Pepin for City Council 2022 410 Initial - I.D. 07/27/2021Statement of Organization
Recipient Committee
0-[ (-1
ECEIVED
tAND FIL
the office of the Secretary of S
Statement Type
initial
threshold met
II Amendment
Amendment
• Terminetlon — See Part 5
Date of termination
H:nd
the State of Cali'nnia
JUL 13 2021
Delivered, Sacreme
Eftrt4014Ptcdfrice
JUL�2 7 2021
L, C of Poway
la Not yet qualified
or
Q Date qualification
Dale qualification threshold met
1. Committee
NAME OF COMMITTEE
Pepin for City Council
Information
I.D. Number
•. •• 2. Weasutetaid
er PifrtcIpel• s
; . '
2022
NAME Of TREASURER
William Baber
MEET ADDRESS '• P.0. BOX
STREET ADDRESS (NO P.0.004
CITY STATE ZIP CODE AREA CODE/PHONE
La Mesa CA 91942
CITY STATE ZIP CODE AREA MU -PHONE
Poway CA 92064
NAME OF ASSISTANT TREASURER, IF ANY
FUL : A1LIN0 ADDRESS 1F DIPPSRENT)
La Mesa, CA 91942
STREET ADDRESS (NO P, O, BOB)
E•MAILMOM REQUIRED)/FAX (OPTIONAL)
CITY STATE LIP CODE ARIA CODE/PHONE
COUNTY OE DOMICILE
San Diego
JURISDICTION WHERE COMMITTEE IS ACTIVE
City of Poway - District I
NAME OF PRINCIPAL OFFICER(B)
Attach additional Information on appropriately labeled continuation sheets,
STREET ADDRESS (NO P.0. BOX)
CITY MAU SIF CODE AREA CODE/PHONE
3. Vet fkatton .
I have used all reasonable dlilgenceTn preparing this statement and to the best of my Knowledge the information contamea Herein Es true ana complete,
penalty of perjury under the laws of the State of California that the foregoing Is true and correct. 7"1
Executed on July a, 2021 By
DATt
Executed on July 8, 2021 By
DATE
Executed on By
DATE
Executed on By
DATE
MASURIA OR ASSISTANT TREASURER
SIONATURP OF CO 0LU ENOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
SIGNATURE 0E CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATI, OR STATE MEASURE PROPONENT
FPPC Form 410 (August/201e)
FPPC Advice: ::e;; : (866/275-3772)
d: yys
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
CALIFORNIA 410
FORM
Pap
COMMITTEE NAME
Pepin for City Council 2022
LD, NUMBER
• All committees must list the financial Institution where the campaign bank account Is located.
NAME OP FINANCIAL INSTITUTION
AREA CODE/PHONE
BANK ACCOUNT NUMBER
ADDRESS
4, Type Of C0111m10ee Complete the applicable sections.
Controlled Cor nn,ttee
CITY
STATE.
ZIP CODE
• List the name of each controlling officeholder, candidate, or state measure proponent. If candidate or officeholder controlled,
also list the elective office sought or held, and district number, if any, and the year of the election.
• List the political party with which each officeholder or candidate is affiliated or check "nonpartisan." Stating "No party preference" is acceptable
• If this committee acts Jointly with another controlled committee, list the name and Identification number of the other controlled committee.
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT
ELECTIVE OFFICE SOUGHT OR HELD
(INCLUDE DISTRICT NUMBER IF APPLICABLE)
YEAR OF
ELECTION
PARTY
CHECK ONE
Brian Pepin
Poway yCouncil - District 1
Cit
2022
Nonpartisan
Partisan
'
(list political party below)
Nonparttaan
Partisan
(list political party below)
Printrnrly 1 o,mrd Committee
Primarily formed to support or oppose specific candidates or measures In a single election. List below:
CANDIDATE(S) NAME OR MEASURE(5) FULL TITLE (INCLUDE BALLOT NO. OR LETTER)
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME.
CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
SUPPORT
OPPOSE
SUPPORT
OPPOSE
FPPC Advice:
FPPC Form 410 (August/2018)
(866/275-3772)