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HomeMy WebLinkAboutDaniel Rivoire - Form 410 - Initial - 07-18-14mm m m — Am a m 7 N n n n 0 � l.= m. S 1 N d� m a m m a �' d A z � a P Ri 0 2.3 3 v \ 2 m I 4 lT c' 3 m I 3 �• CD o 7 °I N A. K m m O0 Ln 3 0 O o Z 3 �^ m � CD � d _ Illinv,M C y d CO N CDCL y -M N .acn z N 3 c co CD d A W a b 3 2.3 3 v \ 2 m I lT c' 3 m I m m 2 o 7 °I N m m d A Ln �M L C gw r y -M .acn z N v A T CL c Q EJ T R Y N Z n 0 3 ^R1 a 3 G_ z m o s a y N m o a T 17'f n O f r m S � 01 N � � ti Q H TT 3 � n n N Q m R 9 Q A QC 9 a O 2 O z 3 3 3 m m . 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X fl if.:•' z m q; Statement of Organization Recipient Committee Statement Type (J Initial ❑ Amendment Nol yel qualdied ❑ or List I D number tt /tel /14 Date qualified as cornnnttee Date qualified as CornrrItWe (iI epPllceble) mmittee Info COI 'COMMIT I EC Vow �Lvot(ZE Ffoi; Crr`( CoL.-"ntc -tt_ 20ILLI ❑ Termination —See Parts List I D number Date of Terailnation STREET ADDRESS (NO PO BOX) 1106 AttA_ sTeEE1- CITY STATE LIP CODE AREA CODE /PHONE SA.J L✓ Ch giKol 8og.2iy.362`t MAILING ADDRESS 0F Oil CHEN II Po.6CD7< e) 111 FAX / E MAIL ADDRESS v ate Civo;LC2 Mat ;l -c-o vl, COON I Y OE OOM ICI I IQ I URISDIC I ION WH ERE CO M MI I I I:�I. IS ACT IVE' 'SAaT �+t5 `'SISPO Co. Gtrh of SAN LJtS ©B\SPa Attach additional information on appropriately labeled continuation sheets Date Stamp Foi Official Use Only LTD JUL 18 2014 2. Treasurer and Other Principal Officers j NAME OF IREASURCH 1AlL(- KELL>✓ SyA4,f- 6S-ALAr i STRErlAAODRFSS(NOPO BOX) CITY SIAIL LIPCODE ARLACUDL' /PHONL ok NAME OF ASSISTANT 1RFASURE: R, If ANY 110,1 Et-LEN GttaSo�J STRLEI AUDRESS(NOPO BOX) CI I SIAIE LIP CODI: AREA CODL / PHONE 5AAv LQtS (966?? CA 0134c) k � NAME: OF PRINCIPAL OFFICLR(S) VAN h %Vc)L JC STRLEIADDRESS(NOPO BOX) Ci FY SIAIE LIP CODE AREA CODL /PHONE Sa�N Lets OaLsl?o �d- Kos I have used all reasonable diligence In preparing this statement and to the best of my knowledge the Information contained herein Is true and complete I ce penalty of perjury ,under the laws of the State of alliforriti TE ^ SIGNAILIRE 01 HCASURCR OR ASS151AN r TREASURER if Executed on I;y UAiE SIGNATU HE OF CON 1110 11ING OFFICE - 10 Lot H, CAN DIDATE ORSTATCMEASURF PROPONENT Executed on By DAI E SIGNATURE OF CONTROLLING OFF ICLHOLDLR, CANDIDATF, OR STATE MLASURE PROPONEN T Executed on DATE By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR SIAIL MEASURE PROPONCN I FPPC Form 410 (Dec /2012) FPPC Advice. advice @fppc.ca gov (866/275 -3772) www.fppc.ca gov Statement of Organization CALIFORNIA ' Recipient Committee FORM INSTRUCTIONS ON REVERSE Page 2 COMMI I I EL NAME 111 NUMBER \iotE FAR 2,0 t %-k • All committees must list the financial Institution where the campaign bank account is located NAME OF 1'INANCIALINSIITUIION ARTA COUE /1'IIONL BANK ACCOUNT NUMBER F�NOEzS (.o+wAvutrt C�jAr.+K a °S .5�(3.650o noZ�� ) ADDRESS CITY STATE LIP CODE S63 �iRSN JTRfET SAN 1--J15 06f5Po C4 `13401 4 Type of Committee Complete the applicable sections • List the name of each controlling officeholder, candidate, or state measure proponent If candidate or officeholder controlled, also list the elective office sought or held, and district number, If any, and the year of the election • List the political party with which each officeholder or candidate Is affiliated or check "nonpartisan." • If this committee acts jointly with another controlled committee, list the name and Identification number of the other controlled committee NAME OF CANDIDATE /OFFICEIIOLDER /STATE MEASURE. PROPONEN I' ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY K ` AtQ �ILQaIKE C• 1 (� % Jt�N yvli DIS�b CiYC`/�,oUNC(� �7 l� .001�1 �NOnparhsan SLJ M ❑ Nonpartisan Primarily formed to support or oppose specific candidates or measures in a single election List below CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO OR LETTCR) CANDIDATES) OFFICE SOUGHT OR HELD OR MEASURES) JURISDICTION (INCLUDE. DISTRICT NO, CITY OR COUNTY, AS APPLICABI E) CHLCK ONE FPPC Form 410(Dec /2012) FPPC Advice. advice @fppc.ca.gov (866/275 -3772) www fppc ca gov ' SUPPORT 1:1 OPPOSE' El SLJ M OP Vt 1 S F, FPPC Form 410(Dec /2012) FPPC Advice. advice @fppc.ca.gov (866/275 -3772) www fppc ca gov Statement of Organization Recipient Committee INSTRUCrIONS ON REVERSE \Io'TE ► WOLKE FO?, (,%" (,o"NGtL 20N Tvpe of Committee ' (Continued)' PROVIDE BRIEF DESCRIP1 ION OP AC I IVI I Not formed to support or oppose specific candidates or measures in a single election Check only one box. ❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee List additional sponsors on an attachment Small ContrlbutorCommittee N CI IV RY GROUP OR AF I LIAI ION Or SPUNS014 SINE ZIP CODE Page 3 1 D NUMBER We qualified 5. Termination Requirements By signing the verificand'n, the treasurer, assistant treasurer and /or candidate, officeholder, or proponent certify that all of the following conditions have been met • This committee has ceased to receive contributions and make expenditures,. y • This committee does not anticipate receiving contributions or making expenditures in the future, • This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations, • This committee has no surplus funds, and • This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions. -- There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates Refer to Government Code Section 89519 -- Leftover funds of ballot measure committees maybe used for political, legislative or governmental purposes under Government Code Sections 89511 - 89518, and are subject to Elections Code Section 18680 and FPPC Regulation 185215 FPPC Form 410(Dec /2012) FPPC Advice advice @fppc.ca gov (866/275 -3772) www fppc ca.gov S tatement of Organization Recipient Committee Statement Type Ef lnitial ❑ Amendment Nolyelquahfed ❑ or List D number ❑ Termination — SeeParts R Ust I D number In 6/ t / Li Dale qualified as committee Date qualified as committee Date of Termination (IF applicable) VoTr_ llwo tge Fog C yy,( �oL;),.tc tt_ ' '2_0 IL LJ STREET ADDRESS (NO PO DUX) MtLRE�L_tr SKoK�s�ar.1 1266 A I S,re EEr CITY STATE ZIP CODE AREA CODE /PHONE 'DA.J L✓Is 0�t5 ?0 CAF R3Kol 5°13.234.31,2'1 MAILING ADDRESS (IF DIFFERENT) Po.6CIK ZIP CODE AREA CODE /PHONE FAX / E ADDRESS W05.5ro.2PAS 'MAIL vcTecrvo%ce. atot •�^'l COUNTY OF DOMI CUE / ')Ari 1� ie, ©RtSpo Co• JURISDICTION WHERE COMMITTEE I5 ACTIVE CtT11 of SAN —015. �8.5Pa Attach additional Jnformotion on appropriately labeled continuation sheets Date Stamp , EIVED AND FILED rifice of the Secretary of State of the State of C I- frnmla JUL 24 2014 nn l� For Official Use Only NAML OF TREASURER MtLRE�L_tr SKoK�s�ar.1 STREET ADORFSS(NOPO BOX) .942 Sa"x5oN TJ`��•N�Icr CITY STATE ZIP CODE AREA CODE /PHONE �N L•+ts C%tc>?c ' CA °131i 1 W05.5ro.2PAS NAME OF A55ISIAN1 7REASURER, IF ANY A4Ry Et_t EN Gl%6e,0 A STREET ADDRESS (NO PO BOX) 12.'21 &C-KON CITY STATE ZIP CODE AREACODE /PIIONE 5gN L%JtS C966 o CA 013LIok "5tiLc.&6zy NAME. OF PRINCIPAL OFFICER(S) LO VA,N [� Jot, r, STREET ADDRESS (NO PO BOX) D CITY SIAIE ZIP CODE AREA CODE/PIIONE SAN L -t5 013tsPo CA- 93-to1 s05.234.3o24 I have used all reasonable diligence In preparing this statement and to the best of my knowledge the Information contained herein Is true and complete I certify under penalty of perjury under the laws of the State of allfornl that th regoing Is true and correct Executed on ILI- By SIGNATURE Or TREASURER OR ASSISTANT TREASURER Executed on y By DATE SIGNATURE. OF CONTROLI ING OFFICEHOLDER, CANDIDATE., OR STATE MEASURF PROPONENT Executed on By DATE SIGNAI URE OF CON I ROLLING UFFICEHOLUk R, CANOIDAI E, OR STAl E ME, ASURC PROPONENI Executed on DATE By SIGNATURE OF CON I ROLLING OFnCLIIOLDER, CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410(Dec /2012) FPPC Advice advice @fppc ca gov (866/275 -3772) www fppc ca gov Statement of Organization Recipient Committee FORM 410. INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME I O NUMBER VarE 2-0 L kA • All committees must list the financial Institution where the campaign bank account Is located NAME OF FINANCIAL INSTITUTION AREA CODE /PHONE BANK ACCOUNT NUMBER FoimVeZs Co+nMUuX Vq(�K g�5.�jK3.(�joo V� � ADDRESS CITY 5 TAT E ZIP CO DE g�3 A4KSH STREET SAN L­',5. OF,(Spo 0 1 4"� 'r•- - �M 15..'. L'�,T� -Jy.T -C'9-T.1'.^. .^.'' ...n - V 'P%.•`. ''y.sU%vi �: r.. . T e pf�'Gommiitee•�,Com lete,the:a Ilcable sectTOns�° ;�' "� `"�_ ar %+ �� -:•�' r'�r~'-yp ;,� *J`+. yKS'�'r��z::�'•x?'yy>xr� �� -� YP _ �I•�;� Tk ::�� I v.�.:.s'.rntru. •::•n,nasxrs.m -,a.• •'uu..,.wsu� - -• :. n �Li. �. �;._.��k` xw _x,:B•.Li <�"I cw •.JM'�'^.SiI ,li, t.+' �w A l_ w„„>,.:�:t is ^'•il +,��+'�'Rai • List the name of each controlling officeholder, candidate, or state measure proponent If candidate or officeholder controlled, also list the elective office sought or held, and district number, if any, and the year of the election • List the political party with which each officeholder or candidate Is affiliated or check "nonpartisan " • If this committee acts jointly with another controlled committee, list the name and Identification number Of the other controlled committee NAME OF CANDIDATE /OFFICEIIOLDER /STATE MEASURE PROPONENT ELECTIVE OFFICE. SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE.) YEAR OF ELECTION PARTY `Day f�L�idIRE SAN �L��$15fb GK1 GoUNC(� 'J 2-01H IzET Nonpartisan IIVVVPPP SUVPOHT ggqIl ❑ Nonpartisan Primarily formed to support or oppose specific candidates or measures in a single election List below CANDIDATE(S) NAME OR MEASURES) FULL TITLE (INCLUDE BALLOT NO OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(5) JURISDICTION (INCLUDE DISTRICT NO, CITY OR COUNTY, AS APPLICABLE) FPPC Form 410(Dec/2012) FPPC Advice. advice @fppc ca gov (866/275 -3772) www fppc.ca gov 111[11 SUPPORT ❑OOO Vr, OPPOSE IIVVVPPP SUVPOHT ggqIl 00 FPPC Form 410(Dec/2012) FPPC Advice. advice @fppc ca gov (866/275 -3772) www fppc.ca gov Statement of Organization ORNIA ' Recipient Committee - INSTRUCT IONS ON REVERSE Page 3 COMMITTEE NAME I D NUMBER \10TE Not formed to support or oppose specific candidates or measures In a single election Check only one box ❑ CITY Committee' ❑ COUNTY Committee ❑ STATE Committee y PROVIDE BRIEF DESCRIP IION OF ACTIVITY List additional sponsors on an attachment NAME OF SPONSOR STREET ADDRESS NO AND STREET Date qualified CITY GROUP OR At FILIAI ION Or SPONSOR STAIE 21P CODE v'T' " -'"C- 3'.G' -L"' -' " b:tirti�' -i. - Si". =N:. M1 -: ' �Y'0='..aY:i =s_ 'Sf1:Y.ti9`ti':u,3 °hf•: ^ "U� "Z!!tA=117i.JSV�'Ti'� i "r','�^,ul -S�ti ;,tl':Sl:- ••�L.:+'+C�.'!'3Y mL:.. -(�"li t. •l 5 .'Termination;Regyirement5,:yg; By;slgmng•thevenficahon „t etreasrer, iassiistanttreasurerlanJ /orycandldate, officeholder, tor, propgney ri_ cemfythat, allofthe followingcondlnOnsihaveigen'met } • This committee has ceased to receive contributions and make expenditures, • This committee does not anticipate receiving contributions or making expenditures in the future, • This committee has eliminated or has no intention or ability to discharge all debts, loans received, and other obligations, • This committee has no surplus funds, and • This committee has filed all campaign statements required by the Political Reform Act disclosing all reportable transactions There are restrictions on the disposition of surplus campaign funds held by elected officers who are leaving office and by defeated candidates Refer to Government Code Section 89519 Leftover funds of ballot measure committees may be used for political, legislative or governmental purposes under Government Code Sections 89511 - 89518, and are subject to Elections Cade Section 18680 and FPPC Regulation 185215 FPPC Form 410(Dec /2012) FPPC Advice. advice @fppc ca gov (866/275 -3772) www.fppc ca gov