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Home My WebLink AboutRIVERA 410 AMEND 7/11/13Statement of Organization Recipient Committee Statement Type ❑ Initial Not yet qualified ❑ or x❑ Amendment List I.D. number: # 1354555 01/16/2013 Date qualified as committee Date qualified as committee Date of Termination (If applicable) Date Stamp ❑ Termination - see Part 5 List I.D. number: NAME OF COMMITTEE Rivera for City Council 2014 Attach additional information on appropriately labeled continuation sheets. I have used all reasonable diligence in p ft penalty of perjury, under the laws of '. Executed on VUL By DATIE ` � Executed on -7 1/ - 13 By DATE Executed on DATE Executed on DATE ,- ag t Is statement off I to the of C ifornia that yFie foregoi NAME OF TREASURER Shawnda Deane For Official Use Only GM 12' 32 NAME OF ASSISTANT TREASURER, IF ANY Willie Rivera STREET ADDRESS (NO P.O. BOX) NAME OF PRINCIPAL OFFICER(S) STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE /PHONE t of my knowled i tru n orre SIGNATURE OF TREASU R SIGNATURE OF CONTROLLING on contained herein is true and complete. I certify un TREASURER CANDIDATE, OR STATE MEASURE PROPONENT By SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT By 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 COMMITTEE NAME I.D. NUMBER Rivera for City Council 2014 1354555 • All committees must list the financial institution where the campaign bank account is located. NAME OF FINANCIAL INSTITUTION AREA CODE /PHONE BANK ACCOUNT NUMBER Community 1st Bank ( • 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 PARTY 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) hNn H OFFICE SOUGHT OR HELD OR MEASURE(S) APP JURISDICTION IINCI t1DF DISTRICT NO.. CITY OR COUNTY. AS APPLICABLE) cFIFCK ONE SUPPORT Q Nonpartisan City of Bakersfield SUM OPPOSE Willie Rivera City Council, Ward 1 2014 ❑ Nonpartisan 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) hNn H OFFICE SOUGHT OR HELD OR MEASURE(S) APP JURISDICTION IINCI t1DF DISTRICT NO.. CITY OR COUNTY. AS APPLICABLE) cFIFCK ONE FPPC Form 410 (Dec /2012) FPPC Advice: advice@fppc.ca.gov (8661275 -3772) www.fppc.ca.gov SUPPORT OPPOSE SUM OPPOSE FPPC Form 410 (Dec /2012) FPPC Advice: advice@fppc.ca.gov (8661275 -3772) www.fppc.ca.gov Statement of Organization Recipient Committee INSTRUCTIONS ON REVERSE NAME Rivera for City Council 2014 General • • 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 Sponsored Committee List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE Page of 3 I.D. NUMBER 1354555 Small Contributor Committee ❑ Date qualified 9 si the verifi atlon the treaSU assista�tttreasurer and /or candidate pffTCehoidei,` or props went certify thatalt of the foilovnngcondipons have been met S.- Terminatlort *Igments ...... s� .ti �: ��.., ... ,..,, ,....,��. . .... < ,�,,. ,�. • 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 Page 1 of 2 Fran: ( Shownda Deane Deane & Company SHIP TO: (661) 3263761 City Clerks Office City of Bakersfield Origin ID: BL BAKERSFIELD, CA 93301 UA Fed]rm Exv,ess 10 J 1311130" 120326 BILL SENDER Ship Date: 16JUL13 ActWgt 1.0 LB CAD: 103146407ANET3370 Delivery imiiivamIIIIIImWiuuueeim Ref# Rivera 2014 13-006 Invoice # Dept # WED -17 JUL 3:OOP TRlca 7962 4578 9114 STANDARD OVERNIGHT 9201 93301 WM BFLA ONT 111 1111 After printing this label: 1 Use the 'Print' button on this page to print your label to your laser or inkjet printer. i 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. 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 conditions 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, non - delivery,misdelivery,or misinformation, unless you declare a higher value, pay an additional charge, document your actual loss and file a timely claim. Limitations found in the current 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, incidental,consequential, 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 items listed in our ServiceGuide. Written claims must be filed within strict time limits, see current FedEx Service Guide. https: / /www.fedex.com/ shipping /html /en/ /PrintIFrame.html 7/16/2013