460 Soubirous (01-01-15 - 04-18-15)_R

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Recipient Committee Campaign Statement Cover Page 1. Type of Recipient Committee Officeholder, Candidate Controlled Committee ❑ 0 State Candidate Election Committee 0 Recall ❑ General Purpose Committee 0 Sponsored ❑ 0 Small Contributor Committee 0 Political Party/Central Committee Statement covers period from 01/01/2015 through 04/18/2015 Primarily Formed Ballot Measure Committee 0 Controlled 0 Sponsored Primarily Formed Candidate/ Officeholder Committee I.D. Number 1-355581 3. Committee Information COMMITITEE NAME Re -Elect Mike Soubirous to City Council 2015 Date of Election If applicable 06/02/2015 (Month, Day, Year) 2. Type of Statement 0 Pre - election Statement ❑ Semi - Annual Statement ❑ Termination Statement ❑ Amendment Treasurer(s) NAME OF TREASURER Dana Hopkins, CPA STREET ADDRESS COVER PAGE APR 2 2 2F Page 1 of 27 City of Rive Ie For Official Use Only City CIS ❑ Quarterly Statement ❑ Special Odd -Year Statement ❑ Supplemental Pre - election Statement - Attach Form 495 CITY STATE ZIP CODE AREA CODE/PHONE Riverside CA NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS (IF DIFFERENT) STREET ADDRESS CITY OPTIONAL! FAX! E -MAIL ADDRESS / STATE ZIP CODE 4. Verification I have used all reasonable diligence in preparing and reviewing this complete. I certify under penalty of perjury ul Executed on `'t _ a x ^ 157 By Executed on 2'Z. ' I S� By Executed on Executed on CITY ADDRESS / STATE ZIP CODE AREA CODE/PHONE and to the best of my knowledge the information contained herein is true and �he foregoing is true and correct. By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT FPPC Form 460 - January/05 State of Califomia/SI