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Statement of Organization <br />Recipient Committee <br />Statement Type O Initial <br />Not yet qualified I0 or <br />Date qualified as committee <br />1. Committee Information <br />Date Stamp <br />(D Amendment <br />O Termination -See Part3 °� <br />. <br />List I.D. number <br />1256312 <br />List I.D. number, <br />10 0 E C 17 PH <br />e• <br />_ <br />Ji C: <br />2 2olo <br /># <br />ri <br />07/23/2008 <br />REGIS! i1 ri LP <br />I <br />V ., <br />- ' ' <br />Date qualified as committee <br />Date of Term OF f IV <br />ER <br />1DE <br />COMMITTTEE/FILER'S NAME <br />Mike Gardner for City Council 2011 <br />STREET ADDRES N PO QOX� <br />VI I r STATE ZIP CODE AREA <br />Riverside CA <br />MAILING ADDRESS (IF DIFFERENT) <br />OPTIONAL: FAX/ E -MAIL ADDRESS <br />COUNTY OF DOMICILE <br />Riverside <br />STATEMENT OF ORGANIZATION <br />2. Treasurer and Other Principal Officers <br />NAME OF TREASURER <br />Richard Teaman <br />For Official Use Only <br />Javier Carrillo <br />CITY <br />Riverside <br />COUNTY WHERE COMMITTEE IS ACTIVE IF DIFFERENT <br />THAN COUNTY OF DOMICILE <br />STREET ADDRESS <br />STATE <br />CA <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />3. Verification <br />I have used all reasonalbe diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein is true and complete. <br />I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. <br />Executed on 1 2- i T q D <br />Executed on 11- -1 s' 10 <br />Executed on <br />Executed on <br />By <br />TURE OF TREASURER OR ASSISTANT TREASURER <br />By <br />U-1-101-01 MIN I nVLL114U LDER, CANDIDATE, STATE MEASURE PROPONENT OR RESPONSIBLE OFFICER OF SPONSOR <br />By <br />SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT <br />By <br />SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT <br />
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