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Home My WebLink AboutDaniel Rivoire - Form 410 - Termination - 01-21-15Statement of Organization Recipient Committee Statement Type ❑ Initial ❑ Amendment Not yet qualified ❑ or List I.U. number: # 1368559 Date qualified as committee Date qualified as committee (If applicable) 1. Committee Information NAME OF COMMITTEE FEB 0 9 2015 • -LE ® Termination —See Part 5 List I.D. number: #1368559 12 /31 /2014 Date of Termination Vote Rivoire for City Council 2014 STREET ADDRESS (NO P.O BOX) CITY STATE ZIP CODE AREA CODE /PHONE Date Stamp EC'EIVED AND FILE the office of the Secretary of St- of the State of California JAN 26 2015 Treasurer and Other Principe NAME OF TREASURER Michelle Shoresman STREET ADDRESS (NO RO BOX) CITY cers For Official USe Only STATE ZIP CODE AREA CODE /PHONE San Luis Obispo CA 93401 ( San Luis Obispo CA 93401 ( MAILING ADDRESS NF DIFFERENT) NAME OF A5515TANT TREASURER, IF ANY P.O. Box 814 FAX/ E -MAIL ADDRESS voterivoire@gmai1.com COUNTY OF DOMICII E JURISDICTION WHERE COMMITTEE IS ACTIVE San Luis Obispo San Luis Obispo Mary Ellen Gibson 51 BEE ADDRESS (NO P.O BOX) CITY STATE ZIP CODE AREA CODE /P11ONE San Luis Obispo CA 93401 ( NAME OF PRINCIPAL OFFICER(S) Dan Rivoire Attach additional information on appropriately labeled continuation sheets. S1 REF. TADDRESS (NO PO BOX) CITY STATE ZIP CO DE AREA CODE /PHONE San Luis Obispo CA 93401 ( 3. Verification - 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 he laws of the State of alifornia that the for going is true and correct. Executed on 1 By U IE i f SIGNATURE OF TREASURER OR ASSISTANT TREASURER Executed on � 2 • 3 �, • `�\ By DATE 51GNRTf)RE OF CONTROWNG OFFIC.EHOI.DER, CANDIDATE, OR STATE MEASURF PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE. MEASURE PROPONENT Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, 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 INSTRUCTIONS ON REVERSE Page 2 COMMITTEE NAME 1.0, NUMBER Vote Rivoire for City Council 2014 11368559 • All committees must list the financial institution where the campaign bank account is located. NAME Or FINANCIAL INSTITUTION Founders Community Bank ADDRESS AREA CODE /PHONE (805)543 -6500 CITY BANK ACCOUNT NUMBER 02003531 STATE ZIP CODE 237 Higuera Street San Luis Obispo CA 93401 4. Type of Committee Complete the applicable suctions. - • 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 /OFFICEHOLDER /STATE MEASURE PROPONENT ELECTIVE OFFICE SOUGHT OR HELD (INCLUDE DISTRICT NUMBER IF APPLICABLE) YEAR OF ELECTION PARTY Dan Rivoire City Council Member 2014 m Nonpartisan sL!PPQBT ❑ 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 LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) rur1W'Mr FPPC Form 410(Dec/2012) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov SUPPORT F-1 OPPOSE EI sL!PPQBT np ?6C. FPPC Form 410(Dec/2012) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 3 [[1MMTTYEE NAMF I.D. NUMBER Vote Rivoire for City Council 2014 1368559 4: Type of Committee (COI`11 11,tad) General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY List additional sponsors on an attachment. NAME OF SPONSOR STREET ADDRESS NO AND STREET CITY INDUSTRY GROUP OR AFFILIATION OF SPONSOR S1AlE ZIP CODE Dale qualified 5. Termination Requirements By signingthe verification, Ilse lrrasorer, assistant treasl,lrlu aald /ol cand1date, offst_elUNsier, (n rlrDptwerI[ cortifylilat all of ±llt2 iallovdvg coliditioils havF. beell 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 Code Section 18680 and FPPC Regulation 18521.5. FPPC Form 410(Dec/2012) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov Statement of Organization Recipient Committee Statement Type ❑ Initial ❑ Amendment Notyet qualified ❑ or List I.D. number: #1368559 Date qualified as committee Date qualified as committee (If applicable) . Committee Information NAME OF COMMITTEE Vote Rivoire for City Council 2014 Date 5tamp m Termination —See Part 5 List I.D. number: JHIV 9 n N q L y 1 2015 #1368559 12 /31 /2014 Date of Termination S IAEEI ADDRESS (NO PO BOX] 1266 Mill Street NAME OF TREASURER CITY STATE ZIP CODE AREA CODE] PIIONE San Luis Obispo CA 93401 (805)234 -3024 MAILING ADDRESS (IF DIFFERENT) P.O. Box 814 STREET ADDRESS (NO Po BOX) FAX /F. -MAII ADDRESS voterivoire @gmail.com 3242 Johnson Avenue COUNTY OF DOMICH F. IIIRISDICTION WHERE. COMMITTEE IS ACTIVE San Luis Obispo San Luis Obispo Attach additional information on appropriately labeled continuation sheets For Official Use Only 2. Treasurer and other Principal Officers NAME OF TREASURER Michelle Shoresman STREET ADDRESS (NO Po BOX) 3242 Johnson Avenue CITY STATE ZIP CODE AREA CODE /PIIONE San Luis Obispo CA 93401 (805)550 -2795 NAME OF ASSISIANT TRFASURFR, IF ANY Mary Ellen Gibson S rREE I ADDRESS (NO P.O W;':l 1251 Buchon Street CITY STATE ZIP CODE AREA CODE /PIIONE San Luis Obispo CA 93401 (805)554 -6624 NAME OF PRINCIPAL OFFICER(S) Dan Rivoire Si BEE ADDRESS (NO RD BOX) 1266 Mill Street CITY SIAI E ZIP CODE AREA COOL /PIIONE San Luis Obispo CA 93401 (805)234 -3024 3. Verification I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and con:piete. I certify under penalty of perjury under he laws of the State of California that the far going is true and correct. Executed on By D-V'n tv Q E SIGNATURE OF TREASURER OR ASSISTANT TREASURER Executed on (LA By DATE SIGNATURF OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURF PROPONFNT Executed on By DATE SIGNATURE OF CONTROLI ING OFFICF.HOI DER, CANDIDATE, OR STATE. MEASURE PROPONENT Executed on By DA1 E SIGNATURE OF CONIROLLING OFFICEHOLDER, 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 INSTRUCTIONS ON REVERSE COMMITTEE NAME Vote Rivoire for City Council 2014 • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITU IION Founders Community Bank AREA CODE /PHONE (805)543 -6500 CITY BANK ACCOUNT NUMBER 02003531 STATE ZIP CODE LD NUMBER 1368559 ADDRESS 237 Higuera Street San Luis Obispo CA 93401 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. ELECTIVE OFFICE SOUGHT OR HELD NAME OF CANDIDATE /OFFICEHOLDER /STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE:) YEAR OF ELECTION Dan Rivoire I City Council Member [2014 Primarily Formed Committee 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 LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) PARTY ® Nonpartisan ❑ Nonpartisan CHECK ONE SUPPORT OPPOSE sLllJ C`� FPPC Form 410(Dec /2012) FPPC Advice: advice @fppc.ca.gov (666/275 -3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE Page 3 COMMITTEE NAME I D NUMBER Vote Rivoire for City Council 2014 1368559 4. Type of Committee) General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box: ❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee PROVIDE BRIEF DESCRIPTION OF ACTIVITY List additional sponsors on an attachment. NAME OF SPONSOR STREET ADDRE55 NO ANUSIRi:E1 Dale qualified Cll Y GROUP OR AFFILIAI ION OF SPONSOR STAIE ZIP CODE S. Termination Requirements By Slgning the verification, the treasurer, assistant treasurer andlor candidate, tlfficehclldpr, or proonnerlt r_arVfy that all of thefollowing conditions rave beer, rnet: • 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 Code Section 18680 and FPPC Regulation 18521.5. FPPC Form 410(Dec/2012) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov