIS RE E VE.D TH OR FORGIVEN
PERIOD THIS PERIOD •
0.0 0 $ ___ _
$ ___ _ $ ___ _
$ ___ _ S----
SUBTOTALS$ 0 .0{l $
~PAIO
S 2,79 8.0 8
□FORGIVEN
0.00
QPAID
$
D FORGIVEN
$
QPAID
$
QFORGIVEN
s
2, 7j8 . 08 $
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 .}
(lndude loans paid by a third party that are also itemized on Schedule A.)
OUTST~~OING
t•l
INTEREST SALANCEAT PAJOTHIS CLOSE OF THIS PERIOD
s 0 .0 0 ~,.
RATE
o.oo
OATEOUE
s __ ,.
AAT E
s
DATE DUE
__ ,.
RATE
$
DATE DUE
o.oo s o. 0-0 1
{Enler(e)oo
I.D. NUMBER
1322067
ORIGINAL
AMOUNTOF
LOAN
S 1 8 ,0 0 0.00
1 0/01 /2010
DATE INCU RRED
$
DATE INCURRED
$
DATE INCURRED
g
CUMULATIVE
CONTRIBUTIONS
TODATE
CALENDAR YEAR
S -2,7 9 8 .0 8
PER ELECTION-
$
CAL ENDAR YEAR
s
PER ELECTION ..
s
CALENDAR YEAR
PER ELECTION.,.
$
SchedtAt E, Une3)
o.oo
2,ne .oa
-2 ,'7 98 .08
t Contri butor Codes
IND-Individual
COM-Recipient Committee
(other than PTY or SCC)
0TH -Other (e.g., business entity)
PTY -Political Party
sec -Small Contributor Committe e 3. Net change this period. (Subtract Line 2 from Line 1.) ............................................................... NET $
Enter the net here and on the Summary Page, Column A, Line 2. (May~ a negawe number)
•Amounts forgiven or paid by another party also must be reported on Schedule A .
.. If requi red.
www.netfile.com
FPPC Form 460 (Jan/2016)
FPPC Advice: advlce@fppc.ca.gov (866/275-3n2)
www.fppc.ca.gov
Schedule D
Summary of Expenditures
Supporting/Opposing Other
Candidates, Measures and Committees
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Re-Elect J a n Ha r n i k Palm Deserc Ci ~y Counci l 2022
DATE
0 6/28 /2024
NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR
MEASURE NUMBER OR LETTER AND JURISDICTION,
OR COMMITTEE
Re-Ele ct J a n Harni~ Paln Desert City Council
202 4
I&] Support D Oppose
D Support D Oppose
0 Support D Oppose
Schedule O Summary
Amounts may be rounded
to whole dollars.
TYPE OF PAYMENT
Kl Monetary
Contribution
□ Nonmonetary
Contribution
D Independent
Expenditure
D Monetary
Contribution
D Nonmonetary
Contribution
D Independent
Expenditure
D Monetary
Contribution
□ Nonmonetary
Contribution
D Independent
Expenditure
DESCRIPTION
(IF REQUIRED)
Statement covers period
from __ 0_1_10_1_1_2_02_4 __ _
through_o_6_/3_0_1_2_02_4 __ _
SCHEDULED
CALIFORNIA 460
FORM
Page __ 5 _ of 9
I.D. NUMBER
13Z206'1
CUMULATIVE TO DATE PER ELECTION
AMOUNT THIS CALENDAR YEAR TO DATE
PERIOD !JAN. 1-DEC. 31 ) (IF REQUIRED)
1 ,903 .16 1 ,903 .16
SUBTOTAL$ 1 ,90 3.161
1. Contributions and independent expenditures made this period of $100 or more. (Include all Schedule D subtotals.) ........................................... $ ____ i ..,., 9 .... o .... 3 -_1_6
2. Unitemized contributions and independent expenditures made this period of under $100 ................................................................................. $ _____ 0'""' • ....;.o ..;..o
3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) ............. TOTAL $ ____ 1 '-' 9_0_3 ·_1_6
www.netfile.com FPPC Form 460 (Jan/2016)
FPPC Advice: advlce@fppc.ca.gov (866/275-3n2}
www.fppc,ca.gov
SCHEDULE E
ScheduleE
Payments Made Amounts may be rounded
to whole dollars.
Statement covers period
from ___ 0_1_1_0_11_2_0_2_4 __
CALIFORNIA 4 6 0
FORM
SEE INSTRUCTIONS ON REVERSE through __ 0_6_/_30_/_2_0_2_4 __ Page _6 __ of __ 9 _
NAME OF FILER
Re-Elect Jan Harnik Palm Desert City Council 2022
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
1.0. NUMBER
132 2067
O,,P 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 campa ign workers' salaries
eve civic donations PET' petition circulating TB. t.v. or cable airtime and production costs
FL candidate filing/ballot fees Pl-0 phone banks 1RC candidate travel, lodging, and meals
FND fundraislng events POL polling and survey research TRS staff/spouse travel, lodging, and meals
N) 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 PRr print ads WEB information technology costs (internet, e-mail)
NAME ANO ADDRESS OF PAYEE
~F COMMITTEE.Al.SO ENloR 1.0. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID
CitiBan k Ca r d Credit: Card Charges-See Sch . G 40a.o o
CitiBank Card Cred i t Card Cha r ges-See Sch. G 305 .17
Ci tiBanl< Card C r edit Ca r d Ch arges -See Sch. G 20 0.00
* Pilyments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL$ 913 . l 7
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.) .............................................................................................................. $ -----'3 ,_4_16_-_3_3
2. Unitemized payments made th ts period of under $100 .......................................................................................................................................... $ ____ ___;o;...;.._o""o
3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) ............................................................................... $ ______ o_._o_o
4 . Total payments made this period . (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) ............................. TOTAL $ ____ 3.:...., 4_1_6_._3_3
www.netfile.com
FPPC Fonn 460 (Jan/2016)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)
www.fppc.ca.gov
Schedule E
(Continuation Sheet)
Payments Made
SCHEDULE E (CONT.)
Amounts may be rounded
to whole dollars.
Statement covers period
from ___ O_l_/_O_l _/ 2_0_2_4 __ _
CALIFORNIA 460
FORM
SEE INSTRUCTIONS ON REVERSE
through __ 0_6_/3_0_/_2_0_2_4 __ _ Page __ 7_ of _9 __
NAME OF FILER
Re-El ec t J an Harni t ~a l m nesert City c ouncil 2022
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
LO .NUMBER
1322 067
O.f> campaign paraphernalia/misc. I\IBR member communications RAO radio airtime and production costs
CNS campa ign consultants MTG meetings and appearances RFD returned contributions
CTB contribution (explajn nonmonetary)" OFC office expenses SAL campaign workers· salaries
eve civic donations PET petition circulating lEL t.v. or cable airti me and production costs
FL candidate filing/ballot fees PHO phone banks lRC cand idate travel , lodging, and meals
fN) fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals
N) independent expenditure supporting/opposing others (explain)" POS postage, delivery and messenger services TSF t ransfer between committees of the same candidate/sponsor
LEG legal defense PRO professional services (legal, accounting ) VOT voter registration
ur campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail)
NAME AND ADDRESS OF PAYEE CODE ~F COMMITTEE. ALSO ENTER 1.0. NUMBER)
Re-Elect Jan Harnik Pa l m
Think Right Compliance, Inc. W£a
* Payments that are contributions or independent expenditures must also be summarized on Schedule D.
www.netfile.com
OR DESCRiPl lON OF PAYMENT AMOUNTPAID
l ,903 .16
600 .00
SUBTOTAL$ 2 ,5 03 .16
FPPC Form 460 (Jan/2016)
FPPC Toll.free Helpline: 866/ASK-FPPC (866/275-3n2)
www.fppc.ca.gov
ScheduleG SeHEDULEG
Payments Made by an Agent or Independent
Contractor (on Behalf of This Committee)
Amounts may be rounded
to whole dollars.
Statement covens period
from __ 0_1_1_0_1_1 _20_2_4 __ _
CALIFORNIA 460
FORM
SEE INSTRUCTIONS ON REVERSE
through_0_6_/_3_0_/_2_o2_4 __ _ Page __ B _ of __ 9_
NAME OF FILER
Re-E l ect Jan Harni k Pa l m Desert Ci ty Council 2 07.2
NAME OF AGENT OR INDEPENDENT CONTRACTOR
CitiBank Card
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
I.D.NUMBER
1 32:2 061
OE> campaign paraphernalia/misc. WBR member communications RAD radio a1rume and production costs
OIIS campaign consultants MTG meetings and appearances RFD returned contributions
CTB contribution (explain nonmonetary)" OFe office expenses SAL campaign workers ' salaries
eve civic donations PET petition circulating 1B. t.v. or cable airtime and production costs
FL candidate filing/ballot fees PH) phone banks ~ candidate travel, lodging, and meals
FllO fundraising events POL polling and survey research TRS staff/spouse travel, lodgi ng, and meals
NJ independent expenditure supporting/opposing others (explain)* PO.S postage, delivery and messenger services TSF transfer between committees of the same candidatefsponsor
LEG legal defense PRO professional services (legal, accounting) VOT voter regi stration
LIT campaign literature and mailings PRT print ads WEB information technology costs (internet. e-mall)
* Payments that are contributions or Independent expenditures must also ba summarized on Schedule D.
NAME AND ADDRESS OF PAYEE OR CREDITOR CODE OR (IF COMMITTEE, ALSO ENTER 1.0. NUMBER t
Na tionB uilde r WEB
USPS POS
Palm Desert Chamber of Con-.'!lerce MTG
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
indepsndent contractor as reported on Schedule E.
www.netfile.com
DESCRIPTION OF PAYMENT AMOUNTPArD
408 .00
2 84 .00
2:00 .00
TOTAL*$ 892 .00
FPPC Fonn 460 (Jan/2016)
FPPC Advice: aclvlce@fppc .ca.gov (866/275-3772)
www.fppc.ca.gov
ScheduleG SCHEDULEG
Payments Made by an Agent or Independent
Contractor (on Behalf of This Committee)
Amounts may be rounded
to whole dollars.
Statement covers period
from ___ Ol_/_O_l_/_2_0 2_4 __ _
CALIFORNIA 460
FORM
SEE INSTRUCTIONS ON REVERSE
through 06/30/2024 Page __ 9_ of __ 9_
NAME OF FILER
Re-Elect Jan Harnik Palm Desert City Council 2022
NAME OF AGENT OR INDEPENDENT CONTRACTOR
Think Right Compliance, Inc.
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
I.D.NUMBER
1322061
o,,p campaign paraphernalia/misc. M3R member communications RAD radio airtime and production costs
OJS campaign consultants MTG meetings and appearances RFD returned contributions
era contribution (explain nonmonetary)" OFC office expenses SAL campaign workers' salaries
eve civic donations PET petition circulating TB.. t.v. or cable airtime and production costs
FL candidate filing/ballot fees Pl-0 phone banks 1RC candidate travel, lodging, and meals
FN> fundraislng events POL polling and survey research TRS staff/spouse travel, lodging, and meals
N) Independent expenditure supporting/opposing others (explain)" POS postage. delivery and messenger services TSF transfer between committees of the same cand idate/sponsor
LEG legal defense PRO professional servrces (legal. accounting) VOT voter registration
UT campaign literature and mailings FRT print ads WEB i nformation technology costs (internet, e-mail)
* Payments that are contribution& or Independent expenditures must also be summarized on Schedule D.
NAME AND ADDRESS OF PAYEE OR CREDITOR CODE OR (IF COMMITTEE, ALSO ENTER 1.0. NUMBER)
Netfi le WEB
Attach additional information on appropriately labeled continuation sheets.
• Do not transfer to any other schedule or to the Summery Page. This t otal may not equal the amount paid t o the agent or
independent contractor as reported on Schedule E.
www.netfile.com
DESCRIPTION OF PAYMENT AMOUNT PAID
ti00 .00
TOTAL•$ 6 00 .00
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov