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Recipient Committee <br />Campaign Statement <br />Cover Page <br />411:11:8 ILI 14,11110.150119 [*1 ILI [004 1 -1:00 -.11*1 <br />Statement covers period Date of election if applicable: <br />from 9-22-2019 1 (Month, Day, Year) <br />through <br />ffl]111116;�l 0 <br />Date Stamp <br />R E LO";"E <br />COVER PAGE <br />Page 1 of 9 <br />For Official Use Only <br />1. Type of Recipient Committee: All Committees — Complete Parts 1, 2,3, and 4. 2. Type of Statement: <br />FO Officeholder, Candidate Controlled Committee El Primarily Formed Ballot Measure Preelection Statement E :1 Quarterly Statement <br />0 State Candidate Election Committee Committee Semi-annual Statement El Special Odd -Year Report <br />0 Recall 0 Controlled F-1 Termination Statement <br />(Also Complete Part 5) 0 Sponsored (Also file a Form 410 Termination) <br />171 General Purpose Committee (Also Complete Part 6) Amendment (Explain below) <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 />3. Committee Information I.D. NUMBER <br />1 1416289 <br />Dr. William Pearce for Ward 7 2019 <br />STREET ADDRESS (NO P.O, BOX) <br />CITY STATE ZIP CODE AREA CODEIPHONE <br />Riverside CA <br />MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX <br />CITY STATE ZIP CODE AREACODE/PHONE <br />Treasurer(s) <br />NAME OF TREASURER <br />Sandra Andersen <br />MAILINGADDRESS <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />Riverside CA <br />NAME OF ASSISTANT TREASURER, IF ANY <br />William Pearce <br />MAILINGAIDDRESS <br />CITY STATE ZIP CODE AREA CODEIPHONE <br />Riverside CA � <br />OPTIONAL: FAX/ E-MAILADDRESS OPTIONAL: FAX/E-MAILADDRESS <br />4. Verification <br />I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the <br />certify under penalty of perjury under the laws of the State of California that the foreg <br />Executed on 10-22-2019 <br />Date <br />Executed on 10-22-2019 <br />Date <br />Executed on <br />Date <br />Executed on <br />Date <br />By <br />contained herein and in the attached schedules is true and complete. I <br />or <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 />www.fppc.ca.gov <br />