460 Gardner (05-22-11 - 06-30-11) R

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Executed on By DATE Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT FPPC Form 460 (JAN /05) FPPC Toll -Free Helpline: 866 /ASK -FPPC State of California Recipient Committee COVER PAGE Campaign Statement Type or print in ink. Date Stamp CALIFORNIA 2001/02 460 (Government Code Sections 84200 - 84216.5) FORM Statement covers period Date of election if applicable: ; I •' 1/7 from 05/22/2011 (Month, Day, Year) For official Use only SEE INSTRUCTIONS ON REVERSE through 06/30/2011 06/07/2011 City Cle!. Ws GWic-e 1. Type of Recipient Committee: All Committees - Complete Parts 1,2,3, and 4. 2. Type of Statement: x❑ Officeholder, Candidate Controlled Committee ❑ Ballot Measure Committee ❑ Pre - election Statement ❑ Quarterly Statement Q State Candidate Election Committee Q Primary Formed O Recall Q Controlled Semi - annual Statement ❑ S ecial Odd -Year Report (Also Complete Part 5.) Q Sponsored E] Termination Statement Supplemental Preelection ❑ pp ❑ General Purpose Committee E] Amendment (Explain below) Statement - Attach Form 495 (Also Complete Part 6.) Q Sponsored ❑ Primary Formed Candidate/ Q Small Contributor Committee Officeholder Committee Q Political Party /Central Committee (Also Complete Part 7.) 3. Committee Information I 125631BER 1256312 Treasurer(s) COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE Mike Gardner for City Council 2011 NAME OF TREASURER Richard Teaman CITY STATE ZIP Riverside CA CITY Riverside STATE CA MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX NAME OF ASSISTANT TREASURER, IF ANY Javier Carrillo MAILING ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE RESS CITY STATE E Riverside CA 0 DRESS 4. Verification 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 certify under penalty of perjury under the laws of the S orrect. Executed on 07/18/2011 By Richard Teaman DATE SIGNATURE OF T Executed on 07/18/2011 By Mike Gardner DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CA ER OF SPONSOR Executed on By DATE Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT FPPC Form 460 (JAN /05) FPPC Toll -Free Helpline: 866 /ASK -FPPC State of California