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- Recipient Committee Date Stamp -i COVER PAGE <br />Campaign Statement �' ' • 1 <br />Cover Page <br />Statement covers period Date of election if applicable:ECENt <br />Page of <br />from <br />1/1/2020 (Month, Day, Year) For Official Use Only <br />FEB 0 12021 <br />SEE INSTRUCTIONS ON REVERSE through 6/30/2020 <br />!'ate of Riverside <br />1. Type of Recipient Committee: All Committees -Complete Parts 1, 2, 3, and 4. 2. Type of Statement: Q's dy Clerk's UMCe <br />Q Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement <br />El Quarterly Statement <br />O State Candidate Election Committee Committee ❑ Semi-annual Statement ❑ Special Odd -Year Report <br />O Recall O Controlled ❑ Termination Statement <br />(Also Complete Part 5) O Sponsored (Also file a Form 410 Termination) <br />(Also Complete Part 6) Amendment (Explain below) <br />❑ General Purpose Committee <br />O Sponsored El Primarily Formed Candidate) To correct pale 2 Column B to reflect Calendar Year to Date Totals <br />O Small Contributor Committee Officeholder Committee <br />O Political Party/Central Committee (Also Complete Part 7) <br />3. Committee Information I.D. NUMBER <br />1407581 <br />COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) <br />Gaby Plascencia Riverside City Council Ward 5 -2019 <br />4. <br />STREET ADDRESS (NO P.O. BOX) <br />CITY STATE ZIP CODE AREACODE/PHONE <br />Riverside CA - <br />MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX <br />CITY STATE ZIP CODE AREACODE/PHONE <br />OPTIONAL: FAX/ E-MAIL ADDRESS <br />Treasurer(s) <br />NAME OF TREASURER <br />Martha E. Trujillo <br />MAILING ADDRESS <br />CITY STATE ZIP CODE AREACODE/PHONE <br />Riverside CA - <br />NAME OF ASSISTANT TREASURER, IF ANY <br />MAILING ADDRESS <br />CITY STATE ZIP CODE AREA CODEIPHONE <br />OPTIONAL: FAX/E-MAIL ADDRESS <br />Verification <br />1 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 perjury under the laws of the State of California that the fore oin is true and correct. <br />Executed art I � "`�� � 0 -24By <br />T%� Date WMirEntliTreasurer <br />Executed on <br />Date <br />Executed on <br />Date <br />Executed on <br />Date <br />By Signature of Controlling Officeholder, Candidate, State Measure Proponent <br />By <br />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 />