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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 05/17/2015 <br />through 06/30/2015 <br />1. Type of Recipient Committee: All Committees - Complete Parts 1,2,3, and 4. <br />Q Officeholder, Candidate Controlled Committee <br />❑ Ballot Measure Committee <br />0 State Candidate Election Committee <br />Q Primary Formed <br />0 Recall <br />Q Controlled <br />(Also Complete Part 5.) <br />0 Sponsored <br />❑ General Purpose Committee <br />(Also Complete Part 6 -) <br />0 Sponsored <br />❑ Primary Formed Candidate/ <br />Q Small Contributor Committee <br />Officeholder Committee <br />Q Political Party /Central Committee <br />(Also Complete Part 7.) <br />3. Committee Information 1 12256312 56312 <br />COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE <br />Mike Gardner for City Council 2015 <br />STREET ADDRESS NO P,O. B X <br />CITY STATE lifIft t <br />Riverside CA <br />MAILING ADDRESS (IF DIFFERENT) NO, AND STREET OR P.O. BOX <br />CITY STATE ZIP CODE AREA CODEPHONE <br />9 <br />COVER PAGE <br />Date stamp CAUEORNIA <br />200�102 <br />Date of election if applicable: I i - F <br />� � �i� I � 1 /9 <br />(Month, Day, Year) For Official Use Only <br />C, tai of Rival <br />06/02/2015 i s NHS Office <br />2. Type of Statement: <br />❑ Pre - election Statement ❑ Quarterly Statement <br />0 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 />MAILING ADDRESS <br />CITY STATE AREA CODEIPHONE <br />Riverside CA <br />NAME OF ASSISTANT TREASURER, IF ANY <br />Javier Carrillo <br />MAILING ADDRESS <br />- ADDRESS CITY STATE ZIP CODE AREA CODE /PHONE <br />Riverside CA - <br />OPTIONAL: FAX/E -MAIL ADDRESS <br />Verification <br />I have used all reasonable diligence in preparing and reviewing this statement and to the best of m knowled a the inform i n ntained herein and in the attached schedules <br />is true and complete. I certify under penalty of perjury, under the laws of t ct. <br />Executed on 07/09/2015 By Richard Teaman <br />DATE SIGNATURE <br />Executed on 07/09/2015 By Mik <br />DATE SIGNATURE OF CONTROLLING OFFICEHOLDER SPONSOR <br />Executed on <br />DATE <br />By <br />Executed on By <br />DATE <br />SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT <br />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 />