HomeMy WebLinkAboutJan Marx - Mayor - Form 410 - Amendment - 03-25-14Statement of Organization
Recipient Committee +�
Statement Type ❑ Initial Amendment El Termination —See Part 5
Not yet qualified ❑ or I List I.D. number: List I.D. number:
Date qualified as committee Date qualified as committee Date of Termination
(If applicable)
1. Committee Informatic
NNAAfa }MEEE OF COMMITTEE
STREET ADDRESS (NO P.0 -BOX)
� -5- /41�✓
CITY
MAILING ADDRESS (IF DIFFERENT)
4.,i Q� - —
STREET ADDRESS IIVO P.O BOX)
. ► a4S^ ,rgl6 g-74-
IURiSDICTION WHERE COMMITTEE IS ACTIVE CITY STATE ZIP CODE ARRREEA�- ,OElPHONE
7f
NAME OF PRINCIPAL OFFICER(S)
Attach additional information on appropriately labeled Continuation Sheets. STREET ADDRESS (NO P.O. BOX)
CIIY STATE ZIP CODE AREA CODE /PHONE
•c
3. venncation
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 the la�jw� s of the State California th the egoing is true and correct.
Executed on t I By
�y DATE d� SIGNATURE Of TREASURER OR ASSISTANT TREASURER
Executed on -� a h i By
DATE
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE. OR STAI E MEASURE PROPONENT
Executed on By � {
DATE SIGNATURE OF CONTROI LING 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 I D. NUMBER
Ilia ✓y 3 G Rio
• All committees must list the financial institution where the campaign bank account is located.
NAME. OF FINANCIAL INSTITUTION AREA CODE /PHONE BANK ACCOUNT NUMBER
-Fro✓✓u-Ars 60mML4'-W` Z 9ps _'' 3 - zI, 0 20 0
ADDRESS CITY STATE ZIP CODE
4. Type of Cohat(rittee Complete the app! t .31A- 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 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) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
T I OPPOSE
OPPOSE
FPPC Form 410(Dec/2012)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov
o,, � � � Lc,�►s o� ' Q
20 r
Nonpartisan
v l
❑ 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) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
(INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE)
CHECK ONE
T I OPPOSE
OPPOSE
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
COMMNTEE NAME -
4O _ I.U. NUMBER 3 �� V
4. Type
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
{Continued)
Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee
Sponsored I List additional sponsors on an attachment.
NAME OF SPONSOR INDUSTRY CROUP OR AFFILIATION OF SPONSOR
STREET ADDRESS NO AND STREET CITY STATE ZIP CODE
!_. ........ ..III�I/ /I ❑
Date qualified
5. Termination Requirements By sgningtne ver:�r anon, the treasurer, ass�s!an: Treasurer and /or sand date, of ike. o&der, or proponent cern-v T.nai a? of :he folio' 3�Ug co- i &rt5ns ha %-e been Rl
• 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
��i LTTTis___t I.D. number:
Not yet qualified ❑ or
136 *d3f
Date qualified as committee Date qualIfied as committee
IIr applsca blal
. Committee Information
NAME OF COMMITTEE
APR 0 0 2014
RED'
in the of
of
❑ Termination — See Part 5
List I.D. number:
Date of Termination
AV-
STREET ADDRESS (NO P.U. BOX)
CITY STATE ZIP CODE AREA CODE /PHONE
r
MAILING ADDRESS (IF DIFFERENT)
04 LID G
FAX /E -MAIL ADDRESS
/4Q 1-4 all Gym . Gay--%
COU h 'Y OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE
S� � Lt fIf ( � rpo
Attach additional information on appropriately labeled continuation sheets.
0
,IVED A "$t HLLU
je State o cast, fOr� tia State
MAR 2 8 2014
:BRA BOWEN
:reta>y of State
2. Treasurer and Other Principal Officers
NAME OF TREASURER
For Official Use Only
STAW ADD RES. 190 P.O. Bf f
—
CI Sri
;—Ty STATE ZIP CODE AREA CODE /PHONE
S��s Qb�f c-t r-ie-2-711-
NAME OF ASSISTANT TR EASI IRER, IF ANY (' 1 - � —0
0-7-1
an Ata a <
STREETADDRESS(NO P.0 BOX)
pFY STATE ZIP CODE AREA CODE /PHONE
NAME OF PRINCIPAL OFFICER(S)
STREET ADDRESS (NO P.O BOX)
CITY
STATE ZIP CODE AREA CODE /PHONE
r
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 penury under the laws of the State alifcrnia th the egging is true and correct.
Executed on
rDATE SIGNATURE OF TREASURER OR ASSISTANT TREASURER
Executed one By kL+
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR SIAI E MEASURE PROPONENT
Executed on
DATE
Executed on
DATE
By
By
SIGNATURE OF CONTROLLING OFFICEHOL DER, CANDIDATE, OR STATE. ME.ASLIRE PRCPONENT
SIGNATURE OF CONTROLLING OFFICE. HOL DER, 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 P91JP.d b'FR
• All committees must list the financial institution where the campaign bank account is located.
NAME. OF FINANCIAL INSTITUTION AREA CODE /PHONE BANK ACCOUN T NUMBER
✓✓10r�y S I.OM M LA-Ii, ga4l,12-
ADDRESS CITY STATE ZIP CODE
23 r]
4. Type of Coeft(i7ittee 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 PARTY
T
J
0V- L J O6
r
Nonpartisan
%
❑ Nonpartisan
I 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)
CHECK ONE
T OPPOSE
OPPOSE
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
COMMNTEE NAME -
4O _ I.U. NUMBER 3 �� V
4. Type
PROVIDE BRIEF DESCRIPTION OF ACTIVITY
{Continued)
Not formed to support or oppose specific candidates or measures in a single election. Check only one box:
❑ CITY Committee ❑ COUNTY Committee ❑ STATE Committee
Sponsored I List additional sponsors on an attachment.
NAME OF SPONSOR INDUSTRY CROUP OR AFFILIATION OF SPONSOR
STREET ADDRESS NO AND STREET CITY STATE ZIP CODE
!_. ........ ..III�I/ /I ❑
Date qualified
5. Termination Requirements By sgningtne ver:�r anon, the treasurer, ass�s!an: Treasurer and /or sand date, of ike. o&der, or proponent cern-v T.nai a? of :he folio' 3�Ug co- i &rt5ns ha %-e been Rl
• 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