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Kevin Juza for Poway City Council 2022 460 Preelection 09/28/2022Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 7/27/2022 through 9/24/2022 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. © Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure O State Candidate Election Committee Committee O Recall O Controlled (Also CompktePart 5) O Sponsored (Also Complefe Part6) ❑ General Purpose Committee O Sponsored ❑ Primarily Formed Candidate/ O Small Contributor Committee Officeholder Committee O Political Party/Central Committee (Also CompktePart 7) 3. Committee Information I.D. NUMBER 1451934 COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Kevin Juza for Poway Clty Council 2022 STREET ADDRESS (NO P.O. BOX) 14701 Fieldview ZIP CODE AREACODE/PHONE Poway CA 92064 858-213- (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FAX/E-MAILADDRESS Date Stamp RECEIVED Date of election if applicable: I S E P 2 8 2022 (Month, Day, Year) COVER PAGE Page 1 of __jJ For Official Use Only CITY OF POWAY 11/08/2022 ]ITY CLERK'S OFFICE 2. Type of Statement: Preelection Statement ❑ Quarterly Statement ❑ Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Treasurer(s) NAME OF TREASURER Kevin Fleck MAILING ADDRESS 14558 Poway ZIP CODE AREA CODE/PHONE Poway NAME OFASSISTANT TREASURER, IF ANY Kevin Juza MAILING ADDRESS CA 92064 562-977- ZIP CODE AREACODE/PHONE Poway CA 92064 858-213- / E-MAIL ADDRESS kevinjuza@gmail.com com. kevinjuza@gmaiil.com I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge 2inlorm contained herein and in the attached schedules is true and complete. I certify under penalty of V16 and r�o2-Z the laws of the State of California that the foregoing is true d orrect. Executed on By ate ign fTreasurerorAssistant Treasurer A (� Z c 7, 2 Executed on By Date Signature of Controlling Officehol r, Ca ate, State Measure Proponent or Responsible Officer of Sponsor Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www fnnr_ra_anu Campaign Disclosure Statement Amounts may be rounded Summary Page to whole dollars. Statement covers period from 7/27/2022 SUMMARY PAGE SEE INSTRUCTIONS ON REVERSE I through 9/24/2022 I Page ofy " ` NAME OF FILER I.D. NUMBER Kevin Juza for Poway City Council 2022 1451934 Contributions Received Column A Column B Calendar Year Summary for Candidates TOTALTHIS PERIOD (FROM ATTACHED SCHEDULES) CALENDARYEAR TOTAL TO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions................................................... Schedule A, Line $ 5,500 $ 5,500 2. Loans Received................................................................ Schedule B, Line 3 31700 3,700 1/1 through 6/30 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 $ 9.200 $ 9,200 20. Contributions Received $ $ 4. Nonmonetary Contributions ............................................ Schedule C, Line 0 0 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED................................Add Lines 3+4 $ 9,200 $ 9,200 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made................................................................ ScheduleE, Line $ 3,946 $ 3,946 Candidates 7. Loans Made....................................................................... Schedule H, Line 3 0 0 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ 3 946 $ 3,946 22. Cumulative Expenditures Made (If Subject to Voluntary Expenditure Limit) 9. Accrued Un Expenses aid Bills p (Unpaid ) �����'�����""�"""�"'�"'�""'�""' Shdl Schedule F, Line 3 Li 0 0 Date of Election Total to Date 10. Nonmonetary Adjustment.........................................................schedule C, Line 0 0 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE....................................Add Lines 6+9+10 $ 3,946 $ 3,946 1. 1 $ Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, line 16 $ 0 13. Cash Receipts........................................................... Column A, Line 3 above 9,200 14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 15. Cash Payments......................................................... Column A, Line 8 above 3,946 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 5,254 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Part2 $ 0 1 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See instructions on reverse $ 0_ 19. Outstanding Debts .............................. Add Line 2+Line 9in Column B above $ 0 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 the first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if a ny). 'Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (8661275-3772) vrww.fppc.ca.gov Schedule A Amounts may be rounded SCHEDULE A {..... M .. I ... J ..11.....- Monetary Contributions Received Statement covers period , _ , from 07/27/2022 • ' • SEE INSTRUCTIONS ON REVERSE through 09l24/2022 Page of NAME OF FILER I.D. NUMBER Kevin Juza for Poway City Council 2022 1451934 DATE FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED CONTRIBUTOR CODE * OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME RECEIVED THIS CALENDAR YEAR TO DATE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 8/22/22 Joy Hou Z IND Metis Real Estate Network $250 $250 ❑ coM CEO Poway, CA 92064 ❑ OTH ❑ PTY ❑ SCC 8/22/22 Tina Young IND LeSar Development $100 $100 ❑ COM Operations Manager Spring Valley, CA 91978 ❑ OTH ❑ PTY ❑ SCC 8/23/22 Chia Hou Z IND Retired $250 $250 ❑ COM Poway, CA 92064 ❑ OTH ❑ PTY ❑ SCC 8/23/22 Peter Babich m IND Retired $250 $250 ❑ COM Poway, CA 92064 ❑ OTH ❑ PTY ❑ SCC 8/23/22 Jelena Radibratovic Z IND Electrical Consultants Inc $250 $250 ❑ coM General Manager San Diego, CA 92127 ❑ OTH ❑ PTY ❑ SCC SUBTOTAL $ 1100 Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule A subtotals.) .............................................. 2. Amount received this period — unitemized monetary contributions of less than $100 .... $ 4,950 $ 550 3. Total monetary contributions received this period. 5,500 (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)......................TOTAL $ 'Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) Schedule A (Continuation Sheet) Monetary Contributions Received IAME OF FILER Kevin Juza for Poway City Council 2022 FULL NAME, STREETADDRESS AND ZIP CODE OF DATE CONTRIBUTOR RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) 8/23/22 Lawrence Ott Poway, CA 92064 8/23/22 Pamela Meuser Denver, CA 80238 8125/22 Jana Johnson Poway, CA 92064 8/26/22 Phyllis Collins Poway, CA 92064 8/27/22 Poway Democratic Club FPPC #1445238 P.O. Box 28 Poway, CA 92064 `Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee Amounts may be rounded to whole dollars. SCHEDULEA (CONT.) Statement covers from 07/27/2022 through 09/24/2022 Page of % CONTRIBUTOR [FAN INDIVIDUAL, ENTER AMOUNT * OCCUPATION AND EMPLOYER RECEIVED THIS CODE (IF SELF-EMPLOYED, ENTER NAME) OF BUSINESS) PERIOD 0 IND Southwest Airline $100 ❑ COM Pilot ❑ OTH ❑ PTY ❑ SCC ® IND Retired $100 ❑ COM ❑ OTH ❑ PTY ❑ SCC Z IND Retired $200 ❑ COM ❑ OTH ❑ PTY ❑ SCC m IND Retired $200 ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND $250 0 COM ❑ OTH ❑ PTY SCC SUBTOTAL $ 850 I.D. NUMBER 1451934 CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) $100 $100 $200 $200 $250 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) Monetary Contributions Received to whole dollars. Statement covers period ,LIFOR , from 7/27/2022 FORM through 9/24/2022 Page =� of l L NAME OF FILER I.D. NUMBER Kevin Juza for Poway City Council 2022 1451934 DATE FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED CONTRIBUTOR CODE * CCU O(F SE PA IION ANDE MPTER OVER -EMPL(IF RECEIVED THIS CALENDAR YEAR TO DATE COMMITTEE,ALSO ENTER I.D. NUMBER) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 8/29/22 George Juza IND Retired $250 $250 El COM Avon, IN 46123 ❑ OTH ❑ PTY ❑ Scc 9/1/22 Phil Factor Z IND Retired $250 $250 ❑ coM Youngsville, NM 87064 ❑ OTH ❑ PTY ❑ SCC 9/1/22 Adam Dutra BIND San Diego Police $200 $200 ❑ coM DNA Technial Manager San Diego, CA 92127 ❑ OTH ❑ PTY ❑ SCC 9/1/22 Karen Cardno MIND Game Chaning $150 $150 ❑ coM Technology, Inc. San Diego, CA 92127 ❑❑ Pry Operations Manager ❑ scc 9/2/22 Christian Thompson Z IND Goodyear Tire $250 $250 ❑ coM Manager Kalamazoo, MI 49009 ❑ OTH ❑ PTY SUBTOTAL $ 1100 r *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (1an/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) IVIVI luLdry l,►Vflir1L)U-L1U"5 mecewea LV WMU'c """°"'' Statement covers period CALIFORNIAA from 7/27/2022 FORM • through 9f24/2022 Page of 167 NAME OF FILER I.D. NUMBER Kevin Juza for Poway City Council 2022 1451934 DATE FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR [FAN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED CONTRIBUTOR * CODE OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME) RECEIVED THIS CALENDAR YEAR TO DATE (IF COMMITTEE,ALSO ENTER I.D. NUMBER) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 9/5/22 James Gavigan OIND MahlGaming $250 $250 13275 Programmer Poway, CA 92064 ❑ OTH ❑ PTY ❑ SCC 9/7/22 Kevin Fleck ® IND Caring Cottages LLC $250 $250 14558 Senior Care Poway, CA 92064 ❑ OTH ❑ PTY ❑ SCC 9/11 /22 Amit Asaravala Z IND Drupal & jQuery $250 $250 14028 Web Developer Poway, CA 92064 ❑ OTH ❑ PTY ❑ SCC 9/13/22 Diane Levey m IND Unemployed $100 $100 14874 San Diego, CA 92127 ❑ OTH ❑ PTY ❑ SCC 9/14/22 Hiram Soto m IND Center for Sustainable $250 $250 14283 Energy Poway, CA 92064 ❑ OTH ❑ PTY Marketing Director SCC SUBTOTAL $ 1100 *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) monetary uontrmutions Keceiv'ea to wnoie sonars. Statement covers period from 7/27/2022 - • —7 16 through 9/24/2022 Pageof NAME OF FILER I.D. NUMBER Kevin Juza for Poway City Council 2022 1451934 DATE FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR IFAN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED CONTRIBUTOR * CODE OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME) RECEIVED THIS CALENDAR YEAR TO DATE (IF COMMITTEE,ALSO ENTER I.D. NUMBER) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 9/15/22 Steve Cobb OIND Retired $100 $100 13275 Poway CA 92064 ❑ OTH ❑ PTY ❑ SCC 9/15/22 Stephanie Cole m IND Retired $250 $250 15856 Cumberland CA 92064 ❑ OTH ❑ PTY ❑ SCC 9/22/22 Nicholas Carruthers IND Unemployed $250 $250 15856 Cumberland CA 92064 ❑ OTH ❑ PTY ❑ SCC 9/24/22 Shannon Ingersoll m IND Neurocrine Biosciences $200 $200 13652 Acorn Poway, CA 92064 ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY SCC SUBTOTAL $ 800 'Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE B -PART 1 C e U e ts — vart 1 to whole dollars. Statement covers period Loans Received ' CALIFORNIA ' • from 07/27/2022 . SEE INSTRUCTIONS ON REVERSE through 09/24/2022 Page of / V NAME OF FILER I.D. NUMBER Kevin Juza for Poway City Council 2022 1451934 FULL NAME, STREETADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATIONAND EMPLOYER a OUTSTANDING AMOUNT o AMOUNT PAID OUTSTANDING e INTEREST ORIGINAL g CUMULATIVE OFLENDER (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS RECEIVED THIS PERIOD OR FORGIVEN THIS PERIOD* BALANCE AT CLOSE OF THIS PAID THIS PERIOD AMOUNTOF LOAN CONTRIBUTIONS TO DATE NAME OF BUSINESS) PERIOD PERIOD Kevin Juza Self Employed ❑ PAID CALENDAR YEAR 14701 To Fulfillment $ o $100 N/A S 100 $ N/A ❑ FORGIVEN PER ELECTIOrt* Poway, CA 92064 RATE $ 0 $ 100 $ 0 12/31 /22 S 0 8/3/22 $ N/A t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED Kevin Juza Self Employed PAID CALENDAR YEAR 14701 To Fulfillment 0 $ 2,500 $ N/A $ 2,500 $ 2,600 ❑ FORGIVEN Poway, CA 92064 RATE - PER ELECTION 0 2,500 $ 0 12/31/22 $ 0 8/9/22 S 2,600 t ® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ $ DATE DUE DATE INCURRED Kevin Juza Self Employed ❑ PAID CALENDAR YEAR 14701 To Fulfillment $ o $ 1,100 N/A $ 1,100 $ 3,700 ❑ FORGIVEN Poway, CA92064 RATE PER ELECTION- 0 S 1,100 $ 0 $ 12/31 /22 0 $ 8/15/22 $ 3,700 tm IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ 3,700 $ 0 $ 3,700 $ 0 Schedule B Summary 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.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.) ............................... Enter the net here and on the Summary Page, Column A, Line 2. *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. ............................ $ 3,700 ....................................$ 0 3 700 ............................. NET $ , (May be a negative number) (Enter (e) on Schedule E, Line 3) tContributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Kevin Juza for Poway City Council 2022 Amounts may be rounded to whole dollars. Statement covers period from 07/27/2022 through 09/24/2022 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment SCHEDULEE % CL Page of .D. NUMBER 1451934 CMP 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 campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND 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 LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID City of Poway FIL 2022 Candidate Statment $1,000 13325 Civic Center Drive Poway, CA 92064 Futura Color LIT Printing of Yard Signs and Flyers $967 12150 Paine Place Poway, CA 92064 Futura Color LIT Flyers and Car Magnets $784 12150 Paine Place Poway, CA 92064 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 2751 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.)....................................................................... 2. Unitemized payments made this period of under$100.................................................................................................... 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)....................................... 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) .. $ 3,406 $ 540 ................. $ 0 .... TOTAL $ 3,946 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E SCHEDULE E CONT. ( ) Amounts may be rounded statement covers period pCALIFORNIA ' (Continuation Sheet) to whole dollars. Payments Made from7/27/2022 0 .. • through 09/24/2022 U SEE INSTRUCTIONS ON REVERSE page r of NAME OF FILER I.D. NUMBER Kevin Juza for Poway City Council 2022 1451934 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP 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 campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND 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 LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID San Diego County Democratic Party CMP Canvasing Applicaiton 300 3934 Murphy Canyon Rd, Unit B103 San Diego, CA 92123 MK Signs LIT Banners for Parade and Sign Waiving 129 12675 Danielson Ct, Unit 410 Poway, CA 92064 Poway Rotary Foundation MTG Parade Entry Fee 125 P.O. Box 184 Poway, CA 92074-0184 PayPal, Inc PRO Transactions Fees for Online Donations $101 2211 N. 1 st Street San Jose, CA 95131 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 655 FPPC Form 460 (Jan 2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fl3pc.ca.gov