Tony Blain for 2024 District 2 Poway City Council 410 Amendment 11/14/2023Statement of Organization
RECEIVEDDate
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Recipient Committee
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the. Qifice of the Secretary of StStatement
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For Off cial Use O
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Type
❑ Initial
0,,Amendment
❑ Termination — See Part 5
Q Not yet qualified
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RECE
O Date qualification threshold met
Date qualification threshold met
Date of termination
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NOV 1 4 2023
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(i(oPPlicable) V�
7AMEDF COM M ITTEENAME
OF TREASURER
IN CLERK'S OFFICy
Blain for 2024 District 2 Poway City Council
J STEVAN KEMP
STREET ADDRESS (NO P.O. BOX)
STREET ADDRESS (NO P.O. BOX)
CITY STATE
ZIP CODE
AREA CODE/PHONE
SAN MARCOS CA
92069
619-548-4084
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF ASSISTANT TREASURER, IF ANY
SAN MARCOS CA 92069 858-248-1509
SARA KEMP
FULL MAILING ADDRESS (IF DIFFERENT)
STREET ADDRESS (NO P.O. BOX)
E-MAIL ADDRESS (REQUIRED) I FAX(DPTIONAL)
CITY STATE
ZIP CODE
AREA CODE/PHONE
ABLAIN@YAHOO.COM
SAN MARCOS CA
92069
760-212-7413
COUNTY OF DOMICILE
JURISDICTION WHERE COMMITTEE 15 ACTIVE
NAME OF PRINCIPAL OFFICER(S)
SAN DIEGO
POWAY
ARTHUR BLAIN
STREET ADDRESS (NO P.O. BOX)
Attach additional information on appropriately labeled continuation sheets.
CITY STATE
ZIP CODE
AREA CODE/PHONE
POWAY CA
92064
858-248-1509
OEM
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 p:(kZ12V2a
der the laws of the State true and correct.
Executed on By I N
nn %DATE SinNATURE OF
Executed on
DATE
Executed on
DATE
By
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (August/2018)
FPPC Advice: advice@fPPc.ca.aov (866/275-3772)
www.fppc.Ca.goy
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Tony Blain for 2024 District 2 Poway City Council
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
BANK OF SAN FRANCISCO 415-755-6700
ADDRESS CITY STATE ZIP CODE
345 California Street, Suite 1600 San Francisco CA 94104
Page 2
I.D. NUMBER
• 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 CAN MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE
Nonpartisan
Partisan
(list political party below)
ARTHUR BLAIN
POWAY CITY COUNCIL
2024
Nonpartisan
Partisan
(list political party below)
FormedPrimarily Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE IINCLUDE 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) CHECK ONE
SUPPORT OPPOSE
SUPPORT OPPOSE
FPPC Form 410 (August/2018)
FPPC Advice:-advice@fppc.ca.Roy (866/275-3772)
www.fppc.ca.gov