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Cover Page <br />SEE INSTRUCTIONS ON REVERSE <br />Statement covers period <br />from 7/1/2019 <br />through 9/21/2019 <br />Date of election if applicable: <br />(Month, Day, Year) <br />1115/2019 <br />Date Stamp <br />COVER PAGE <br />I of Z..' <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 />Officeholder, Candidate Controlled Committee E71 Primarily Formed Ballot Measure El Preelection Statement 171 Quarterly Statement <br />0 State Candidate Election Committee Committee M Semi-annual Statement El Special Odd -Year Report <br />0 Recall 0 Controlled 0 Termination Statement <br />(Also Complete Pad 5) 0 Sponsored (Also file a Form 410 Termination) <br />El General Purpose Committee (Ma Complete Part 6) W Amendment (Explain below) <br />0 Sponsored El Primarily Formed Candidate/ To Add Schedule B Part I <br />0 Small Contributor Committee Officeholder Committee <br />0 Political Party/Central Committee (Rso Complete Part 7) <br />3. Committee Information I.D. NUMBER <br />1 1407581 <br />COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) <br />Gaby Plascencia Riverside City Council Ward 5, 2019 <br />STREET ADDRESS (NO RO. BOX) <br />Riverside CA � <br />MAILING ADDRESS (IF DIFFERENT) NO.. AND STREET OR P.O. BOX <br />CITY STATE ZIP CODE AREA CODEIPHONE <br />OPTIONAL: FAX/ E-MAIL ADDRESS <br />Treasurer(s) <br />NAME OF TREASURER <br />Martha Trujillo <br />MAILINGADDRESS <br />CITY <br />STATE ZIP CODE AREACODEIPHONE <br />Riverside <br />CA � <br />NAME OF ASSISTANT TREASURER, IF ANY <br />MAILING ADDRESS <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />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 information contained herein and in the attached schedules is true and complete. I <br />certify under penalty of ' under the laws of the State of California that the foregoing is true and <br />p"'ury <br />/71' 1,��) By <br />Executed on - i, —.1 6 <br />I / -Date sistant Treasurer <br />Executed on h By <br />Date Sionaturn- nf coot <br />Executed on <br />Date <br />Executed on <br />Date <br />By Signature of Controlling Officeholder, Candidate, Marc Measure Proponent <br />By Signature of Controiling Officeholder, Candidate, State Measure Proponent <br />FPPC Form 460 (Jan/2016) <br />FPPC Advice: advicePfppc.ca.gov (866/275-3772) <br />www.fppc.ca.gov <br />