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-Recipient Committee COVERPAGE <br />Campaign Statement Date Stamp _ <br />Cover Page ' <br />(Government Code Sections 84200-84216.5) <br />SEE INSTRUCTIONS ON REVERSE <br />Statement covers period <br />from 01/01/2021 <br />through 04/24/2021 <br />1. Type of Recipient Committee: All Committees— Complete Parts 1, 2, 3, and 4. <br />❑x Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure <br />Q State Candidate Election Committee Committee <br />Q Recall Q Controlled <br />(Also Complete Part 5) 0 Sponsored <br />(Also Complete Part 6) <br />❑ General Purpose Committee <br />0 Sponsored ❑ Primarily Formed Candidate/ <br />0 Small Contributor Committee Officeholder Committee <br />0 Political Party/Central Committee (Also Complete Part 7) <br />3. Committee InformationI I.D. NUMBER <br />1428458 <br />COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) <br />Monrow Mabon for Riverside City Council 2021 <br />STREET ADDRESS (NO P.O. BOX) <br />c/o <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />Covina CA _ <br />MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX <br />N/A <br />CITY <br />OPTIONAL: FAX / E-MAIL ADDRESS <br />STATE ZIP CODE AREA CODE/PHONE <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 underthe laws of the State of California that the foregoing is true and% <br />Executed on 04/27/2021 <br />Date <br />Executed on 04/27/2021 <br />Date <br />Executed on <br />Date <br />Executed on <br />Date <br />Date of election if applicable: <br />(Month, Day, Year) <br />06/08/2021 <br />>. i <br />City of Riverside <br />Ciel C°serWs Office <br />Page 1 of 277 <br />For Official Use Only <br />2. Type of Statement: <br />Q Preelection Statement ❑ Quarterly Statement <br />❑ Semi-annual Statement ❑ Special Odd -Year Report <br />❑ Termination Statement ❑ Supplemental Preelection <br />(Also file a Form 410 Termination) Statement -Attach Form 495 <br />❑ Amendment (Explain below) <br />Treasurer(s) <br />NAME OF TREASURER <br />Yolanda Miranda <br />MAILING ADDRESS <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />Covina CA <br />NAME OF ASSISTANT TREASURER, IF ANY <br />MAILING ADDRESS <br />CITY STATE ZIP CODE AREA CODE/PHONE <br />OPTIONAL: FAX / E-MAIL ADDRESS <br />n and in the attached schedules is true and complete. I certify <br />By <br />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 />