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Statement of Organization Date Stamp • -
Recipient Committee CLERKS DE".
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Statement Type ��D Ar D FILELD For Official Use Only
❑Initial ® Amendment El Termination—See F%�b6 ffice of the Secretary Of State
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Q Date qualification threshold met Date qualification threshold met Date of termination AUG o g g021is
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Committee1. . • I.D. Number 14002312. Treasurer and Other Principal
(f applicable)
NAME OF COMMITTEE NAME OF TREASURER
Zak Schwank For Council 2022 Jennifer Schwank
STREET ADDRESS(NO P.O.BOX)
43648 Buckeye Road
STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE
43648 Buckeye Road Temecula CA 92592 951-326-9245
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY
Temecula CA 92592 951-326-9245
FULL MAILING ADDRESS(IF DIFFERENT) STREETADDRESS(NO P.O.BOX)
E-MAILADDRESS(REQUIRED)/FAX(OPTIONAL) CITY STATE ZIP CODE AREA CODE/PHONE
zakschwank@gmail.com
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE NAME OF PRINCIPAL OFFICER(S)
Riverside City of Temecula Zak Schwank
STREETADDRESS(NO P.O.BOX)
43648 Buckeye Road
Attach additional information on appropriately labeled continuation sheets. CITY STATE ZIP CODE AREA CODE/PHONE
Temecula CA 92592 951-326-9245
3. Verification
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 G — 3 D!Z-1 By
DATE J',,;,,5IGYURE OF TREASURER OR ASSISTANT TREASURER
Executed on 7— By Z=7
DATE SIGNATURE OF CONTROLLING 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:advicegfppc.ca.eov(866/275-3772)
www.fppc.ca.gov
Statement of Organization CALIFORNIA
Recipient Committee FORM
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME I.D.NUMBER
Zak Schwank For Council 2022 1400231
• All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
Provident Bank 951-296-2429 5447545
ADDRESS CITY STATE ZIP CODE
40705 Winchester Road Suite 6 Temecula CA 92591
4.Type of Committee Complete the applicable sections.
• 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 CHECKONE
Zak Schwank City of Temecula Council District 5 2022 Nonpartisan Partisan (list political party below)
If
Nonpartisan Partisan (list political party 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) CHECK ONE
SUPPORT OPPOSE
SUPPORT OPPOSE
FPPC Form 410(August/2018)
FPPC Advice:advice@fPPc.ca.eov(866/275-3772)
www.fppc.ca.gov