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COVER PAGE <br /> Recipient Committee Date Stamp <br /> Campaign Statement CALIFORNIA 460 <br /> FORM <br /> Cover Page /� <br /> (Government Code Sections 84200-84216.5) F I V E <br /> Statement covers period Date of election if applicable: <br /> (Month, Day,Year) Page 1 of 7 <br /> from 09/23/2018 OCT 25 2018 For Official Use Only <br /> City or t.llnO Hills <br /> SEE INSTRUCTIONS ON REVERSE through 10/20/2018 11/06/2018City Clerk's Oepartrne It <br /> 1. Type of Recipient Committee: All Committees—Complete Parts 1,2,3,and 4. 2. Type of Statement: <br /> ❑x Officeholder.Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ❑x Preelection Statement ❑ Quarterly Statement <br /> 0 State Candidate Election Committee Committee ❑ Semi-annual Statement 0 Special Odd-Year Report <br /> 0 Recall 0 Controlled ❑ Termination Statement ❑ Supplemental Preelection <br /> (Also Complete Part 5) 0 Sponsored (Also file a Form 410 Termination) Statement-Attach Form 495 <br /> (AoComptete Part 6) ❑ Amendment(Explain below)❑ General Purpose Committee <br /> 0 Sponsored ❑ Primarily Formed Candidate/ <br /> 0 Small Contributor Committee Officeholder Committee <br /> Pan <br /> 0 Political Party/Central Committee (Also COrls'fBfB7) <br /> 3. Committee Information I I.D. NUMBER Treasurer(s) <br /> 1408345 <br /> COMMITTEE NAME(OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER <br /> Gabriel DeLuna for Chino Hills City Council 2018 Yolanda Miranda <br /> MAILING ADDRESS <br /> STREET ADDRESS(NO P.O.BOX) <br /> NAME OF ASSISTANT TREASURER. IF ANY <br /> MAILING ADDRESS(IF DIFFERENT)NO.AND STREET OR P.O.BOX MAILING ADDRESS <br /> CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE <br /> OPTIONAL: FAX/E-MAIL ADDRESS OPTIONAL: FAX/E-MAIL ADDRESS <br /> 4. Verification <br /> I have used all reasonable diligence in preparing and reviewing this statement and to the b true and complete. I certify <br /> under penalty of perjury under the laws of the State of California that the foregoing is true a <br /> Executed on 10/24/2018 By <br /> Gale <br /> Executed on 10/24/2018 By <br /> Dale <br /> Executed on `. <br /> Date Signature of Contrding Officeholder.Conciliate.State Meagre Proponent <br /> Executed on '. <br /> Dale $gnatureoiControa gM+ficenolder.Canditlate,StateMeasreProponent FPPC Form 460(Jan/2016) <br /> FPPC Advice:advice@fppc.ca.gov(866/275-3772) <br /> www.fppc.ca.gov <br /> www.neifile.corn <br />