Kevin Juza for Poway City Council 2022 410 Termination 12/08/2022Statement of Organization
Recipient Committee
Statement Type ❑ Initial ❑ Amendment
O Not yet qualified
or
O Date qualification threshold met Date qualification threshold met
• • S.D. Number 1451934
NAME OF COMMITTEE
Kevin Juza for Poway City Council 2022
STREET ADDRESS (NO P.O. BOX)
CITY
Poway
FULL MAILING ADDRESS (IF DIFFERENT)
E-MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL)
kevinjuza@gmail.
OF DOMICILE
San Diego
STATE ZIP CODE AREA CODE/PHONE
CA 92064 858-
WHERE COMMITTEE IS
City of Poway
Attach additional information on appropriately labeled continuation sheets.
Termination — See Part 5
Date of termination
12 / 08 / 2022
NAME OF TREASURER
Kevin Fleck
Date Stamp
RECEIVEC
DEC 6 8 2022
CITY OF POWAy
STREET ADDRESS (NO P.O. BOX)
14558
STATE ZIP CODE
Poway CA 92064
NAM E OF ASSISTANT TREASURER, IF ANY
STREET ADDRESS (NO P.O.
CITY STATE ZIP COD
NAME OF PRINCIPAL OFFICER(S)
Kevin Juza
STREET ADDRESS (NO RO. BOX)
14701
STATE ZIP CODE
Poway CA 92064
For Official Use Only
AREA CODE/PHONE
(562)
CODE/PHONE
AREA CODE/PHONE
(858)
have used all reasonable diligence in preparing this statement and to th best of my knowledge the information contained herein is,rue and complete. I certify under
penalty of perjury under the laws of the State of Calif rnia that the re o' g is true and correct.
Executed on 12/08/2022 By %���
DATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER
Executed on 12/08/2022
DATE By
SIGNIOTURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE r SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (August/2018)
FPPC Advice: adviceRPfppc.Ca.gov (866/275-3772)
www.[up c.c=.'
®f Orrgan zataon
Redp ent cComvnKtee
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME I.D. NUMBER
Kevin Juza for Poway (City Council 2022 11451934
All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
US Bank 3581-391-7040
ADDRESS CITY STATE ZIP CODE
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 jointly with another controlled committee, list the name and identification number of the other controlled committee.
ELECTIVE OFFICE SOUGHT OR HELD YEAR OF PARTY
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT IINCI IIOF DISTRICT NI IMRFR IF nool IrAw ❑1
Kevin Juza
Poway City Council District 3
c -
2022
Nonpartisan
P
C;/
Partisan
(list political party below)
Nonpartisan
Partisan
(list political parry 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) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY. AS APPLICABLE)
SUPPORT OPPOSE
SUPPORT OPPOSE
FPPC Form 410 (August/2018)
FPPC Advice: gov (966/275-3772)
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
:OMMITTEE NAME Page 3
Kevin Juza for Poway City Council 2022 I.D. NUMBER
1451934
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
List additional sponsors on an attachment.
D I —I AUUKLJ]
Small Contributor Committee
CITY
NDUSTRY GROUP OR AFFILIATION OF SPONSOR
• This committee has ceased to receive contributions and make expenditures;
STATE ZIPCODE AREA CODE/PHONE
• 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(Mfpvc.ca.gov (866/275-3772)
4i yy LAI.-a--pC.Ca.goV