CA Form 410 Jeff Chen for RPV City Council 2024 Statement of Organization Date Stamp CALIFORNIA 41 0
Recipient Committee RECEIVED FORM
Statement Type ®Initial ❑ Amendment ❑ Termination f I See Part c 'T'0FBA1\1CHoPALoS VERDES For Official Use Only
0 Not yet qualified AUG UG 0 7 2024
0 Date qualification threshold met Date qualification threshold met Date of termination
/ / / / CLERKS
OF CITY
1. Committee Information I.D. Number 2. Treasurer and Other Principal Officers
(if applicable)
NAME OF COMMITTEE NAME OF TREASURER
JANET CHEN
JEFF CHEN FOR RPV CITY COUNCIL 2024 STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE
5557 SEASIDE HEIGHTS DR Rancho Palos Verdes CA 90275
EMAIL ADDRESS OF TREASURER(REQUIRED) AREA CODE/PHONE
STREET ADDRESS(NO P.O.BOX) treasurer@chen4rpv.com 310-408-1106
5557 SEASIDE HEIGHTS DR
NAME OF ASSISTANT TREASURER,IF ANY
CITY STATE ZIP CODE AREA CODE/PHONE
Rancho Palos Verdes CA 90275 424-888-0178 STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE
FULL MAILING ADDRESS(IF DIFFERENT)
46 Peninsula Center,Ste E PMB 191,Rolling Hills Estates,CA 90274 EMAIL ADDRESS OF ASSISTANT TREASURER(REQUIRED) AREA CODE/PHONE
E-MAIL ADDRESS OF COMMITTEE(REQUIRED)/FAX(OPTIONAL)
jeff@chen4rpv.com NAME OF PRINCIPAL OFFICER(S)
COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE JEFFREY CHEN
LOS ANGELES Rancho Palos Verdes STREET ADDRESS(NO P.O.BOX) CITY STATE ZIP CODE
5557 SEASIDE HEIGHTS DR Rancho Palos Verdes CA 90275
EMAIL ADDRESS OF PRINCIPAL OFFICER(S)(REQUIRED) AREA CODE/PHONE
Attach additional information on appropriately labeled continuation sheets.
jeff@chen4rpv.com 424-888-0178
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 tr e and cc/rect.
8/1/2024 ( " -7---------- -------------------
Executed on By
DATE S OF TR SURER OR ASSISTANT TREASURER
Executed on 8/1/2024 By
DATE SIGNATURE OF CONTROL G OF ICEHOLDER,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(October/2023)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov
41 0
Statement of Organization CALIFORNIA
Recipient Committee FORM
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME I.D.NUMBER
JEFF CHEN FOR RPV CITY COUNCIL 2024
=l All committees must list the financial institution where the campaign bank account is located and the person(s)authorized to obtain bank records.
NAME OF FINANCIAL INSTITUTION AND PERSON(S)AUTHORIZED TO OBTAIN BANK RECORDS AREA CODE/PHONE BANK ACCOUNT NUMBER
MALAGA BANK 310-541-3000 03-114524-06
ADDRESS OF FINANCIAL INSTITUTION CITY STATE ZIP CODE
27450 Hawthorne Blvd Rolling Hills Estates CA 90274
4.Type of Committee Complete the applicable sections. •
Controlled Committee
L' 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.
C] 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 CHECK ONE
Nonpartisan Partisan (list political party below)
JEFFREY CHEN City Council,City of Rancho Palos Verdes ' 2024 ✓
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(October/2023)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fp_pc.ca.gov