410 Rubio CC W3 (06-20-19)_R - Laserfiche WebLink

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Statement of Organization Recipient Committee Statement Type 0 Initial RECEIVED 0 Not yet qualified or 0 Date qualification threshold met / / ,Amendment Date qualification threshold met /1(e_/6C( JUN 2 0 2019 Date Stamp City of RiversideC�'ED AND �� � �� Pa' -HT office of the Secretary of State of the State of California CALIFORNIA 410 FORM Date of termination / / MAY 24 2019 For Official Use Only 1. Committee Information I.D. Number (if applicable) ID#1416175 2. Treasurer and Other Principal Officers NAME OF COMMITTEE Rubio for Riverside City Council WARD 3 - Election Year 2019 - Committee to Elect Richard STREET ADDRESS (NO P.O. BOX) CITY STATE Riverside CA ZIP CODE NAME OF TREASURER Joe Deledonne STREET ADDRESS (NO P.O. BOX) CITY Riverside STATE CA AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY FULL MAILING ADDRESS (IF DIFFERENT) E-MAIL ADDRESS(REQUIRED)/ FAX (OPTIONAL) COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE 15 ACTIVE Attach additional information on appropriately labeled continuation sheets. ZIP CODE AREA CODE/PHONE STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE NAME OF PRINCIPAL OFFICER(S) STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE 3. Verification I have used all reasonable diligence in penalty of perjury under the 19.,ws of thl _ Executed on DATE Executed on 5//6/ DATE )rmation contained herein is true and complete. I certify under -REASURER SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT Executed on g Y DATE Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov