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Cover Page <br />SEE INSTRUCTIONS ON REVERSE <br />Statement covers period <br />from 10/20/2019 <br />through 12/31/2019 <br />Date of election if applicable: <br />(Month, Day, Year) <br />11/5/2019 <br />COVER PAGE <br />Date Stamp <br />'El'V Page of <br />'E <br />JAN 3 0 Z020 I For Official Use Only <br />1. Type of Recipient Committee: All Committees – Complete Parts 1, 2,3, and 4. 2. Type of Statement: <br />W Officeholder, Candidate Controlled Committee El Primarily Formed Ballot Measure F-1 Preelection Statement Quarterly Statement <br />0 State Candidate Election Committee Committee W Semi-annual Statement F-1 Special Odd -Year Report <br />0 Recall 0 Controlled Termination Statement <br />(Also Complete Part 5) 0 Sponsored (Also file a Form 410 Termination) <br />F-1 General Purpose Committee (Also Complete Pad 6) El Amendment (Explain below) <br />• Sponsored El Primarily Formed Candidate/ <br />• Small Contributor Committee Officeholder Committee <br />• Political Party/Central Committee fAlso Compkte Part 7) <br />3. Committee Information <br />1,13. NUMBER <br />1407581 <br />Gaby Plascencia Riverside City Council Ward 5, 2019 <br />STREET ADDRESS (NO P.O. BOX) <br />CITY STATE ZIP CODE AREACODE/PHONE <br />Riverside CA <br />MAILINGADDRESS (IF DIFFERENT) NO.. AND STREET OR RO. BOX <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />OPTIONAL: FAX/ E-MAILADDRESS <br />Treasurer(s) <br />NAME OF TREASURER <br />Martha Trujillo <br />MAILING ADDRESS <br />CITY STATE ZIP CODE <br />Riverside CA <br />NAME OF ASSISTANT TREASURER, IF ANY <br />MAUNGADDRESS <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />OPTIONAL: FAX/ E-MAIL ADDRESS <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, <br />certify under penalty of perjury uyder the laws of the State of California that the .............. ........... <br />Executed on — <br />11311 Date reasurer <br />Executed on — az";iz) <br />Date no re o an ro ME ce o er an a a a easure onent 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 />www.fppc.ca.gov <br />