CA Form 410 Termination Jeff Chen for RPV City Council 2024 , ,
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Statement of Organization q �j PALOS t=r�!FORM:1=0RNIA
Recipient Committee C��OF R41 0
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Statement Type � ?. 5❑Initial ❑ Amendment ® Termination See Part 5 �UL For Official Use Only
O Not yet qualified -----
Or
O Date qualification threshold met Date qualification threshold met Date of terminationr'4' CLERK'S OFFICE
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_____,_____/ ______/____/ 06 / 30 / 2025
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1, Committee InformationI.D. Number 2. Treasurer and Other Principal Officers
(if NAME OF COMMITTEE NAME OF TREASURER
JEFF CHEN FORRPV JANET CHEN
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.COn1 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 true and correct( _....,-
,,,__
Executed on 7/30/2025 ByA
DATE ,%' SIGN RE OF TREASURER OR ASSISTANT TREASURER
7/30/2025 .
Executed on By -�'
DATE SIGNATURE ROL FICEHOLDER,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@ppc.ca.gov(866/275-3772)
www.fppc.ca.goy
Statement of Organization CALIFORNIA 41 0
Recipient Committee FORM
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME I.D.NUMBER
JEFF CHEN FOR RPV CITY COUNCIL 2024 1473420
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
P 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.
17 List the political party with which each officeholder or candidate is affiliated or check"nonpartisan."Stating"No party preference"is acceptable.
U 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:advicg@fpp.c.ca.gov(866/275-3772)
www.fppc.ca.. ov
Statement of Organization
CALIFORNIA 41 0
Recipient Committee FORM
INSTRUCTIONS ON REVERSE
Page 3
COMMITTEE NAME I.D.NUMBER
JEFF CHEN FOR RPV CITY COUNCIL 2024 1473420
4.Type of Committee (Continued)
General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
Sponsored Committee List additional sponsors on an attachment.
NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREET ADDRESS NO.AND STREET CITY STATE ZIP CODE AREA CODE/PHONE
Small Contributor Committee ❑
Date qualified
5.Termination Requirements 8y signing the verification,the treasurer,assistant treasurer and/or candidate,officeholder,or ponent certify that all of the following conditions have been met:
14 This committee has ceased to receive contributions and make expenditures;
This committee does not anticipate receiving contributions or making expenditures in the future;
This committee has eliminated or has no intention or ability to discharge all debts,loans received,and other obligations;
This committee has no surplus funds;and
This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions.
U There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to
Government Code Section 89519.
Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code Sections 89511-
89518,and are subject to Elections Code Section 18680 and FPPC Regulation 18521.5.
FPPC Form 410(October/2023)
FPPC Advice:advice(fppc.ca.gov(866/275-3772)
www.fppc.ca.gov