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Recipient Committee <br />Campaign Statement <br />Cover Page <br />SEE INSTRUCTIONS ON REVERSE <br />Statement covers period <br />from 7/1/19 <br />through 12/31/19 <br />1. Type of Recipient Committee: All Committees - Complete Parts 1, 2,3, and 4. <br />R1 Officeholder, Candidate Controlled Committee El Primarily Formed Ballot Measure <br />0 State Candidate Election Committee Committee <br />0 Recall 0 Controlled <br />(Aiso complete Part 5) 0 Sponsored <br />(PJSO 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 (Ailso Complete Part 7) <br />3. Committee Information <br />1*19,01"KITEin; <br />,OMMrTTEE NAME (OR CANDIDATE'S NAME IF NO COMMn7EP <br />Philip Falcone for Riverside City Council Ward 1 2019 <br />CITY STATE ZIP CODE <br />Riverside CA <br />MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX <br />1402303 <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />COVER PAGE <br />Date Stamp <br />Date of election if applicable: PECEIVED Page 1 of 4 <br />(Month, Day, Year) JAN 2 7 20Z0 For Official Use Only <br />6/4/19 C4 of Riverside <br />2. Type of Statement: Q44 Clock's 121111C <br />F] Preelection Statement El Quarterly Statement <br />10 Semi-annual Statement El Special Odd -Year Report <br />50 Termination statement <br />(Also file a Form 410 Termination) <br />1:1 Amendment (Explain below) <br />Treasurer(s) <br />NAME OF TREASURER <br />Paula Leivas <br />MAILINGAIDDRESS <br />CITY STATE ZIP CODE <br />Riverside CA <br />NAME OF ASSISTANT TREASURER, IF ANY <br />Michaela Montgomery <br />MAILINGADDRESS <br />Riverside CA <br />OPTIONAL: FAX/ E-MAIL ADDRESS OPTIONAL: FAX/ E-MAIL ADDRESS <br />4. Verification <br />I have used all reasonable diligence in preparing and reviewing this statement <br />certify under penalty of perjury under the laws of the State of California that thE <br />Executed on — / C� o .2 C—) <br />Date <br />Executed on Gq C;10 <br />Date <br />Executed on <br />Date <br />Executed on <br />Date <br />By Signature of Controlling Officeholder, Candidate, State Measure Proponent <br />�s is true and complete. <br />FPPC Form 460 (Jan/2016) <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />www_fnnc_ca_L7nv <br />