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Poway Democratic Club 410 Amendment 03/24/2023Statement of Organization _- omei!ia a . Recipient Committee , , RECEIVED • rcromnmUFEonly Statement Type DIn)tial ® Amendme�p ❑ Tenminatlon—See Part5 O Notyetqualifietl ��� d� 1 eyr C v`I As•i-Tizastlreradd� MAR 2 4 2023 or O Date qualification threshold met Date qualification threshold met Date of termination CITY OF POWAY CITY CLERKIS OFFICE LDNu 1445238 F ,;'B nmber NAME OF COMMIriEE NAME OF rRGSURER Poway Democratic Club Delta Esparta VIVEETADDREAINOPA.aOn MEETADDRCII NO PED.8100 Clry MARF Zm CODE AREACIODUPHORE Poway CA 9206.1 CITY DATE zIPmOR l OyPNONE NAME OF ASSURNANCTIREASILDIDER, IF ANY Poway CA 92064 7analohnson AND. MAILING ADORESSOF DIFFERENT) SCRIBET ADVIRICa(NO RO, BOX) oway, CA 92074 ETrAI ACOReS IREOUIREMI FAR(OPENONRLI Co, VATE MPCOM AREACODERNONE Poway CA 92064 CDummoomiaLE 1 LRISDICTIGN MEN COMMnrEE 1E REVIVE NAM E OF FRINEIPA OFNCERISI San Diego City of Poway Amit Asaravala STREET ADDRESS 00 W. BOX] Attach additional information on appropriately labeled continuation sheets. CIFY /ATE zIP LICE AREA CODE/PAVINE Poway CA 920" 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 Califor Tia that the foregoing is true and correct. Fantod on 3�2.2� yOL3 By Executed on By NA! SIGNNUM OFCONAOWpG OFNCEHOLOER CANGOAIE, OR EVER MEASURE PROPONENT Executed on By DATE SIGNMURE OF CONTROULUB 1CFFptOER, GNOIDRTR OR STAE MEr3URE PROIONENT Executed On By UAE EIGNAURE OF CONTROWNG OFRIDEXDIVER,CANDIDATE, OR AAFE MEASURE PROPONENT FPPCForm410(August/2018) FPPCAdviw: ze.riooj �fna:.a.R,.v (866/27S.3M) ar fen_ a.,,O