410 Mill CC W5 (07-05-18) Initial_R

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Statement of Organization Recipient Committee Statement Type ® Initial ® Not yet qualified or O Date qualified as committee / 1. Committee Information 0 Amendment Date qualified as committee 0 Termination — See Part 5 / / Date of termination I.D. Number (if applicable) NAME OF COMMITTEE Sean Mill for Riverside City Council ao t 9, STREET ADDRESS (NO P.O. BOX) CITY Riverside STATE ZIP CODE CA AREA CODE/PHONE MAILING ADDRESS (IF DIFFERENT) E-MAIL ADDRESS (REQUIRED) / FAX (OPTIONAL) COUNTY OF DOMICILE Riverside JURISDICTION WHERE COMMITTEE IS ACTIVE amity of Riverside Attach additional information on appropriately labeled continuation sheets. JUL 0 5 2018 City of Riversid City Clerk's Offic For Official Use Only 2. Treasurer and Other Principal Officers NAME OF TREASURER Sean Mill STREET ADDRESS (NO P.O. BOX) CITY Riverside STATE CA ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Trenna Mill STREET ADDRESS (NO P.O. BOX) CITY Riverside STATE CA ZIP CODE AREA CODE/PHONE NAME OF PRINCIPAL OFFICER(S) Sean Mill STREET ADDRESS (NO P.O. BOX) CITY Riverside STATE CA ZIP CODE AREA CODE/PHONE 3. Verification I have used all reasonable diligence in preparing this sta penalty of perjury under the laws of the State of Califor 6/13/2018 By DATE Executed on 6/13/2018 By DATE Executed on By DATE Executed on By DATE e the information contained herein is true and complete. I certify under t. R ASSISTANT TREASURER ANDIDATE, OR STATE MEASURE PROPONENT ANDIDATE, OR STATE MEASURE PROPONENT SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (February/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov