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Recipient Committee Date Stamp COVER PAGE <br />Campaign Statement10%9"Ml <br />CoverPage = <br />(Government Code Sections 84200-84216.5) <br />D. NUMBER <br />3. Committee Information I I.D. <br />NAME (OR CANDIDATE'S NAME IF NO <br />Andy Melendrez for Mayor 2020 <br />STREET ADDRESS (NO P.O. BOX) <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />Riverside CA <br />MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX <br />N/A <br />CITY STATE ZIP CODE AREA CODE/PHONE <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 <br />under penalty of perjury under the laws of the State of California that the foregoing is true aW <br />Executed on <br />09/23/2020 By <br />Statement covers period <br />Date <br />Date of election if applicable: <br />09/23/2020 By <br />SEP 2 4 2OZO page 1 of 29 <br />Date <br />Executed on <br />BY <br />(Month, Day, Year) <br />Executed on <br />By <br />- <br />Date <br />from 07/01/2020 <br />City of Riversid, For Official Use Only <br />SEE INSTRUCTIONS ON REVERSE <br />through 09/19/2020 <br />11/03/2020 <br />City c$ '°s o <br />1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. <br />2, Type of Statement: <br />� Officeholder, Candidate Controlled Committee <br />❑ Primarily Formed Ballot Measure <br />0 Preelection Statement <br />❑ Quarterly Statement <br />0 State Candidate Election Committee <br />Committee <br />❑ Semi-annual Statement <br />M Special Odd -Year Report <br />0 Recall <br />0 Controlled <br />El Termination Statement <br />El Supplemental Preelection <br />(Also Complete Part S) <br />0 Sponsored <br />(Also file a Form 410 Termination) Statement - Attach Form 495 <br />❑ General Purpose Committee <br />(Also Complete Part 8J <br />E] Amendment (Explain below) <br />0 Sponsored <br />El Primarily Formed Candidate/ <br />0 Small Contributor Committee <br />Officeholder Committee <br />0 Political Party/Central Committee <br />(Also complete Part 7) <br />D. NUMBER <br />3. Committee Information I I.D. <br />NAME (OR CANDIDATE'S NAME IF NO <br />Andy Melendrez for Mayor 2020 <br />STREET ADDRESS (NO P.O. BOX) <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />Riverside CA <br />MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX <br />N/A <br />CITY STATE ZIP CODE AREA CODE/PHONE <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 <br />under penalty of perjury under the laws of the State of California that the foregoing is true aW <br />Executed on <br />09/23/2020 By <br />Date <br />Executed on <br />09/23/2020 By <br />Date <br />Executed on <br />BY <br />Date <br />Executed on <br />By <br />- <br />Date <br />Treasurer(s) <br />NAME OF TREASURER <br />Andy Melendrez <br />MAILING ADDRESS <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />Riverside CA <br />NAME OF ASSISTANT TREASURER, IF ANY <br />MAILING ADDRESS <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />herein and in the attached schedules is true and complete. I certify <br />FPPC Form 460 (Jan/2016) <br />FPPC Advice: advice@fppc.ca.gov (8661275-3772) <br />www.fppc.ca.gov <br />