460 Gardner (01-01-09 - 06-30-09) R

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Recipient Committee Campaign Statement (Government Code Sections 84200 - 84216.5) Type or print in ink. Statement covers period from 01/01/2009 SEE INSTRUCTIONS ON REVERSE I through 06/30/2009 1. Type of Recipient Committee: All Committees - Complete Parts 1,2,3, and 4. X❑ Officeholder, Candidate Controlled Committee ❑ Ballot Measure Committee 0 State Candidate Election Committee 0 Primary Formed 0 Recall 0 Controlled (Also Complete Part 5.) 0 Sponsored ❑ General Purpose Committee (Also Complete Part 6.) 0 Sponsored ❑ Primary Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party /Central Committee (Also Complete Part 7.) 3. Committee Information COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE Friends of Mike Gardner I.D.NUMBER 1256312 THE BOX) CITY STATE Q AREA CODE/PHONE Riverside CA MAILING ADDRESS IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE Riverside CA - ADDRESS EW 4. Verification I have used all reasonable diligence in preparing and reviewing this is true and complete. I certify under penalty of perjury under the lav Executed on 07/27/2009 By Kathleen Dale DATE SIGP Executed on 07/27/2009 By Mike Gardner DATE SIGNATURE OF CONTROLLING OFFICE Executed on DATE Executed on DATE By By Date of election if, (Month, Day, 11/06/2007 COVER PACE Date Stamp CALIFORNIA 460 2005/06 FORM CEIVED AUG 0 3 2009 2. Type of Statement: ❑ Pre - election Statement Semi - annual Statement ❑ Termination Statement ❑ Amendment (Explain below) Treasurer(s) For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report ❑ Supplemental Preelection Statement - Attach Form 495 NAME OF TREASURER Kathleen Daley t MAILING ADDRESS CITY STATE i AREA (C)DF/PHC)NF Riverside CA NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/E -MAIL ADDRESS information contained herein and in the attached schedules true and correct. OFFICER OF SPONSOR SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT SIGNATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE, STATE MEASURE PROPONENT FPPC Form 460 (January /05) FPPC Toll -Free Helpline: 866 /ASK -FPPC State of California