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COVER PAGE <br /> Recipient Committee RECIE�iD CALIFORNIA <br /> Campaign Statement 460 <br /> FORM <br /> Cover Page <br /> Statement covers period Date of election if applicable: JAN 3 O Z023 page 1 of 7 <br /> from 08-01-2022 (Month,Day,Year) OFFICE OF THE For Official Use Only <br /> CITY CLERK <br /> SEE INSTRUCTIONS ON REVERSE through 12-31-2022 11 08 2022 <br /> 1. Type of Recipient Committee: All Committees-Complete Parts 1,2,3,and 4. 2. Type of Statement: <br /> Z Officeholder,Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement <br /> U State Candidate Election Committee Qommittee m Semi-annual Statement ❑ Special Odd-Year Report <br /> O Recall U Controlled ❑ Termination Statement <br /> (Also Complete Pert 5) 0 Sponsored (Also file a Form 410 Termination) <br /> (Also Complete Part 6) ❑ Amendment(Explain below) <br /> ❑ General Purpose Committee <br /> O Sponsored ❑ Primarily Formed Candidate/ <br /> 8 Small Contributor Committee Officeholder Committee <br /> Political Party/Central Committee (Also Complete Part 7) <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 /> 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 foregoing is true nd correct. <br /> Ly <br /> Executed on 1-28-2023 By a <br /> Date q l N Signature o9Treasurer or Assistant Treasurer <br /> 1-28-2023 _- <br /> Executed on By <br /> Date Signature of ontr ling Officeholder.Candidate.State Measure Proponent or Responsible Officer of Sponsor <br /> k <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 />