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Recipient Committee <br />Campaign Statement <br />Cover Page <br />SEE INSTRUCTIONS ON REVERSE <br />Statement covers period <br />from 7/1/2018 <br />through 12/31/2018 <br />COVER PAGE <br />Date of election if applicable: <br />(Month, Day, Year) <br />06/04/2019 <br />FEB 0 6 2019 <br />City of Riverside <br />City Cleric's Office <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 Pert 5) <br />❑ General Purpose Committee <br />O Sponsored <br />O Small Contributor Committee <br />O Political Party/Central Committee <br />❑ Primarily Formed Ballot Measure <br />Committee <br />O Controlled <br />O Sponsored <br />(Also Complete Pert 6) <br />❑ Primarily Formed Candidate/ <br />Officeholder Committee <br />(Also Complete Part 7) <br />2. Type of Statement: <br />❑ P• reelection Statement <br />Semi-annual Statement <br />❑ T• ermination Statement <br />(Also file a Form 410 Termination) <br />Amendment (Explain below) <br />Adding cities to zip codes on "Schedule A "Monetary Contributions <br />❑ Quarterly Statement <br />❑ Special Odd -Year Report <br />Received <br />3. Committee Information <br />I.D. NUMBER <br />1407581 <br />COMMITTEE NAME (OR CANDIDATES NAME IF NO COMMITTEE) <br />Gaby Plascencia Riverside City Council Ward 5, 2019 <br />STREET ADDRESS (NO P.O. BOX) <br />Riverside <br />CITY <br />Riverside <br />STATE ZIP CODE <br />CA <br />AREA CODE/PHONE <br />MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX <br />CITY <br />STATE ZIP CODE <br />AREA CODE/PHONE <br />OPTIONAL: FAX / E-MAIL ADDRESS <br />Treasurer(s) <br />NAME OF TREASURER <br />Martha Trujillo <br />MAILING ADDRESS <br />Riverside <br />CITY <br />Riverside <br />STATE ZIP CODE <br />CA <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 information contained herein and in the attached schedules is true and complete. I <br />certify under penalty ofperju under the laws of the State of California that the foregs i s ' r. <br />Executed on <br />Executed on <br />Executed on <br />Executed on <br />Date <br />L9-01 <br />I ate <br />lCj <br />Date <br />Date <br />By <br />By <br />By <br />By <br />asurer <br />nent or Responsible 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 />www.fppc.ca.gov <br />