460 Avery CC W3 (09-22-19 - 10-19-19)_R

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Recipient Committee Campaign Statement Cover Page 1. Type of Recipient Committee Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall F� General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information Statement covers period from 09/22/2019 through 10/19/2019 Primarily Formed Ballot Measure Committee 0 Controlled 0 Sponsored F] Primarily Formed Candidate/ Officeholder Committee LD, Number 1416490 COMMITTTEE NAME Warren Avery For Riverside City council Ward 3 2019 STREET ADDRESS (NO PO BOX) CITY STATE ZIPCODE AREACODE/PHONE Riverside CA MAILING ADDRESS (IF DIFFERENT) CITY STATE ZIP CODE Date of Election if applicable 11/05/2019 (Month, Day, Year) OCT 2 4 2019 i, i 4 RM -119 2. Type of Statement Pre-election Statement Semi -Annual Statement Termination Statement Amendment Treasurer(s) NAME OF TREASURER Susan Leivas-Struner STREET ADDRESS COVER PAGE Page 1 of 1-1 For Official Use Only E] Quarterly Statement F"� Special Odd -Year Statement E] Supplemental Pre-election Statement - Attach Form 495 CITY STATE ZIPCODE AREACODE/PHONE Riverside CA NAME OF ASSISTANT TREASURER, IF ANY STREET ADDRESS CITY OPTIONAL: FAX / E-MAIL ADDRESS OPTIONAL: FAX/ E-MAIL ADDRESS STATE ZIPCODE AREACODE/PHONE 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein is true and complete. I certify under penalty of perjury under the laws of the State of California that the fore oin istrue axid correct. Executed on (0 -2-LI By U SISTAN'T TREASURER 41-1 Executed on By RE SIGNATO MEASURE PROPONENT OR RESPONSIBLE OFFICER OF SPONSOR Executed on SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT Executed on By SIG NATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONErVpC Fonn 4650 -(JAN/2016) State of Cai