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Recipient Committee <br />Campaign Statement <br />Cover Page <br />SEE INS I RUCTIONS ON REVERSE <br />Statement covers period <br />,-7-1 A. 1 <br />through 5-7\F s1. <br />1. Type of Recipient Committee: AO committees - Complete Paris 1, 2, 3, and 4. <br />{ Officeholder, Candclate.Contrelled Committee <br />O State Candidate Election Committee <br />O Recall <br />• (AND Complete Pert <br />sj <br />General Purpose Corrlmtiitee <br />O Sponsored <br />O Small Contributor Committee <br />O Political PartyiCentral Committee <br />❑ Primarily Formed Ballot Measure <br />Committee <br />O Controlled <br />• Sponsored <br />(caro Complete Part 8) <br />E Primarily Formed Candidate/ <br />Officeholder Committee <br />jN n Complete PM iJ <br />Date of election if applicable: <br />(Month, Day, Year).:... <br />TtAn Lt 2)0 1,9 <br />2.. Type of. State hent; <br />® Preelection Statement <br />• ❑ ..Scutt -annul Statement <br />• Termination Statement <br />(Also:.fiie a: Form 410 Termination) <br />❑ Amendment (Explain below) <br />Date Sump <br />RECEIVE <br />MAY 2 2019 <br />City of Riverside <br />nay Clerk's Ciffoc <br />COVER PAGE <br />CALIFORNIA 460 <br />FORM <br />Page of <br />For Oficial. use Only <br />0. Quarterly Statement <br />0 Special. Odd -Year Report <br />3. Committee Information <br />1.D, NUMBER <br />4! <br />COMMrrTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) <br />Dr i i t t a`r"1 S` e"Jte - r L.) Pa 7 ` Ot'1 <br />STREET ADDRESS NO P.O, BO <br />CI rZ° STATS =� <br />t ver-53cj-e C.4 <br />MAILING ADDRESS (IF DIFFERENT) NO. ANO STREET OR P.C. BOX <br />CITY <br />STATE Z1P CODE AREA CODE/PHONE <br />IIP T lfl I • FAY f F.M4€r.dffP SS <br />4. Verification <br />l have used all reasonable diligence in preparing and reviewing this statementand to thebest ofmy <br />certify under penalty of perjury under the taws of the State of California that the foregoing is tr r <br />Executed on Etas <br />Executed on <br />Dare <br />Executed on <br />Executed on <br />Date <br />irate <br />By <br />By <br />By <br />BY <br />Treasurer(a) <br />NAME OF TREASURER <br />bow d- Per, I�i1 �. <br />MAILING ADDRESS <br />Crit STATE 2 <br />NAME OF ASSISTANT i RPASIRER, IF ANY <br />Til P <br />MAILING P <br />ift <br />CITY <br />re)!lamC Cl r% <br />- e <br />Y �i J <br />STATE ZIP CODE <br />C <br />owlet the infanra`ion contained herein and in the attahed schedules is true and complete. 1 <br />of Treasurer or Assistant Treasurer <br />SiOnahire otr Controlling Oftlaeholder,Candidate, Stare RMSesure Proponent. or Re caseate Officer of Sporisor. <br />Signature of Conte leg Ofcehalder, Candidate, State Measure Prepolent <br />Signature of Controlling Officeholder, Candidate, State Measure Proponent <br />FPPC Form 460 (Jarrf2416) <br />FPPC Advice: advice@fppc.ca-gov (266/275-3772) <br />