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HomeMy WebLinkAboutRIVERA 410 AMEND 2/19/16Statement of Organization Recipient Committee Statement Type ❑ Initial Not yet qualified ❑ or Date qualified as committee 1. Committee Information NAME OF COMMITTEE Rivera for City Council 3014 STREET ADDRESS (NO PO. BOX) 0 Amendment Listl.D.number: r ]354555 OS / 16 r 2013 Date qualified as committee (n aP —U.) 0 Termination -See List I . number: # 1354555 Attach additional information on appropriately labeled continuation sheets. 2016 DateofTermination RE$EIVED AND FILED in the office of the Secretary of State FEB 22 2016 "MAR 23 AM E: ti3ihL1`F �jI I,f 2. Treasurer and Other Principal Officers NAME OF TREASURER Shawnda Deane STREET ADDRESS (NO P.O. BOX) NAME OF ASSISTANT TREASURER, IF ANY Willie Rivera STREET ADDRESS (NO PO. BOX) NAME OF PRINCIPAL OFFICERS) P.O. BOX) CRY STATE ZIPCODE AREACODE /PHONE 3. Verification I have used all reasonable diligence in preparing this statement. tot a best of my knowledge the information contained herein is true and complete. Icenifyunder penalty of perjury under(the laws of the State of California Mat a dreg. g - e antl cor Executed on -1l- V11 By Otp1iE ``-- IG RE OF A NNT Execuledon By DATE SIGNWURE OF WNTROLLING OFFICEHOL CANDIDR60R SIAEMEPSV0.E PROPoNEM Executed on B/ DATE SIGNRVNE OF CONT0.0LLING OFFICEHOLDER, CPNnIDRE OR STATE MFASVRE PROPONENT rEExecuted on B,' DATE F l GJ x FFSU PoNEn FPPC Form 410 (dan=16) www.netfife.com FPPC Advice: advice@tppc.ca.gov (6661275 -3772) www.foac.ea.nov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE for City Council 2014 • All committees must list the financial institution wherethe Campaign bank account is located. 1st Bank Page 2 of 3 1354555 ADDRESS CITY STATE ZIP CODE 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 CANOIDREI OFFICEHOLDER /STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IFAPPUCABLE) YEAR OF ELECTION PARTY Primarily formed to support or oppose specific Candidates or measures in a single election. Listbelow: CANDIDATE($) NAME OR MEASURE(S) FULLTITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK Irwww.netlle.com FPPC Form 410 (Jan12016) FPPC Advice: advice @fppc.ca.gov (8661275 -3772) /. www.fppc.ca.goV City Council, Ward 1: City of Bakersfield 0 Nonpartisan Willie Rivera ❑ Nonpartisan Primarily formed to support or oppose specific Candidates or measures in a single election. Listbelow: CANDIDATE($) NAME OR MEASURE(S) FULLTITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK Irwww.netlle.com FPPC Form 410 (Jan12016) FPPC Advice: advice @fppc.ca.gov (8661275 -3772) /. www.fppc.ca.goV Statement of Organization Recipient Committee ' INSTRUCTIONS ON REVERSE Page 3 of 3 Rivera for City Council 2014 1354555 4. Type of Committee (Continued) Notformedtosuppodoroppose specific candidates or measures in a single election. Check only one box. CITY Committee ❑ COUNTYCommittee ❑ STATECommittee PROVIDE BRIEF DESCRIPTION OF ACTIVITY NAME OF SPONSOR List additional sponsors on an attachment. ❑ ��- Datequahlied 5.Termination Requirements By signing the verification, the treasurer, assistant treasurer and /orrandidate, oficehokler, or proponent certify that all ofthe following conditions have been 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 (Jan/2016) frwww.nel// /e.com FPPC Advice: advice@fppc.ca.gov (866/275-3772) 1 www.fppc.ca.gov W r D a c ,r.1, OW W � O os U m O w cn rs N m T M 0 A G M A Z L7 2 1 https: //w . fedm. com /shipping/htmllen/PrintlF=e.h=i a M N T M r O a w 2� A y toe o"a yyCy 9 r ts After printing this label: 1. Use the'Print' button on this page W print your label In your laser or inkjet printer. 2. Fold the printed page along the horizontal line. 3. Place label in shipping pouch and affix It to your shipment so that the barcode portion of the label can be read and scanned. i �m � m Warning: Use only the printed original label for shipping. Using a photocopy of this label for shipping purposes is fraudulent and could result in additional billing charges, along with the cancellation of your FedEx account number. Use of this system constitutes your agreement to the service condidons in the current FedEx Service Guide, available on fedex.com.FedEx will not be responsible for any claim in excess of $100 per package, whether the result of loss, damage, delay. norWelivery,madelivery,or misinformation, unless you declare a higher value, pay an additional charge, document your actual loss and file a timely dalm.Umitations found in the comerit FedEx Service Guide apply. Your right to recover from FedEx for any loss, including Intrinsic value of the package, loss of sales, income interest, profit, attorney's fees, costs, and other forms of damage whether direct, incli ental,consequentlal, or special is limited to the greater of $100 or the authorized declared value. Recovery cannot exceed actual documented Ioss.Maximum for items of extraordinary value is $1,000, e.g. jewelry, precious metals, negotiable instruments and other hems listed in our ServiceGuide. Wriften claims must be filed within strict time limits, see current FedEx Service Guide. 1 of 2 2/19/2016 3:14 PM