HomeMy WebLinkAboutMarx, Jan 410 08-13-2020Statement of Organization
Date Stamp
,
Recipient Committee
i•
RECEIVE®
- 4
Statement Type Initial ❑ Amendment
❑ Termination — See Part 5
For Offlclal Use Only
AUG 13 2020
Not yet qualified
or
Date qualification threshold met Date qualification threshold met
t
Date of termination l
�, • CITY CLERK
Committee1.
2. Treasurer and
Other PrincipalOfficers
i an licablel
NAME OF COMMITTEE
Jan Marx for City Council 2020
NAME OF TREASURER
Gregory Ty Griffin
�
STREET ADDRESS (NO P.O. BOX)
2075 Hutton
San Luis Obispo
CA
93401 805-543-2679
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF ASSISTANT TREASURER, IF ANY
San Luis Obispo CA 93405
Jan Marx
FULL MAILING ADDRESS (IF DIFFERENT)
STREET ADDRESS (NO P.O. BOX)
same
E-MAIL ADDRESS (REQUIRED)/FAX (OPTIONAL)
CITY
STATE
ZIP CODE
COUNTY OF DOMICILE
JURISDICTION WHERE COMMITTEE IS ACTIVE
NAME OF PRINCIPAL OFFICER(S)
San Luis Obispo
City of San Luis Obispo CA
Jan Marx
Attach additional information on appropriately labeled continuation sheets.
CITY
STATE
ZIP CODE AREA LODE/PHONE
San Luis Obispo
CA
93405
3. Verification
1 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
Executed on
DATE
Executed on
DATE
By
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (August/2018)
FPPC Advice: advlce fuPc-ca.gov (866/275-3772)
www.fppc.ca.Jtov
Statement of Organization CALIFORNIA,
Recipient Committee • -
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME I.D. NUMBER
Jan Marx for City Council 2020
All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
Founders Community Bank 805-547-2535f-""-
863 Marsh Street San Luis Obispo CA 93401
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." Stating "No party preference" is acceptable
• 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 YEAR OF PARTY
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE
Jan Marx
San Luis Obispo City Council
2020
Nonpartisan
Partisan
(list political party below)
n/a
Nonpartisan
Partisan
(list political party below)
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
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE
n/a
SUPPORT I
OPPOSE
n/a
SUPPORT
OPPOSE
FPPC Form 410 (August/2018)
FPPC Advice: adylce(�fnpt.ca.av (866/275-3772)
WMWOD gua
Statement of Organization
Recipient Committee
INSTRUCTIONS ON REVERSE
COMMITTEE NAME
Jan Marx for City Council 2020
Page 3
I.D. NUMBER
• 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
n/a
Sponsored Committee List additional sponsors on an attachment.
TRY GROUP OR AFFILIATION OF SPONSOR
n/a NAME OF SPONSOR INBUS
STREET ADDRESS NO. AND STREET CITY STATE ZIP CODE AREA COWIPNONE
n/a
5. Termination Requirements By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or ponent certify that all of the following conditions have been inet:
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 (August/2018)
FPPC Advice: ayic iPOc.ta.P,ov 1866/275-3772)
www.fnnc-ca.gav