Kevin Juza for Poway City Council 2022 410 Termination I.D. 01/09/2023♦7LG1LV111G11L VI VI lJ. QIIILdUVII
Date Stamp
iCALIFORNIA
Recipient Committee
•
Statement Type ❑ Initial ❑ Amendment
I��w�4>E sl r', ry
® Termination — See Parti'St ie office of the Secretary of State
FORM
Q Not yet qualified
of the State of California
niy
or
Q Date qualification threshold met Date qualification threshold met
Date of termination DEC 22 2022
JAN 0 9 2023
12 08 2022
CITY OF POWAY
• • I.D. Number 1451934
• .. •
i a licable
NAMEOF COMMITTEE
NAME OF TREASURER
Kevin Juza for Poway City Council 2022
Kevin Fleck
STREET ADDRESS (NO P.O. BOX)
14558 Poway Mesa Court
STREET ADDRESS (NO P.O. BOX)
CITY STATE
ZIP CODE AREA CODE/PHONE
14701 Fieldivew Way
Poway CA
92064 (562) 977-7686
CITY STATE ZIP CODE AREA CODE/PHONE
NAM E OF ASSISTANT TREASURER, IF ANY
Poway CA 92W 858-213-5680
FULL MAILING ADDRESS (IF DIFFERENT)
STREET ADDRESS (NO P.O. BOX)
E-MAIL ADDRESS (REQUIRED)/FAX (OPTIONAL)
CITY STATE
ZIP CODE AREA CODE/PHONE
kevinjuza@gmail.com
COUNTY OF DOMICILE
JURISDICTION WHERE COMMITTEE IS ACTIVE
NAME OF PRINCIPAL OFFICER(S)
San Diego
City of Poway
Kevin Juza
STREET ADDRESS (NO P.O. BOX)
14701 Fieldview Way
Attach additional information on appropriately labeled continuation sheets.
CITY STATE
ZIP CODE AREA CODE/PHONE
Poway CA
92064 (858) 213-5680
I haves ucart all raacnnahla rliliaonro in nrannrina chic cfni—nn+ nm,4 +lk , 1., + , 4: .,
I,
penalty of perjury under the laws of the State of
Executed on 12/08/2022 By
DATE
Executed on 12/08/2022 By
DATE
Executed on
DATE
Executed on
DATE
By
- - - -- -- -•• --- - "" .... .••� -b� •� • wn�alucu ncicnl u u uc allu wlntJleLe. I cerLlry under
alifgrnia that theSore oifig is true and correct.
ew NAI URt OF I RtASURtR OR ASSISTANT TREASURER
Ur LON I NULLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
—1-1 unt Ur LUN I BULLING UI-HLLHULDtR, CANDIDATE, OR STATE MEASURE PROPONENT
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (August/2018)
FPPC Advice: advice Pfppc.ca.eov (866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIA
Recipient Committee FOR41
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME
I.D. NUMBER
Kevin Juza for Poway City Council 2022 1451934
• 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 858-391-7040 157530278728
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 (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION
CHECK ONE
Kevin Juza
Poway City Council -District 3
2022
Nonpartisan
Partisan
(list political party below)
Nonpartisan
Partisan
(list political party below)
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) CANDIDATES) 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) CHECK ONE
SUPPORT OPPOSE
SUPPORT OPPOSE
FPPC Form 410(August/2018)
FPPC Advice: advice CcDfpnc.cagov (866/275-3772)
www.fppc.ca.eov
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Kevin Juza for Poway City Council 2022
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.
NAME OF SPONSOR
STREETADDRESS NO. AND STREET
Date qualified
CITY
INDUSTRY GROUP OR AFFILIATION OF SPONSOR
Page 3
I.D. NUMBER
1451934
STATE ZIP CODE AREA CODE/PHONE
• 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( a�fpPc. ca. eov (866/275-3772)
www.fppc.ca.eoy