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Recipient Committee <br />COVER PAGE <br />Campaign Statement <br />Date Stamp <br />Cover Page <br />R E (0 I 'VE <br />Statement covers period <br />Date of election If applicable: I <br />;`E <br />— of <br />1!! <br />from 1/1/19 <br />(Month, Day, Year) <br />DEC 0,9 2019 <br />For Official Use Only <br />SEE INSTRUCTIONS ON REVERSE <br />through 11/25/19 <br />6/4/2019 <br />City of kiverside <br />City aerk's Office <br />I Type of Recipient Committee: All Committees — Complete Parts 1, 2,3, and 4. <br />2. Type of Statement: <br />Officeholder, Candidate Controlled Committee <br />0 State Candidate Election Committee <br />1771 Primarily Formed Ballot Measure <br />1771 Preelection statement' <br />Quarterly Statement <br />0 Recall <br />Committee <br />0 Controlled <br />F-1 Semi-annual Statement Special Odd -Year Report <br />Termination Statement <br />(Atso Complete Part 5) <br />0 Sponsored <br />(Also file aForm 410 Termination) <br />El General Purpose Committee <br />0 Sponsored <br />(Also Complete Part 6) <br />O�Primarily Formed Candidate/ <br />El Amendment (Explain below) <br />0 Small Contributor Committee <br />Officeholder Committee <br />0 Political Party/Central Committee (Also Complete Part 7) <br />3. Committee Information I.D. NUMBER <br />1 1416175 <br />Rubio for Riverside City CounciINVard-3 <br />Election Year 2019 <br />Committee to Elect Richard #1416175 <br />I <br />CITY STATE ZIP CODE AREA OODE/PHONE <br />OPTIONAL: FAX/ E-MAIL ADDRESS <br />Treasurer(s) <br />NAME OF TREASURER <br />Joseph A. Deledonne <br />17—AILINGADDR9–SS <br />Riverside CA <br />NAME OF ASSISTANT TREASURER, IF ANY <br />MAILINGADDRESS <br />71TY STATE ZIP CODE AREA CODEIPHONE <br />OPTIONAL: FAX/ E-MAIL ADDRESS <br />4. Verification <br />I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the li;Iformation contained herein and in the attached schedules is true and complete, I <br />certify under penalty of pedury under the laws of the State of California that the foregoing ' & <br />Executed on 12/4/2019 <br />Date <br />Executed on 12/4/2019 <br />Date <br />Executed on <br />Date <br />Executed on <br />Date <br />By Signature of Controlling Officeholder, Candid � Mato Measure 7—oponent <br />By Signature of Controlling Officeholder. Candlolate I -,State Measure Proponent <br />FPPC Form 460 (Jan/2016) <br />FPPC Advice: advice@fppc.ca.gov (866/275-37,72) <br />www.fppc.ca.gov <br />