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460 Fitzpatrick 2021 from 01/01 to 02/01 TerminationRecipient Committee Campaign vtatu-nent Cooper page Statement covers period from ,Jan 1, 2021 SEE INSTRUCTIONS ON REVERSE through Feb 1, 2021 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4 ® fficeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure State Candidate Election Committee �gmmittee ❑ Recall u Controlled (Also Complete Parl 5) Sponsored (Also Complefe Part 6) neral Purpose Committee Sponsored ❑ Primarily Formed Candidate/ Smell Contributor Commlttee Officeholder Committee Political PartylCeritral Committee (Also Complete Part 7) 3. Committee Information I D. NUMBER 1426501 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Kathleen Fitzpatrick for La Quinta City Council 2020 STREET ADDRESS (NO PO, BOX) CITY STATE ZIP CODE AREA CODE/PHONE La Quinta CA 92253 MAILING ADDRESS (IF DIFFERENT) NO. AND S-1 REET OR P.O. BOX CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS /i to tiEIVE,D AND FILED Of the State of Secretary of State Crsi%I�p�116-- D:sL SIamp COVER PAGE �0�t �� r RECEIVED u^ 11:::, W'_ Date of election if applicab ; • O n 7 # age 1 of 5 _ (ffipllt�],iJay.•YEar} �; - FEB X 1 202I For Official Use Only &TY CF LA t-I lNTA TY CLERK GrP► RTMIEN . 2. Type of Statement: Preelection Statement Quarterly Statement Semi-annual Statement H Special Odd -Year Report Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) �e Treasurer(s) NAME OF TREASURER Qimin Wang MAILING ADDRESS 79405 Hwy 111 Ste 9-318 CITY STATE ZIP CODE_ AREA CODE/PHONE La Quinta CA 92253 NAME OF ASSISTANT TREASURER, IF ANY N/A MAILTNG ADDRESS CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FAX/E-MAILAODRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the certify under penalty of perjury undert a laws of the State of California that the foregoing is true and correct. Executed on . i I� I ? t 2 I B Dale y Executed on �2 d� By ${pn91 re o anualgnn oI er. Executed on FXPCUted on —_ — By herein and in the attached schedules is true and complete. I or r`roponenl By Signs ure of ConlrolFing ORceholder, Candi ale, Stale AAeasure Proponent FPPC Form 496 (Feb/2019) FPPC Advice: adviceClfppc.ca.gov 1866/275-3772) vvvrw.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Kathleen Fitzpatrick OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) La Quinta City Council RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP La Quinta CA 92253 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 N/A NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER N/A NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) COVER PAGE - PART 2 l I Page 2 of 5 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE N/A BALLOT NO. OR LETTER JURISDICTION ❑ SUPPORT N/A ❑ OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT N/A OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Farmed Candidate/Officeholder Committee List names of otficeholdWs) or candidatefsf for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT N/A ❑ 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 CITY STATE ZIP CODE AREA CODE/PHONE Attach continuation sheets if necessary FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign D'SClosure Statement Amounts may be rounded to whole dollars. Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Kathleen Fitzpatrick for La Quinta City Council 2020 Statement covers period from Jan 1, 2021 through Feb 1, 2021 Contributions Received Column A TOTAL THIS PERIOD Column B CALENDARYEAR (FROM ATTACHED SCHEDULES) TOTAL TO DATE 1. Monetary Contributions ................................................ Schedule A, Line 3 $ 0.00 $ 7,900.00 2. Loans Received ................................. ............................... Schedule B, Line 3 0.00 5,664.00 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 $ 0.00 $ 13,564.00 4. Nonmonetary Contributions ............................................ schedule e, Line 3 0.00 0 5. TOTAL CONTRIBUTIONS RECEIVED................................Add Lines 3+4 $ 0.00 $ 13,564.00 Expenditures Made 6. Payments Made .............. :......... .............. ...... Schedule E, Line 4 $ 0.00 $ 8,513.09 7. Loans Made ....................... ...........................,.,.... .............. Schedule H, Line 3 4,498.46 4,498.46 8. SUBTOTAL CASH PAYMENTS ..................... .. Add Lines 6+7 $ 4,498.46 $ 13,011.55 9. Accrued Expenses (Unpaid Bills) .. - --------- .......--- ------ ......... Schedule F Line 3 0 0 10. Nonmonetary Adjustment............:........................................... Schedule C, Line 3 0.00 0 11. TOTAL EXPENDITURES MADE....................................Add Lines 6+9+10 $ 4,498.46 $ 13,011.55 Current Cash Statement 12. Beginning Cash Balance ............................ Previous summary Page, Line 16 $ 4,298.46 To calculate Column B, 13. Cash Receipts ................................................ .......... Column A, Line 3 above 0.00 add amounts in Column 200.00 A to the corresponding 14. Miscellaneous Increases to Cash ................................... Schedule 1, Line 4 amounts from Column B 15. Cash Payments................... ""' '"""" .......... Column A, Line 6 above 4,498.46 of your last report. Some =""""' amounts in Column A may 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 0.00 be negative figures that should be subtracted from if this is a termination statement, Line 16 must be zero. previous period amounts. If this is the first report being 17. LOAN GUARANTEES RECEIVED .......... .:.............:..... Schedule B, Part 2 $ 0 filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts 0 any). 18. Cash Equivalents ............... _............................... See instructions on reverse $ SUMMARYPAGE Page 3 of 5 I I.D. NUMBER 1426501 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 20. Contributions Received $ $ 21. Expenditures Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made' (If Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) 'Amounts in this section may be different from amounts reported in Column B. 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ 1,165.54 ; FPPC Form 496 (Feb/2019) 11 FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULEH Schedule H Amounts may be rounded Statement covers period 0 " * to whole dollars. Loans Made to ®there from Jan 1, 2021 i 9 1 + " through Feb 1, 2021 g Page 4 of 5 SEE INSTRUCTIONS ON REVERSE g NAME OF FILER I.D. NUMBER Kathleen Fitzpatrick for La Quinta City COUCH 2020 1426501 FULL NAME, STREET ADDRESS AND ZIP CODE , OCCUPATIONIF AN INDIVIDUALENTER AND EMPLOYER a I OUTSTANDING AMOUNT c REPAYMENTOR OUTSTAI DING e ORIGINAL CUMULATIVE OF RECIPIENT (IF COMMITTEE,ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER BALANCE (BEGINNING THIS LOANED THIS FORGIVENESS BALANCE AT CLOSE OF THIS INTEREST RECEIVED AMOUNT OF LOANS NAME OF BUSINESS) PERIOD THIS PERIOD" LOAN TO DATE Ron Fitzpatrick Retired ® PAID CALENDAR YEAR 81824 Contento 62 s % s $ La Quinta, CA 92253 $ RATE FORGIVEN PER ELECTION* S g $ $ i DATE DUE DATE INCURRED �❑ PAID CALENDAR YEAR $ 5 u s g FORGIVEN PER ELECTION" RATE S g S S DATE INCURRED DATE DUE *Loans that are contributions to another candidate or committee must also be summarized on Schedule D. Loans forgiven must also be reported on Schedule E, SUBTOTALS $ 1 $ 1 $ :$ (Entar (a) on Schedule I, Line 3) Schedule H Summary 1. Loans made this period................................................................... (Total Column (b) plus unitemized loans of less than $100.) 2. Payments received on loans........................................................... (Total Column (c) plus unitemized payments of less than $100.) 3. Net change this period. (Subtract Line 2 from Line 1.) ..................... (Enter the net here and on the Summary Page, Column A, Line 7.) ..............................................................._.._....................$ ...................................................................... $ **If Required ........................................................... NET $ 4,498.62 (May be a negative number) FPPC Form 496 (Feb/2019) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule I Amounts may be rounded SCHEDULE I Miscellaneous Increases to Cash to whole dollars. Statement covers period . frnm Jan 1, 2021 ` through Feb 1, 2021 Page 5 of 5 SEE INSTRUCTiONS ON REVERSE NAME OF FILER I D NUMBER Kathleen Fitzpatrick for La Quinta City Council 2020 1426501 DATE FULL NAME AND ADDRESS OF SOURCE AMOUNT OF RECEIVED (IF COMMITTEE,ALSO ENTER I D NUMBER) DESCRIPTION OF RECEIPT I INCREASE TO CASH 1/7/2021 City of La Quinta Campaign sign deposit refund $200.00 Attach additional information on appropriately labeled continuation sheets zocneaule i zkurrmmary 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.).............................................................................................................. SUBTOTAL $ $ 200.00 ..................$ 0 .................-....$ 0 200.00 TOTAL. $ FPPC Form 496 (Feb/2019) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov