Laserfiche WebLink
Recipient Committee <br />Campaign Statement <br />Cover Page <br />SEE INSTRUCTIONS ON REVERSE <br />Statement covers period <br />from 4/21/2019 <br />5/18/2019 <br />through <br />Date of election if applicable: <br />(Month, Day, Year) <br />06/04/2019 <br />❑ate Stamp <br />RECEIVE <br />MAY 23 2019 <br />City of Riverside <br />City Clerk's Office <br />COVER PAGE <br />CALIFORNIA 460 <br />FORM V <br />Page <br />of 1 <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 />0 Recall <br />(Also Complete Pm15) <br />❑ General Purpose Committee <br />O Sponsored <br />O Small Contributor Committee <br />O Politica! Party/Central Committee <br />❑ Primarily Formed Ballot Measure <br />Committee <br />0 Controlled <br />0 Sponsored <br />{A/so Compete Pat E) <br />❑ Primarily Formed Candidate) <br />Officeholder Committee <br />Asa CompieIe Pert?) <br />2. Type of Statement: <br />• Preelection Statement <br />❑ Semi-annual Statement <br />❑ Termination Statement <br />(Also file a Form 410 Termination) <br />O Amendment (Explain below) <br />O Quarterly Statement <br />❑ Special Odd -Year Report <br />3. Committee Information <br />I.Q. NUMBER <br />1407581 <br />COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) <br />Gaby Plascencia Riverside City Council Ward 5, 2019 <br />STREET ADDRESS (NO P.O. BOX) <br />CITY <br />Riverside <br />STATE ZIP CODE <br />CA <br />AREA CODE/PHONE <br />MAILING ADDRESS (1F DIFFERENT) NO. AND STREET OR PO. BOX <br />CITY STATE ZIP CODE <br />AREA CODE+PHONE <br />Treasurer(s) <br />NAME OF TREASURER <br />Martha Trujillo <br />MAILING ADDRESS <br />cuTY <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 I E-MAILADDRESS OPTIONAL: FAX r 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 of perjury under the laws of the State of California that the fore ^^ • i <br />Executed on <br />Executed on <br />h <br />Dale <br />Executed on <br />Date <br />Executed on <br />Date <br />By. <br />By. <br />By <br />By <br />Assistant Treasurer <br />.,ly„a,., .,y vo, ,,,.„ ,,,.,asure Proponent 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 ($65/275-3772) <br />www.fppc.ca.gov <br />