460 Soubirous (05-17-15 - 06-30-15)_R

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Recipient Committee Campaign Statement Cover Page Statement covers period from 05/17/2015 through 06/30/2015 1. Type of Recipient Committee Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure O State Candidate Election Committee Committee O Recall 0 Controlled ❑ General Purpose Committee 0 Sponsored 0 Sponsored Primarily Formed Candidate/ a Small Contributor Committee Officeholder Committee d Political Party/Central Committee 3. Committee Information I.D. Number 1355581 COMMITTTEE NAME Re -Elect Mike Soubirous to City Council 2015 STREET ADDRESS (NO PO BOX) CITY STATE ZIP CODE AREA CODE /PHONE Riverside CA MAILING ADDRESS (IF DIFFERENT) CITY STATE ZIP CODE Date of Election if applicable (Month, Day, Year) Date Stamp ECEIVE Page 1 of 8 JUL 3 0 2015 11 For Official Use Only 2. Type of Statement ❑ Pre - election Statement Semi - Annual Statement ❑ Termination Statement ❑ Amendment Treasurer(s) NAME OF TREASURER Dana Hopkins, CPA STREET ADDRESS ❑ Quarterly Statement ❑ Special Odd -Year Statement ❑ Supplemental Pre - election Statement - Attach Form 495 CITY STATE ZIP CODE AREA CODEIPHONE Riverside CA NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX/ E -MAIL ADDRESS OPTIONAL: FAX/ E -MAIL ADDRESS 4. Verification I have used all reasonable diligence in prepal f my knowledge the information contained herein is true and complete. I certiV3b nder enalty of perjury I regoing is true and correct. Executed on 0 g E - RER OR ASSISTANT TREASURER Executed on E Executed on SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT Executed on By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT FPPC Form 460 - January/05 State of CalifornialSl