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Recipient Committee <br />Campaign Statement <br />Cover Page <br />SEE INSTRUCTIONS ON REVERSE <br />—Atatement covers period <br />.klps� \ s2b1$ JUL 2 6 2018 <br />��(( <br />City of Riverside <br />throug 20ft City 's Office <br />Date of election if applicable: <br />(Month, Day, Year) <br />COVER PAGE <br />from <br />Page of <br />For Official Use Only <br />1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. <br />❑ Officeholder, Candidate Controlled Committee <br />O State Candidate Election Committee <br />O Recall <br />(Also Complete Part 5) <br />❑ General Purpose Committee <br />O Sponsored <br />O Small Contributor Committee <br />O Political Party/Central Committee <br />0 Primarily Formed Ballot Measure <br />Committee <br />O Controlled <br />O Sponsored <br />(Also Complete Part 6) <br />❑ Primarily Formed Candidate/ <br />Officeholder Committee <br />(Also Complete Part 7) <br />2. Type of Statement: <br />❑ Preelection Statement <br />®'lemi-annual Statement <br />O Termination Statement <br />(Also file a Form 410 Termination) <br />IWAMendment (Explain below) <br />0 Quarterly Statement <br />❑ Special Odd -Year Report <br />3. Committee Information LD. NUMBER <br />t3N% 55'� <br />COMMITTEE NAME (OR CANDID E'S NAME IF NypOMMITTE-156e..sor ;cif.4E� - - ,�_ <br />(NO P.O. BOX) <br />` .\,) CSS. <br />CITY STATE Z CODE ARE CODE/PHONE <br />MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX <br />CITY STATE <br />ZIP CODE AREA CODE/PHONE <br />OPTIONAL: FAX / E-MAIL ADDRESS <br />Treasurer(s) <br />NAME OF TREASURER <br />CITY <br />STATE ZIP CODE <br />AREA CODE/PHONE <br />NAME OF ASSISTANT TREASURER, IF ANY <br />MAILING ADDRESS <br />CITY <br />STATE ZIP CODE <br />AREA CODE/PHONE <br />OPTIONAL: FAX / E-MAIL ADDRESS <br />4. Verification <br />I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the <br />certify under penalty of perjury under the I • s of the State of California that the foregoing is true and correct. <br />Executed on <br />Executed on <br />Executed on <br />Date <br />Executed on <br />Date <br />Date <br />By <br />By <br />By <br />By <br />S <br />schedules is true and complete. I <br />esponslble Officer of Sponsor <br />Signature of Controlling Officeholder, Candidate, State Measure Proponent <br />Signature of Controlling Officeholder, Candidate, State Measure Proponent <br />FPPC Form 460 (Jan/2016) <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />