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Hiram Soto For Poway City Council 2022 410 - I.D. 04/28/2022penalty of perjury htdq he laws of the State of Califon Executed on U�/ By 3 Z OA E Executed on 1 6 (Z 2 By DATE 57 Statement of Organization Recipient Committee RECEVEITPAND Fi In the office of the Secretary o of the State of California APR 04 2022 CALIFORNIA 410 FORM Far 0'Ic a se Only APR 2 8 2022 CITY OF POWAY CITY CLERK'S OFFICE Statement Type n Initial 0 Not yet qualified or t(D Date qualification threshold met 03 / 01 2022 MI Date Amendment qualification threshold met /_/ II Termination — See Part 5 Date of termination /_/ 1 Committee information .,.: . i - . � .., .. I.D. Number (!/ opDIk bk) I.; ,, ; _, ,, :, , . ; , ,I, , _.,: • i 1 NAME OF COMMITTEE Hiram Soto For Poway City Council 2022 NAME OF if.EASURER Paul Trivino STREET ADDRESS INO P.O. BOX) STREET ADDRESS ENO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Poway CA 92064 CITY STATE Zip CODE AREA CODE/PHONE Poway CA 92064 NAME OF ASSISTANT TREASURER, IF ANY Hiram Soto FULL MAILING ADDRESS (IF DIFFERENT) (same) STREET ADDRESS (NO P.O. BOX) EMAIL ADDRESS RE.UIRED FAX OPTIONAL) CITY STATE ZIP CODE AREA CODE PHONE Poway CA 92064 COUNTY OF DOMICILE San Diego County JURISDICTION WHERE COMMITTEE IS ACTIVE City of Poway NAME OF PRINCIPAL OFFICERS) N/A Attach additional information on appropriately labeled continuation sheets. 3 Verification.` STREET ADDRESS (NO D.O. 130X) CITY STATE ZIP CODE AREA CODE/PHONE have used all reasonable diligence in preparing this stattmeny'and to the best of my knowledge the information contained herein is true and complete. I certify under correct. ASURER OR ASSISTANT TREASURER SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on By DATE Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (August/2018) FPPC Advice: advice@fppc.ca.,gov (866/275-3772) www.fppc.ca.pov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE CALIFORNIA 410 FORM Page 2 COMMRTEE NAME Hiram Soto for Poway City Council 2022 I.D. NUMBER • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION U.S. Bank AREA CODE/PRONE (858) 391-7040 BANE ACCOUNT NUMBER ADDRESS 13395 Poway Road 4 Type of Committee Complete the applicable sections, Controlled Committee CITY Poway STATE CA ZIP CODE 92064 • 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 HELO (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY CHECK ONE Hiram Soto Poway City Council District -1 2022 Nonpartisan Partisan (list political party below) Nonpartisan Partisan (list political party below) Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below: CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. CANDIDATE(5) OFFICE SOUGHT OR HELD OR MEASURES) JURISDICTION (INCLUDE DISTRICT NO.. CITY OR COUNTY, AS APPLICABLE) CHECK ONE SUPPORT OPPOSE SUPPORT OPPOSE FPPC Form 410 (August/2018) FPPC Advice: advice( afppc.ca•gov (866/275-3772) ww pc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE COMMITTEE NAME Hiram Soto for Poway City Council 2022 I.D. NUMBER 4. Type of Committee ` (Continued) General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY Sponsored Committee List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE AREA CODE/PHONE Small Contributor Committee Date qualified 5. Termination Requirements By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or patient certify that all of the following conditions have been met: • This committee has ceased to receive contributions and make expenditures; • This committee does not anticipate receiving contributions or making expenditures in the future; • This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations; • This committee has no surplus funds; and • This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. - There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government Code Section 89519. - Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code Sections 89511- 89518, and are subject to Elections Code Section 18680 and FPPC Regulation 18521.5. FPPC Form 410 (August/2018) FPPC Advice: advice(fppc_ca, pv (866/275-3772) www_fppc.ca.nov