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COVER PAGE <br /> Recipient Committee Date Stamp CALIFORNIA 460 <br /> Campaign Statement RECEIVED FORM <br /> Cover Page <br /> Statement covers period Date of election If applicable: <br /> JUL 2'b2023 Page 1 of 4 <br /> from 01-1-2023 (Month,Day,Year) For Official Use Only <br /> OFFICE OF THE <br /> CITY CLERK <br /> SEE INSTRUCTIONS ON REVERSE through 06-30-2023 <br /> 1. Type of Recipient Committee: All Committees-Complete Parts 1,2,3,and 4. 2. Type of Statement: <br /> 0 Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 Preelection Statement ❑ Quarterly Statement <br /> 0 State Candidate Election Committee Committee m Semi-annual Statement ❑ Special Odd-Year Report <br /> 0 Recall 0 Controlled 0 Termination Statement <br /> (Also Complete Part 5) 0 Sponsored (Also file a Form 410 Termination) <br /> (Also Complete PM 6) 0 Amendment(Explain below) <br /> ❑ General Purpose Committee <br /> (� Sponsored El Primarily Formed Candidate! <br /> 8 Small Contributor Committee Officeholder Committee <br /> Political Party/Central Committee (Also Complete Pad7) <br /> 3. Committee Information I.D.NUMBER Treasurer(s) <br /> 1456333 <br /> COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER <br /> Kelly Chastain for Colton Council 2022 Kelly Chastain <br /> MAILING ADDRESS <br /> <br /> STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE AREA CODE/PHONE <br /> <br /> CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER,IF ANY <br /> Marlon Chastain <br /> MAILING ADDRESS(IF DIFFERENT)NO.AND STREET OR P.O.BOX MAILING ADDRESS <br /> <br /> CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE - <br /> <br /> OPTIONAL: FAX!E-MAIL ADDRESS OPTIONAL: FAX/E-MAIL ADDRESS <br /> <br /> 4. Verification <br /> I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the Information contained herein and in the attached schedules Is true and complete. I <br /> certify under penalty of perjury under the laws of the State of California that the foregol is e an co a t. <br /> Executed onl 5-r 20 2 3 By <br /> Date Signe of Treasurer or Assistant Treasurer <br /> ?7- AS- 20 213 <br /> Executed on Date By Signature C [ling Officeholder,Candidate,State Measure Proponent or Responsible Officer of Sponsor <br /> Executed on Date By Signature of Controlling Officeholder,Candidate,State Measure Proponent <br /> Executed On - Date By Signature of Controlling Officeholder,Candidate,State Measure Proponent <br /> FPPC Form 460(Jan/2016)) <br /> FPPC Advice:advice@fppc.ca.gov(866/275-3772) <br /> www.fppc.ca.gov <br />