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Recipient Committee <br />Campaign Statement <br />Cover Page <br />1. Type of Recipient Committee <br />Officeholder, Candidate Controlled Committee <br />0 State Candidate Election Committee <br />0 Recall <br />❑ General Purpose Committee <br />0 Sponsored <br />0 Small Contributor Committee <br />0 Political Party/Central Committee <br />Statement covers period <br />from 07/01/2018 <br />through 12/31/2018 <br />❑ Primarily Formed Ballot Measure <br />Committee <br />0 Controlled <br />0 Sponsored <br />❑ Primarily Formed Candidate/ <br />Officeholder Committee <br />COVER PAGE <br />Date Stamp <br />ECEIVE <br />Date of Election if applicable I I Page 1 of 19 <br />JAN N19 1 For Official Use Only <br />(Month, Day, Year) Iit i Nereids <br />2. Type of Statement - <br />❑ Pre-election Statement ❑ Quarterly Statement <br />Semi -Annual Statement ❑ Special Odd -Year Statement <br />❑ Termination Statement ❑ Supplemental Pre-election <br />❑ Amendment Statement - Attach Form 495 <br />Number I.D.1256312 <br />3. Committee Information Treasurer(s) <br />COMMITTfEE NAME NAME OF TREASURER <br />Mike Gardner for City Council 2019 Richard Teaman <br />STREET ADDRESS <br />STREET ADDRESS (NO PO BOX) CITY STATE ZIP CODE AREA CODE/PHONE <br />Riverside CA <br />CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY <br />Riverside CA Javier Carrillo <br />MAILING ADDRESS (IF DIFFERENT) STREET ADDRESS <br />CITY STATE ZIP CODE CITY STATE ZIP CODE AREA CODE/PHONE <br />Riverside CA <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 information contained herein is true and <br />complete. I certify under penalty of perjury under the laws of the State of California that the nd correct. <br />Executed on 9 By <br />Ap <br />MODIDATE, <br />Executed on TREASURER OR ASSISTANT TREASURER <br />t, � By <br />SIGNATURE OF CONTROSTATE MEASURE PROPONENT OR RESPONSIBLE OFFICER OF SPONSOR <br />Executed on <br />By <br />Executed on By <br />SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT FPPC Form 460 -(JAN/2016) <br />State of California/Sl <br />