Kevin Juza for Poway City Council 2022 410 Initial 09/06/2022Statement of Organization Date Stamp
Recipient Committee
Statement Type 0 initial 0 Amendment 0 Termination — See Parts RECEIVED AND FILE
i i the office of the Secretary of St,
0 Not
qualifed of the State of Cailfornis;
or
Dat, qualification threshold met Date qualification threshold met Date of termination AU6 15 202Z
09 2022
I.D. Number
NAME OF COMMITTEE NAME 0; TREASURER
Kevin Juza for Poway City Council 2022 Kevin Fleck
STREET ADDRESS INO f"O, BOX)
STREET ADDRESS ('40 ;J, BOX)
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STATE
71P CODE
AREA COCE/T,140NE
Poway
CA
92054
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CITY
STATE ZIPCODE AREA CODEMHONE
NAME OF ASS157AN i TREASURER, IF Ali'
Poway
CA 92064
Kevin Juza
FULL ",'�AIUNG ADDRESS W DIFFERE rr)
STREET ADDRESS INC P.O.BOX)
E-MAIL ADDRESS tRECUIRED) / TAX ((PTIONAO
CITY
STATr
ZW(OOE
AREA COCEIPHONE
kevinjuza@gmail,corn
Poway
CA
92064
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COUNTY 0, DOMICILE
kit OSDICTION WHERE COMMITTEE 15 ACTIVE
NAME OF PRINCIPAL OFFICERl5i
San Diego
City of Poway
Kevin Juza
STREET AVDRE5S INO P0 BOX)
CITY
C
Poway
STATE
CA
LIP ZODE
92064
AREA CODZIPHCNt
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Attach additional inforrration on appropriately labeled continuation sheets.
I have used all reasonatle diligence in prepa
penalty of perjury und e- the laws of the Stal
Executed on 8/10/2022 BY
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Executed on 8/ 1 OnO22 By
CAT E
Executed on L�vZez,_ BY
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ExecU ted on Y/ / ),/ J_BY
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s statement
lifornia that
?St of My Knowieage
is true and correct.
S I C N AT U RE OF TREASURER 0 r ASS I S TA N - 7 P E AS U R F. R
(ONTRC LL ING OFFIC ENO LEI ER, CANDIDATE, C R STATE MEASURE FROPIDNENT
OF CO N T RO LC INN 0 F, I C E H 0 L C, ER, CANDIDATE, 11 R STATE MEASURE r R 0 P' 0 N E NT
n is
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E Or CONTROU INC, OR STATE MEASURE PROPONENT
FPPC Form 410 (August/2028)
FPK Advice: ad'v. Ice'
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
Page 2
COMNUrTE1 NAME NUMUE
Kevin Juza for Poway City Council 2022
All committees must list the financial institution where the campaign bank account is located.
NAME OF fINANCAONSMUTION AREA CODE/PHONE BANK ACC,"OUNT NUMBER
US Bank 858-391-7040
ADDRESS CITY STATE ZIP ZODE
13395 Poway Rd Poway CA 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 jontly with another controlled committee, list the name and identification number of the other controlled committee.
NAME OF CANDIDATE/OF ICEHQL.`DER/STATE MEASURE PROPONE14T
ELSECT WE OFFICE SOL)GHT OR HELD YEAR (W PARTY
(INCLUDE D'STR"'T NUMBER IF APPLiCAC-E) E,-EC710N CHECK ONE
Kevin Juza
Poway City Council - District 3
2022
Noripa nisan
if
Partisan
(list r"Atical party below)
Nonpartisan
Partisan
(list Political party below)
JIM it Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE! ' 51 NAME Oil NEASURE(S) FULL TITLE (INCLUDE BALLOT NO. aR LET7ERj CANDID AT, P(S) OFFICE SOUG HT OR =41ELD OR M [ASURE(S) IQR:SDIC I ION
IF A RECALL, STATE -4 LCALU' IN FRUN I U F I HE OPHCE HOLDER'S NAME, (INCLUDE DIS I F ICI NO -CITY OR CO UNTY, AS APPLICABLE( CMUK ONE
SUPPORT OPPOSE
SUPPORT OPPOSE
FPPC Form 410 (August/201.8)
FPPC Advice:
Statement of Organization
Recipient Committee
INSTRUCTIONS ownsvc"ss
COMmms,wAME,
Kevin Juza for Poway City Council 2022
NAME OF SPO'45OR
Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
0 CITY Committee D COUNTY Committee 0 STATE Committee
List additional sponsors on an attachment.
uai.
^ 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 nosurplus 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 qfballot measure committees may beused 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 (A*gust/2018)