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Recipient Committee <br />Campaign Statement <br />Cover Page <br />SEE INSTRUCTIONS ON REVERSE <br />Rett4 e I iveyed <br />Date Stamp <br />RECEIVED <br />Statement covers period <br />from 5/19/2019 <br />6/30/2019 <br />through <br />Date of election if applicable: <br />(Month, Day, Year) <br />11/5/2019 <br />JUL 31 2019 <br />City of Riverside <br />City Clerk's Office <br />COVER PAGE <br />CALIFORNIA 460 <br />FORM <br />Page <br />/ of <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 Part 5) <br />❑ General Purpose Committee <br />O Sponsored <br />O Small Contributor Committee <br />O Political Party/Central Committee <br />O Primarily Formed Ballot Measure <br />Committee <br />O Controlled <br />O Sponsored <br />(Also Complete Part 5) <br />❑ Primarily Formed Candidate/ <br />Officeholder Committee <br />(Also Complete Pert 7) <br />2. Type of Statement: <br />O Preelection Statement <br />2 Semi-annual Statement <br />❑ Termination Statement <br />(Also file a Form 410 Termination) <br />O Amendment (Explain below) <br />❑ Quarterly Statement <br />❑ Special Odd -Year Report <br />3. Committee Information <br />I.D. 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 <br />CA <br />ZIP CODE AREA CODE/PHONE <br />MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX <br />CITY STATE <br />ZIP CODE AREA CODE/PHONE <br />OPTIONAL: FAX / E-MAIL ADDRESS <br />Treasurer(s) <br />NAME OF TREASURER <br />Martha Trujillo <br />MAILING ADDRESS <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 an e attached schedules is true and complete. I <br />certify under penalty of erjury ynder the laws of the State of California that the fc <br />a <br />Executed on / <br />hot/� ate <br />Date <br />Executed on <br />Executed on <br />Executed on <br />Date <br />Date <br />By <br />By <br />e 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 />