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Statement of 'Organization Date Stamp !ifl <br />" � .,Recipient Coirnmittee RECEIVB - 1 <br />Statement T e <br />Type ®Initial ©Amendment ❑Termination •-See Part 5 For Official Use Only <br />O Not yet. qualified SEP 2 5 2018 <br />or 06 28 20118 <br />0 Date qualified cs committee •-•/ %---/----�:f• Is�� Fg Riverside <br />� f l <br />Date (JUalified as committee Date of termination <br />(,-i�y avi k,S tI iC: <br />:L. Committee Information I.D. Number 14o6osz 72.V'reasurer a.nd Other Principal �:►ffice 's <br />(if applicable) <br />NAME OF COMMITTEE• -- NAME OF TREASURER <br />Shawnda Deane <br />Erin Edwards for City Council Ward 1 2019 <br />STREET ADDRESS (NO P.O. BOX) �•� _- CITY <br />S a:; rament o <br />CITY STATE ZIPCi OD � � AREA CODE/PHONE NAMF OF ASSISTANT TF -71 <br />Sacramento CA Erin Edwards <br />MAILING ADDRESS(IF I:11FFERENT) ter- rte— - STRE cT ADDRESS (NO P.O. <br />E-MAIL ADDRESS (REQUIRED) / FAx (OPTIONAL) <br />COUNTY OF DOMICILE JUE SDICTION WHERE COMMITTEE 15 ACTIVE <br />Sacramento County City of RiversiG.e <br />Attach additional information on appropriately labeled continuation sheets. <br />have used all reasonable diligen(e in pn <br />penalty of perjury under t ie h((Ja(�Jws of the : <br />Executed on --� / .LL— By <br />Cl GTE <br />Executed on _ (�_, -9—v— By <br />DATE <br />Executed on w E By _ <br />DATSIGNATURE OI' <br />Executed on By <br />GATE �;I(iNATI1RP OF <br />Riverside <br />LAME OF PRINCIPAL OF <br />ADDRESS (NO P.O. <br />5 -'ATE ZIP CODE AREA <br />CA <br />CA <br />CITY STATE ZIP CODE AREA CODE/PHOT <br />knowledge the information contained herein is true and complete. I certify under <br />nd correct. <br />ON <br />FPFIC Form 410 (February/2018) <br />FPPC Advice: advice C° (865/27'5-3772) <br />www* <br />