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Recipient Committee <br />Campaign Statement <br />Cover Page <br />SEE INSTRUCTIONS ON REVERSE <br />Statement covers period <br />from 7-1-0 <br />through q-zt-lq <br />1. Type of Recipient Committee: All Committees – Complete Parts 1, 2, 3, and 4. <br />X Officeholder, Candidate Controlled Committee El Primarily Formed Ballot Measure <br />0 State Candidate Election Committee Committee <br />0 Recall 0 Controlled <br />(Also Complete Part 5) 0 Sponsored <br />(Also Complete Part 6) <br />El General Purpose Committee <br />0 Sponsored El Primarily Formed Candidate/ <br />0 Small Contributor Committee Officeholder Committee <br />0 Political Party/Central Committee (Also Complete Part 7) <br />D. NUMBER <br />3. Committee Information I.I q) 4 Z gq <br />NO COMMITTEE) <br />Pir, iW11111.1am, fleao'e-e t4,14,Ad -7 ZOO <br />STREETADDRESS (NO P.O. BOX) <br />f <br />IV <br />CITY STATE ZIP CODE AREACODE/PHONE <br />OPTIONAL: FAX/ E-MAILADDRESS <br />COVER PAGE <br />Date Stamp <br />I -E' 19 <br />Date of election if applicable: Page of 1ECEN U <br />(Month, Day, Year) For Official Use Only <br />SEP 2 4 2019 <br />City of Riverside <br />2. Type of Statement: <br />Preelection Statement F-1 Quarterly Statement <br />❑ Semi-annual Statement ❑ Special Odd -Year Report <br />❑ Termination Statement <br />(Also file a Form 410 Termination) <br />❑ Amendment (Explain below) <br />Treasurer(s) <br />NAME OF TREASURER <br />I <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 foregoin is yeand corrects <br />Executed on — - ze I By <br />Date sistant Treasurer <br />Executed on — 3 Z�:Ylq By <br />Date asure Proponent or Responsible Officer of Sponsor <br />Executed on <br />Date <br />Executed on <br />Date <br />By Signature of Controlling Officeholder, Candidate, State Measure Proponent <br />By 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 />