Yuri Bohlen For Mayor Poway 2022 410 Termination I.D. 1/27/2023Statement of Organization Date Stamp ,
Recipient Committee wCEIVED AND FILE
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Statement Type El initial ❑ Amendment ® Termination — See Part 6) he office of the Secretary of Stat FDra�yQ�
Q Not yet qualified of the State of California
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O Date qualification threshold met Date qualification threshold met Date of termination JAN 0 3 2023 JAN 2 7 2023
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(ij applimble)
NAME OF COMMITTEE
NAME OF TREASURER
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STREET ADDRESS (NO P.O. BOX)
STREET ADDRESS (NO P.O. BOX)
cIT STATE ZIP CODE
AREA CODE/PHONE
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CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY
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FULL MAILING ADDRESS (IF DIFFERENT) STREET ADDRESS (NO P.O. BOX)
E-MAIL ADDRESS (REQUIRED)/FAX (OPTIONAL) CITY STATE ZIP CODE AREA CODE/PHONE
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S)
Joy
ADDRESS (NO P.O. BOX)
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CITY STATE ZIP CODE AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets.
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I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and complete. I certify under
penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on - 2 7 _A ), I By
/y DATE SIG AT RE OF TREASURER OR ASSISTANT TREASURER
Executed on / ?., 2 A By
DATE SIGNATURE OF CONTRO G OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE 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: advice Pfppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIA,
Recipient Committee • -
INSTRUCTIONS ON REVERSE
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COMMITTEE NAME I.D. NUMBER
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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
STREET ADDRESS NO. AND STREET
Small Contributor Committee
CITY
GROUP OR AFFILIATION OF SPONSOR
STATE ZIP CODE AREA CODE/PHONE
Date qualified
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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�fopc.ca. gov (866/275-3772)
www.fppc.ca.gov