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Kevin Juza for Poway City Council 2022 460 Preelection 10/27/2022Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Date Stamp RECEIVED Statement covers period Date of election if applicable: from 9/25/2022 (Month, Day, Year) O C T 2 7 2022 through 10/22/2022 1. Type of Recipient Committee: All Committees — complete Parts 1, 2, 3, and 4. m Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Part5) O Sponsored (Also Complete Part 6) ❑ General Purpose Committee O Sponsored ❑ Primarily Formed Candidate/ O Small Contributor Committee Officeholder Committee O Political Party/Central Committee (Also Compk(ePart 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 STATE ZIP CODE AREA CODE/PHONE Poway CA 92064 858- ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FAX/E-MAILADDRESS COVER PAGE Page of — For Official Use Only 11/08/2022 kTY CITY OF POWAY (:I FRK'� C1FF1( F 2. Type of Statement: I1 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 STATE ZIP CODE AREA CODE/PHONE Poway NAME OFASSISTANT TREASURER, IF ANY Kevin Juza MAILING ADDRESS CA 92064 562- STATE ZIP CODE AREACODE/PHONE Poway CA 92064 858- FAX / E-MAIL ADDRESS kevinjuza@gmail. kevelrey@hotmail. Treasurer: kevinjuza@gmaiil. Verification 1 have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowled a the information contained herein and in the attached schedules is true and complete. I certify under penalty o�fp/erjury uner the laws of the State of California that the foregooil� true and co cExecuted on By T of Treasurer or Assistant Treasurer (� Executed on G ze/Z By Date Signature of C of ��Signature Officeholder, 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) wrww.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded Summary Page to whole dollars. Statement covers period from 9t25122 SUMMARY PAGE SEE INSTRUCTIONS ON REVERSE through 10/22/22 Page of 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 $ 2,975 $ 8,475 2. Loans Received................................................................ schedule s, Line 3 0 3,700 1/1 through 6/30 7/1 to Date 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 $ 2,975 $ 12,175 20. Contributions Received $ $ 4. Nonmonetary Contributions ............................................ Schedule C, Line 0 0 21. Expenditures 5. TOTAL CONTRIBUTIONS RECEIVED................................Add Lines 3+4 $ 2,975 $ 12,175 Made $ $ Expenditures Made Expenditure Limit Summary for State 6. Payments Made................................................................ Schedule E, Line 4 $ 4,463 $ 8,709 Candidates 7. Loans Made....................................................................... Schedule H, Line 3 0 0 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ 4 463 $ 8,709 22. Cumulative Expenditures Made` (If Subject to Voluntary Expenditure Limit) 9. Accrued Un Expenses aid Bills p (Unpaid � �"��'��'��'��"'��'�� Schedule , Line 3 "' ShdlFLi 0 0 Date of Election Total to Date 10. Nonmonetary Adjustment......................................................... Schedule C, Line 3 0 0 (mm/dd/yy) 11. TOTAL EXPENDITURES MADE....................................Add Lines 6+9+10 $ 4,463 $ 8,709 � $ Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 4,954 13. Cash Receipts........................................................... Column A, Line 3 above 2,975 14. Miscellaneous Increases to Cash .................................. schedule 1, Line 4 0 15. Cash Payments......................................................... column A, Line 6 above 4,463 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 3,466 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 9 in Column 8 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 any). *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule Amounts may be rounded SCHEDULE A ' Monetary Contributions ReceivedCALIFORNIA Statement covers period � 60 from 09/25/22 . SEE INSTRUCTIONS ON REVERSE through 10/22/22 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 't 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) 9/26/22 Damon Semprebon m IND Unemployed $100 $100 ❑ coM Poway, CA 92064 ❑ OTH ❑ PTY ❑ SCC 9/27/22 Janet Bernard W] IND Retired $200 $200 ❑ COM Poway, CA 92064 ❑ OTH ❑ PTY ❑ SCC 9/27/22 Robert Stavros Z IND Retired $250 $250 ❑ COM Poway, CA 92064 ❑ OTH ❑ PTY ❑ SCC 9/28/22 Fiona Stavros m IND Renabis Parmaceuticals $250 $250 ❑ coM VP Pre -Clinical Affairs Poway, CA 92064 ❑ OTH ❑ PTY ❑ SCC 10/2/22 Maria Flores Z IND Barnhart -Reese $150 $150 ❑ COM Constructiion Poway, CA 92064 ❑❑OTHO Payroll/Accounts Payable ❑ SCC SUBTOTAL $ 950 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 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.)....... $ 2,655 $ 320 .......TOTAL $ 2,975 *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.) ivionetary ContrllDuvons Reeeivea W wno!e aouars. Statement covers period from 9/25/22 FPage through 10/22/22 of NAME OF FILER - I.D. NUMBER Kevin Juza for Poway Clty 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) 10/3/22 Peter Imwalle IND RPA $250 $250 ❑ coM Advertising Executive Rolling Hills Estates, CA 90274 ❑ OTH ❑ PTY ❑ SCC 10/3/22 Lindsay Imwalle m IND Unemployed $250 $250 ❑ COM Rolling Hills Estates, CA 90274 ❑ OTH ❑ PTY ❑ SCC 10/7/22 Nicole MacDonald Z IND Sash Group Inc $250 $250 ❑ COM CEO San Diego, CA 92103 ❑ OTH ❑ PTY ❑ SCC 10/12/22 Mary Andrews m IND Andrews Performance Inc. $100 $100 ❑ coM President San Diego, CA 92129 ❑ OTH ❑ PTY ❑ SCC 10/14/22 Kathyrn DeBolt m IND Unemployed $150 $150 ❑ COM Poway, CA 92064 ❑ OTH ❑ PTY SCC SUBTOTAL $ 1,000 *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.) ww _ � Ivlofleidry VonLrivuiiun5 meceivea "''""'V'C 111°" Statement covers period from 9/25/22 FORM • through 1 B/22/22 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 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) 10/14/22 Jimmy Karam D IND Koam Engineering $105 $105 ❑ coM Systems, Inc. Poway, CA 92064 ElOTHO Program Manager ❑ scC 10/17/22 Robert Leiter Z IND Unemployed $100 $100 ❑ COM Poway, CA 92064 ❑ OTH ❑ PTY ❑ SCC 10/19/22 Michael Neal Z IND City of Chula Vista $250 $250 ❑ COM Fire Fighter Poway, CA 92064 ❑ OTH ❑ PTY ❑ SCC 10/21/22 Renee Capriola m IND Unemployed $250 $250 ❑ coM ❑ OTH ❑ PTY ❑ SCC ® IND ❑ COM ❑ OTH ❑ PTY SCC SUBTOTAL $ 705 *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 Amnrrntc may he mnnrin 4 SCHEDULE B -PART 1 auneume n — t"an "I to whole dollars. Statement covers period Loans Received • _ • ' from 9/25/22 . SEE INSTRUCTIONS ON REVERSE through 10/22/22 Page of NAME OF FILER I.D. NUMBER Kevin Juza for Poway City Council 2022 1451934 FULL NAME, STREETADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER a OUTSTANDING AMOUNT ° AMOUNT PAID OUTSTANDING e INTEREST ORIGINAL 9 CUMULATIVE OF LENDER (IF COMMITTEE, ALSO ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER BALANCE BEGINNINGTHIS RECEIVED THIS PERIOD OR FORGIVEN THIS PERIOD* BALANCE AT CLOSE OF THIS PAID THIS PERIOD AMOUNT OF LOAN CONTRIBUTIONS TO DATE NAME OF BUSINESS) PERIOD PERIOD Kevin Juza Self Employed ❑ PAID CALENDAR YEAR Coach To Fulfillment o $100 N/A $ 100 $ N/A ❑ FORGIVEN PER ELECTION** Poway, CA 92064 RATE $_ g 0 g 0 12/31/22 $0 8/3/22 N/A t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED Kevin Juza Self Employed PAID CALENDARYEAR Coach To Fulfillment 0 s 2,500 N/A % 2,500 $ 2,600 s ❑ FORGIVEN - PER ELECTION Poway, CA 92064 RATE 0 0 0 12/31/22 $ 0 8/9/22 2,600 tm IND El COM ❑ OTH El PTY El SCC $ DATE DUE DATE INCURRED Kevin Juza Self Employed ❑PAID CALENDAR YEAR Coach To Fulfillment $ o $1,100 N/A 1,100 S 3,700 Poway, CA92064 RATE ❑ FORGIVEN PER ELECTION- 0 0 0 12/31/22 0 8/15/22 5 3,700 t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC DATE DUE DATE INCURRED SUBTOTALS $ 0 $ 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. $ 0 .......................... NET $ 0 (May be a negative number) (Enter (e) on Schedule 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 Kevin Juza for Poway City Council 2022 Amounts may be rounder) to whole dollars. Statement covers period from 9/25/22 through 10f22/22 SCHEDULEE Page of .D. NUMBER 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 LIT Mailer $310 3934 Murphy Canyon Rd., Suite B103 San Diego, CA 92123 Digital Impact & LIT Design and Social Media $2,000 P.O. Box #3628 San Diego, CA 92163 Futura Color LIT Mailer $1,801 12150 Paine Place Poway, CA 92064 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 4,111 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.) .. $ 4,311 $ 152 ................. $ 0 .... TOTAL $ 4,463 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 P . ' . . - � (Continuation Sheet) to whole dollars. Payments Made from 9/25/22 • • " SEE INSTRUCTIONS ON REVERSE through 10/22/22 Page 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 VVEB 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 Tershishner Enterprises, LLC 1948 Villa Del Dios Glen Escondido, CA 92029 MBR Marketing and Copy Editing $200 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 200 FPPC Form 460 (Jan 2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov