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Recipient Committee <br />Campaign Statement <br />Cover Page <br />SEE INSTRUCTIONS ON REVERSE <br />from <br />Statement covers period <br />07/01/2021 <br />through 12/31/2021 <br />1. Type of Recipient Committee: All committees - complete Parts 1, 2, 3, and 4. <br />® Officeholder, Candidate Controlled Committee <br />❑ Primarily Formed Ballot Measure <br />0 State Candidate Election Committee <br />Committee <br />0 Recall <br />0 Controlled <br />(Also Complete Part 5) <br />0 Sponsored <br />(Also Complete Part 6) <br />❑ General Purpose Committee <br />0 Sponsored <br />❑ Primarily Formed Candidate/ <br />0 Small Contributor Committee <br />Officeholder Committee <br />0 Political Party/Central Committee <br />(Also Complete Part7) <br />3. Committee Information I.D. NUMBER <br />1423362 <br />COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) <br />ECHEVARRIA FOR CITY COUNCIL 2020 - JOHN ECHEVARRIA <br />STREETADDRESS (NO P.O. BOX) <br /> <br />CITY STATE ZIP CODE AREACODE/PHONE <br />N/A <br />MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX <br />CITY STATE ZIP CODE AREACODE/PHONE <br />OPTIONAL: FAX / E-MAIL ADDRESS <br />4. Verification <br />COVER PAGE <br />Date Stamp CALIFORNIA , <br />.- <br />E'ey <br />Date of election if applicable: � Page 1 of 6 <br />(Month, Day, Year) For Official Use Only <br />11 3 7 D <br />2. Type of Statement: <br />❑ Preelection Statement ❑ Quarterly Statement <br />Semi-annual Statement ❑ Special Odd -Year Report <br />f Termination Statement <br />(Also file a Form 410 Termination) <br />® Amendment (Explain below) <br />Correction on Summary Page c <br />Treasurer(s) <br />NAME OF TREASURER <br />Veronica Echevarria <br />MAI LI NG AD D RESS <br /> <br />CITY STATE ZIP CODE AREACODE/PHONE <br /> <br />NAME OF ASSISTANT TREASURER, IF ANY <br />N/A <br />MAILING ADDRESS <br />CITY STATE ZIP CODE AREACODE/PHONE <br />OPTIONAL: FAX/E-MAIL ADDRESS <br />I have used all reasonable diligence in preparing and reviewing this statement and to the best of r y 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 foregoing is true arid correct. <br />Executed on ft <br />By <br />D e Signature o Treas er or Assistan Treas <br />Executed on _C75_�_n a By <br />Date Signature of Ontrolll O i ,'eanHrdate, Stale Measure Proponent or Responsible Officer of Sponsor <br />Executed on By <br />Date Signature of Controlling Officeholder, Candidate, State Measure Proponent <br />Executed on By <br />Date 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 />