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Recipient Committee <br />Campaign Statement <br />Cover Page <br />SEE INSTRUCTIONS ON REVERSE <br />Statement covers period <br />from 111119 <br />4120119 <br />through <br />Date of election if applicable: <br />(Month, Day. Year) <br />614119 <br />COVER PAGE <br />1. Type of Recipient Committee: All Committees —Complete Parts 1, 2, 3, and 4. <br />O Officeholder. Candidate Controlled Committee <br />O State Candidate Election Committee <br />Q Recall <br />Aso Complete Part 5) <br />❑ General Purpose Committee <br />O Sponsored <br />• Small Contributor Committee <br />Q Political Party/Central Committee <br />❑ Primarily Formed Ballot Measure <br />Committee <br />O Controlled <br />O Sponsored <br />(Atsa Complete Part 6) <br />❑ Primarily Formed Candidate/ <br />Officeholder Committee <br />/Aim Complete Part 7) <br />M:.. ?3 019 <br />City _ de <br />City t tfice <br />2. Type of Statement: <br />® Preelection Statement <br />E l Semi-annual Statement <br />❑ Termination Statement <br />(Also file a Form 410 Termination) <br />® Amendment (Explain below) <br />I.D. Number added to Committee Information on Cover Page <br />For Official Use Only <br />❑ Quarterly Statement <br />❑ Special Odd -Year Report <br />3. Committee Information <br />I. D. NUMBER <br />1402303 <br />COMMITTEE NAME {OR CANDIDATES NAME IF NO COMMITTEE) <br />Philip Falcone for Riverside City Council Ward 1 2019 <br />STREET ADDRESS (NO P.O. BOX) <br />CITY <br />Riverside <br />STATE <br />CA <br />ZIP CODE AREA CODEIPHONE <br />MAILING ADDRESS (IP DIFFERENT) NO. AND STREET OR P.O. BOX <br />CITY <br />STATE <br />ZIP CODE AREA CODE/PHONE <br />OPTIONAL: FAX! E-MAIL ADDRESS <br />philip@falconeforward1.com <br />4. Verification <br />I have used all reasonable diligence in preparing and reviewing this statement and to th <br />certify under penalty of perjury under the laws of the State of California that the foregoi <br />—71,;? -17 <br />Executed on <br />Executed on <br />Executed on <br />Executed on <br />Date <br />Date <br />5-fi <br />Date <br />;-� <br />Date <br />By <br />By <br />By <br />By <br />Treasurer(s) <br />NAME OF TREASURER <br />Paula Leivas <br />MAILING ADDRESS <br />CITY <br />Riverside <br />STATE ZIP CODE <br />CA <br />NAME OF ASSISTANT TREASURER, IF ANY <br />Michaela Montgomery <br />AREA CODE/PHONE <br />MAILIN ADDRES <br />CITY <br />Riverside <br />STATE ZIP CODE <br />CA <br />OPTIONAL: FAX 1E -MAIL ADDRESS <br />in the attached schedules is true and complete. I <br />ponsible 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.fnnr.ra.nnv <br />