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Recipient Committee Date Stamp COVER PAGE <br />Campaign Statement1 �' ' • 1 <br />CoverPage <br />SEE INSTRUCTIONS ON REVERSE <br />Statement covers period <br />from 711/2023 <br />12131/2023 <br />through <br />Date of election if applicable: <br />(Month, Day, Year) <br />JAN 2 5 H?4 <br />Cid of Riverside <br />City Clerk's Office <br />Page I of 1 :5. <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 />[Vi Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑ Preelection Statement ❑ Quarterly Statement <br />0 State Candidate Election Committee Committee ® Semi-annual Statement ❑ Special Odd -Year Report <br />0 Recall 0 Controlled <br />{ornpfetaPaK5] ❑ Terminationination Statement <br />PJsoc <br />0 Sponsored (Also file a Form 410 Termination) <br />(Also Camplefa Part B) <br />ElGeneral Purpose Committee ❑ Amendment (Explain below) <br />0 Sponsored ❑ Primarily Formed Candidate/ <br />0 Small Contributor Committee Officeholder Committee <br />0 Political Party/Central Committee (AfsoCoWfatePwt7J <br />3. Committee Information <br />LD. NUMBER <br />1407581 <br />Re-elect Gaby Plascencia Riverside City Council Ward 5 - 2024 <br />STREETADDRESS (NQ P.Q. BOX) <br />CITY STATE ZIP CODE AREACODEJPHONE <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 1 E-MAILADDRESS <br />4. Verification <br />Treasurer(s) <br />NAME OF TREASURER <br />Martha Trujillo <br />MAILING ADDRESS <br />CITY STATE ZIP CODE AREACODEIPHONE <br />Riverside 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 />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. <br />certify under penalty of perjury under the laws of the State of California that the foregoing is true an <br />Executed ors `_ By <br />C Date urer <br />Executed on "r S <br />Date nt or Responsible Officer of Sponsor <br />Executed on <br />Date <br />Executed on <br />Date <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 (Ian/20261 <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />