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Cover Page <br />SEE INSTRUCTIONS ON REVERSE <br />Statement covers period <br />from 4/21/2019 <br />through �� -Li d� / 9F <br />Date of election if applicable: <br />(Month, Day, Year) <br />06/04/2019 <br />Date Stamp <br />JAN* 3 0 2020 <br />COVER PAGE <br />Page i of � <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 />W Officeholder, Candidate Controlled Committee El Primarily Formed Ballot Measure F-1 Preelection Statement El Quarterly Statement <br />0 State Candidate Election Committee Committee F-1 Semi-annual Statement El Special Odd -Year Report <br />0 Recall 0 Controlled 0 Termination Statement <br />(Also Complete Part 5) 0 Sponsored (Also file �a Form 410 Termination) <br />E-1 General Purpose Committee (Aiso complete Pad 6) W Amendment (Explain below) <br />0 Sponsored Primarily Formed Candidate/ To add Schedule B part 1 <br />0 Small Contributor Committee Officeholder Committee <br />0 Political Party/Central Committee (Also 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 />STREETADDRESS (NO P.O. BOX) <br />CITY STATE ZIP CODE AREACODE/PHONE <br />Riverside CA � <br />CITY STATE ZIP CODE AREACODE/PHONE <br />Treasurer(s) <br />NAME OF TREASURER <br />Martha Trujillo <br />MAILING ADDRESS <br />M <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />Riverside CA <br />NAME OF ASSISTANT TREASURER, IF ANY <br />MAILINGADDRESS <br />CITY STATE ZIP CODE AREACODE/PHONE <br />OPTIONAL: FAX I E-MAIL ADDRESS OPTIONAL: FAX/ E-MAIL ADDRESS <br />4. Verification <br />I have used all reasonable I 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 pjrjury un er the laws of the State of California that the foregoing is true and correct. <br />Executed on 7'?q?_j By <br />Date r <br />ZI J <br />Executed on 04L_e�3� By <br />Date RPi;non.qlhlP. Offiner of Srinn— <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 (8661275-3772) <br />www.fppc.ca.gov <br />