Laserfiche WebLink
Recipient Committee <br />Campaign Statement <br />(Government Code Sections 84200 - 84216.5) <br />SEE INSTRUCTIONS ON REVERSE <br />Type or print in ink. <br />Statement covers period <br />from 01/01/2015 <br />through 04/18/2015 <br />1. Type of Recipient Committee: All Committees - Complete Parts 1,2,3, and 4 <br />❑ Officeholder, Candidate Controlled Committee ❑ <br />0 State Candidate Election Committee <br />0 Recall <br />(Also Complete Part 5.) <br />❑ General Purpose Committee <br />0 Sponsored <br />0 Small Contributor Committee <br />0 Political Party /Central Committee <br />3. Committee Information <br />Ballot Measure Committee <br />0 Primary Formed <br />0 Controlled <br />0 Sponsored <br />(Also Complete Part 6.) <br />❑ Primary Formed Candidate/ <br />Officeholder Committee <br />(Also Complete Part 7.) <br />COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE <br />Mike Gardner for City Council 2015 <br />STREET ADDRESS NO P.O. BOX <br />I.D.NUMBER <br />1256312 <br />CITY STATE AREA DE/ <br />Riverside CA <br />MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX <br />CITY <br />STATE ZIP CODE AREA CODE /PHONE <br />COVER PAGE <br />a t p CALIFORNIA': <br />2001/0 <br />FORM ;, <br />Date of election if applicable: APR 2 3 2015 1/34 <br />(Month, Day, Year) City of Riverside For Official Use Only <br />City Clerk's Office <br />06/02/2015 <br />2. Type of Statement: <br />0 Pre - election Statement ❑ Quarterly Statement <br />❑ Semi - annual Statement ❑ Special Odd -Year Report <br />❑ Termination Statement ❑ Supplemental Preelection <br />❑ Amendment (Explain below) Statement - Attach Form 495 <br />Treasurer(s) <br />NAME OF TREASURER <br />Richard Teaman <br />CITY STATE <br />Riverside CA <br />NAME OF ASSISTANT TREASURER, IF ANY <br />Javier Carrillo <br />OPTIONAL: FAX/E -MAIL ADDRESS CITY STATE ji CODE AREA CODE /PHONE <br />Riverside CA <br />DDRESS <br />4. 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 co I te. I ertif under penalty of perjury under the laws of <br />Executed on , t_ / By Richard Teaman <br />DA T SIGNATU <br />Executed on 14 �) By Mike Gardner <br />DWrE SIGNATURE OF CONTROLLING OFFICE IDATE, STATE MEASURE PROPONENT OR RESPONSIBLE OFFICER OF SPONSOR <br />Executed on <br />DATE <br />Executed on <br />By <br />By <br />SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT <br />DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT <br />FPPC Form 460 (JAN /05) <br />FPPC Toll -Free Helpline: 866 /ASK -FPPC <br />State of California <br />