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Recipient Committee <br />COVER PAGE <br />Date Stamp <br />CALIFORNIA CA <br />Campaign Statement yp e or p rint in ink. <br />2001102 460 <br />(Government Code Sections 84200 - 84216.5) <br />RECEIVED <br />FORM <br />Statement covers period <br />Date of election if applicable: <br />(Month, Day, Year) <br />JAN 2 2 2014 <br />1 /8 <br />For Official use only <br />from 07/01/2013 _ <br />City of Riverside <br />SEE INSTRUCTIONS ON REVERSE through 12/31/2013 <br />06/02/2015 <br />City Clerk's Office <br />1. Type of Recipient Committee: All Committees <br />- Complete Parts 1,2,3, and 4. <br />2. Type of Statement: <br />X❑ Officeholder, Candidate Controlled Committee ❑ <br />Ballot Measure Committee <br />❑ Pre - election Statement ❑ Quarterly Statement <br />O State Candidate Election Committee <br />Q Primary Formed <br />El Semi-annual Statement ❑Special Odd -Year Report <br />Q Recall <br />O Controlled <br />(Also Complete Part 5.) <br />Q Sponsored <br />El Termination Termination Statement Supplemental Preelection <br />r-1 General Purpose Committee <br />E] Amendment (Explain below) Statement - Attach Form 495 <br />Q Sponsored <br />(Also Complete Part 6.) <br />❑ <br />Primary Formed Candidate/ <br />O Small Contributor Committee <br />Officeholder Committee <br />Q Political Party /Central Committee <br />(Also Complete Part 7.) <br />3. Committee Information I 125631BER <br />1256312 <br />Treasurer(s) <br />COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE <br />NAME OF TREASURER <br />Mike Gardner for City Council 2015 <br />Richard Teaman <br />STREET ADDRESS <br />MAILING ADDRESS <br />CITY STATE ZIP CODE <br />Riverside CA <br />AREA CODE /PHONE <br />CITY STATE ZIP CODE AREA C:ODE/PHONF <br />Riverside CA - <br />MAILING ADDRESS (IF DIFFERENT) N0, AND STREET OR P.O. BOX <br />NAME OF ASSISTANT TREASURER, IF ANY <br />Javier Carrillo <br />CITY STATE ZIP CODE <br />AREA CODE /PHONE <br />MAILING ADDRESS <br />OPTIONAL: FAX/E -MAIL ADDRESS <br />CITY STATE ZIP CODE AREA CODE E <br />Riverside CA <br />IL ADDRESS <br />4. <br />Verification <br />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 <br />is true and complete. I certify under penalty of perjury under the laws of the nd correct. <br />Executed on 01/17/2014 By Richard Teaman <br />DATE SIGNATURE OF TR <br />Executed on 01/17/2014 By Mike Gardner <br />DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CA FFICER OF SPONSOR <br />Executed on <br />DATE <br />Executed on <br />DATE <br />By <br />By <br />SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT <br />SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT <br />FPPC Form 460 (JAN 105) <br />FPPC Toll -Free Helpline: 866 /ASK -FPPC <br />State of California <br />