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UNITED STATES SECURITIES
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OMB APPROVAL
OMB Number: 3235-0076
Expires: June 30, 2012
Estimated Average burden hours per response: 4.0
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Notice of Exempt Offering of Securities
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| 1. Issuer's Identity | ||
| CIK (Filer ID Number) | Previous Name(s) o None | Entity Type |
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0000896076
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MICHELIN COMPAGNIE GENERALE DES ETABLISSEMENTS MICHELIN /FI
MICHELIN COMPAGNIE GENERALE DES ETABLISSEMENTS MICHELIN /FI
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o
Corporation
o
Limited Partnership
x
Limited Liability Company
o
General Partnership
o
Business Trust
o
Other
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| Name of Issuer | ||
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MICHELIN COMPAGNIE GENERALE DES ETABLISSEMENTS MICHELIN /FI
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| Jurisdiction of Incorporation/Organization | ||
| FRANCE | ||
| Year of Incorporation/Organization | |||
| x | Over Five Years Ago | ||
| o | Within Last Five Years (Specify Year) | ||
| o | Yet to Be Formed | ||
| 2. Principal Place of Business and Contact Information | ||||
| Name of Issuer | ||||
| MICHELIN COMPAGNIE GENERALE DES ETABLISSEMENTS MICHELIN /FI | ||||
| Street Address 1 | Street Address 2 | ||
| 12, COURS SABLON |
| City | State/Province/Country | ZIP/Postal Code | Phone No. of Issuer |
| CLERMONT-FERRAND | FRANCE | 63000 | 330473985900 |
| 3. Related Persons |
| Last Name | First Name | Middle Name |
| Rollier | Michel |
| Street Address 1 | Street Address 2 |
| 16A COURS SABLON |
| City | State/Province/Country | ZIP/Postal Code |
| Clermont-Ferrand | FRANCE | 63000 |
| Relationship: | x | Executive Officer | x | Director | o | Promoter |
| Clarification of Response (if Necessary) | |
| Managing General Partner | |
| Last Name | First Name | Middle Name |
| Senard | Jean-Dominique |
| Street Address 1 | Street Address 2 |
| 41 AVENUE DES COTTAGES |
| City | State/Province/Country | ZIP/Postal Code |
| Clermont-Ferrand | FRANCE | 63000 |
| Relationship: | o | Executive Officer | x | Director | o | Promoter |
| Clarification of Response (if Necessary) | |
| Non-General Managing Partner | |
| Last Name | First Name | Middle Name |
| Miraton | Didier |
| Street Address 1 | Street Address 2 |
| 4 RUE DU TERRAIL |
| City | State/Province/Country | ZIP/Postal Code |
| Clermont-Ferrand | FRANCE | 63000 |
| Relationship: | o | Executive Officer | x | Director | o | Promoter |
| Clarification of Response (if Necessary) | |
| Non-General Managing Partner | |
| Last Name | First Name | Middle Name |
| Quillet | Jean-Noel |
| Street Address 1 | Street Address 2 |
| 12, cours Sablon |
| City | State/Province/Country | ZIP/Postal Code |
| Clermont-Ferrand | FRANCE | 63000 |
| Relationship: | x | Executive Officer | o | Director | o | Promoter |
| Clarification of Response (if Necessary) | |
| Last Name | First Name | Middle Name |
| Dalibard | Barbara |
| Street Address 1 | Street Address 2 |
| 15 RUE PIERRE NICOLE |
| City | State/Province/Country | ZIP/Postal Code |
| Paris 05 | FRANCE | 75005 |
| Relationship: | o | Executive Officer | x | Director | o | Promoter |
| Clarification of Response (if Necessary) | |
| Last Name | First Name | Middle Name |
| Potier | Benoit |
| Street Address 1 | Street Address 2 |
| 6 RUE PUVIS DE CHAVANNE |
| City | State/Province/Country | ZIP/Postal Code |
| Paris | FRANCE | 75017 |
| Relationship: | o | Executive Officer | x | Director | o | Promoter |
| Clarification of Response (if Necessary) | |
| Last Name | First Name | Middle Name |
| Cox | Patrick |
| Street Address 1 | Street Address 2 |
| 17 ASHBORO SHANANKIEL |
| City | State/Province/Country | ZIP/Postal Code |
| Cork | IRELAND | Co Cork |
| Relationship: | o | Executive Officer | x | Director | o | Promoter |
| Clarification of Response (if Necessary) | |
| Last Name | First Name | Middle Name |
| Parisot | Laurence |
| Street Address 1 | Street Address 2 |
| 34 AVENUE JACQUES PARISOT |
| City | State/Province/Country | ZIP/Postal Code |
| ST LOUP SUR SEMOUSE | FRANCE | 70800 |
| Relationship: | o | Executive Officer | x | Director | o | Promoter |
| Clarification of Response (if Necessary) | |
| Last Name | First Name | Middle Name |
| Gallois | Louis |
| Street Address 1 | Street Address 2 |
| 179 AVENUE MARGUERITE RENAUDIN |
| City | State/Province/Country | ZIP/Postal Code |
| Clamart | FRANCE | 92140 |
| Relationship: | o | Executive Officer | x | Director | o | Promoter |
| Clarification of Response (if Necessary) | |
| Last Name | First Name | Middle Name |
| SOCIETE AUXILIAIRE DE GESTION | SAGES |
| Street Address 1 | Street Address 2 |
| 126 RUE ARMAND FALLIERES |
| City | State/Province/Country | ZIP/Postal Code |
| Clermont-Ferrand | FRANCE | 63100 |
| Relationship: | x | Executive Officer | x | Director | o | Promoter |
| Clarification of Response (if Necessary) | |
| General Partner | |
| Last Name | First Name | Middle Name |
| BOURDAIS FAUVELET DE CHARBONNIERE DE BOURRIENNE | Erica |
| Street Address 1 | Street Address 2 |
| 19 QUAI AUX FLEURS |
| City | State/Province/Country | ZIP/Postal Code |
| Paris | FRANCE | 75004 |
| Relationship: | o | Executive Officer | x | Director | o | Promoter |
| Clarification of Response (if Necessary) | |
| Last Name | First Name | Middle Name |
| Grappotte | Francois |
| Street Address 1 | Street Address 2 |
| 45 RUE SCHEFFER |
| City | State/Province/Country | ZIP/Postal Code |
| Paris 16 | FRANCE | 75116 |
| Relationship: | o | Executive Officer | x | Director | o | Promoter |
| Clarification of Response (if Necessary) | |
| Last Name | First Name | Middle Name |
| Michelin | Pierre |
| Street Address 1 | Street Address 2 |
| 55 AVENUE DE LA SABLIERE |
| City | State/Province/Country | ZIP/Postal Code |
| COURBEVOIE | FRANCE | 92400 |
| Relationship: | o | Executive Officer | x | Director | o | Promoter |
| Clarification of Response (if Necessary) | |
| Last Name | First Name | Middle Name |
| Henry | Marc |
| Street Address 1 | Street Address 2 |
| 12, cours Sablon |
| City | State/Province/Country | ZIP/Postal Code |
| Clermont-Ferrand | FRANCE | 63000 |
| Relationship: | x | Executive Officer | o | Director | o | Promoter |
| Clarification of Response (if Necessary) | |
| 4. Industry Group |
| o | Agriculture | Health Care | o | Retailing | ||||
| Banking & Financial Services | o | Biotechnology | o | Restaurants | ||||
| o | Commercial Banking | o | Health Insurance | Technology | ||||
| o | Insurance | o | Hospitals & Physicians | o | Computers | |||
| o | Investing | o | Pharmaceuticals | o | Telecommunications | |||
| o | Investment Banking | o | Other Health Care | o | Other Technology | |||
| o |
Pooled Investment Fund
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Travel | ||||||
| o | Other Banking & Financial Services | x | Manufacturing | o | Airlines & Airports | |||
| Real Estate | o | Lodging & Conventions | ||||||
| o | Commercial | o | Tourism & Travel Services | |||||
| o | Construction | o | Other Travel | |||||
| o | REITS & Finance | o | Other | |||||
| o | Residential | |||||||
| o | Other Real Estate | |||||||
| o | Business Services | |||||||
| Energy | ||||||||
| o | Coal Mining | |||||||
| o | Electric Utilities | |||||||
| o | Energy Conservation | |||||||
| o | Environmental Services | |||||||
| o | Oil & Gas | |||||||
| o | Other Energy | |||||||
| 5. Issuer Size |
| Revenue Range | Aggregate Net Asset Value Range | ||
| o | No Revenues | o | No Aggregate Net Asset Value |
| o | $1 - $1,000,000 | o | $1 - $5,000,000 |
| o | $1,000,001 - $5,000,000 | o | $5,000,001 - $25,000,000 |
| o | $5,000,001 - $25,000,000 | o | $25,000,001 - $50,000,000 |
| o | $25,000,001 - $100,000,000 | o | $50,000,001 - $100,000,000 |
| x | Over $100,000,000 | o | Over $100,000,000 |
| o | Decline to Disclose | o | Decline to Disclose |
| o | Not Applicable | o | Not Applicable |
| 6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply) |
| o | Rule 504(b)(1) (not (i), (ii) or (iii)) | o | Rule 505 | |||
| o | Rule 504 (b)(1)(i) | x | Rule 506 | |||
| o | Rule 504 (b)(1)(ii) | o | Securities Act Section 4(6) | |||
| o | Rule 504 (b)(1)(iii) | o | Investment Company Act Section 3(c) | |||
| 7. Type of Filing |
| x | New Notice | Date of First Sale | 2010-10-25 | o | First Sale Yet to Occur |
| o | Amendment |
| 8. Duration of Offering |
| Does the Issuer intend this offering to last more than one year? | o | Yes | x | No |
| 9. Type(s) of Securities Offered (select all that apply) |
| o | Pooled Investment Fund Interests | x | Equity |
| o | Tenant-in-Common Securities | o | Debt |
| o | Mineral Property Securities | o | Option, Warrant or Other Right to Acquire Another Security |
| o | Security to be Acquired Upon Exercise of Option, Warrant or Other Right to Acquire Security | o | Other (describe) |
| 10. Business Combination Transaction |
| Is this offering being made in connection with a business combination transaction, such as a merger, acquisition or exchange offer? | o | Yes | x | No |
| Clarification of Response (if Necessary) | ||||
| 11. Minimum Investment |
| Minimum investment accepted from any outside investor | $ 1000 USD |
| 12. Sales Compensation |
| Recipient | Recipient CRD Number | o | None | ||
| (Associated) Broker or Dealer | o | None | (Associated) Broker or Dealer CRD Number | o | None |
| Street Address 1 | Street Address 2 | ||||
| City | State/Province/Country | ZIP/Postal Code |
| State(s) of Solicitation | o | All States |
| 13. Offering and Sales Amounts |
| Total Offering Amount | $ 1702394608 USD | o Indefinite |
| Total Amount Sold | $ 1702394608 USD | |
| Total Remaining to be Sold | $ 0 USD | o Indefinite |
| Clarification of Response (if Necessary) |
| $ amount based on the 1.3929 exchange rate published by Federal Reserve Bank of New York for Oct 22, the most recent Federal Reserve exchange rate available on Oct 25. *One accredited investor in South Carolina, all others foreign (number indeterminable). |
| 14. Investors |
| o |
Select if securities in the offering have been or may be sold to persons who do not qualify as accredited investors,
Number of such non-accredited investors who already have invested in the offering |
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| Regardless of whether securities in the offering have been or may be sold to persons who do not qualify as accredited investors, enter the total number of investors who already have invested in the offering: | 1 |
| 15. Sales Commissions & Finders' Fees Expenses |
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Provide separately the amounts of sales commissions and finders' fees expenses, if any. If the amount of an expenditure is not known, provide an estimate and check the box next to the amount.
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| Sales Commissions | $ 0 USD | o | Estimate |
| Finders' Fees | $ 0 USD | o | Estimate |
| Clarification of Response (if Necessary) |
| 16. Use of Proceeds |
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Provide the amount of the gross proceeds of the offering that has been or is proposed to be used for payments to any of the persons required to be named as executive officers, directors or promoters in response to Item 3 above. If the amount is unknown, provide an estimate and check the box next to the amount.
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| $ 0 USD | o | Estimate |
| Clarification of Response (if Necessary) |
| Signature and Submission |
| Please verify the information you have entered and review the Terms of Submission below before signing and clicking SUBMIT below to file this notice. |
| Terms of Submission |
| In submitting this notice, each Issuer named above is: | ||
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| Each Issuer identified above has read this notice, knows the contents to be true, and has duly caused this notice to be signed on its behalf by the undersigned duly authorized person. | |
| For signature, type in the signer's name or other letters or characters adopted or authorized as the signer's signature. | |
| Issuer | Signature | Name of Signer | Title | Date |
| MICHELIN COMPAGNIE GENERALE DES ETABLISSEMENTS MICHELIN /FI | Marc Henry | Marc Henry | Chief Financial Officer | 2010-10-25 |