HomeMy WebLinkAboutMarx - Form 410_2024-04-08_RedactedStatement of Organization
Recipient Committee
Statement Type ® Initial ❑ Amendment
O Not yet qualified
or
0 Date qualification threshold met Date qualification threshold met
.. _ , .. I.D. Number
Jan Marx for City Council 2024
CITY
San Luis Obispo
FULL MAILING ADDRESS (IF DIFFERENT)
same
E-MAIL ADDRESS OF COMMITTEE (REQUIRED) / FAX (OPTI
janmarx@stanfordalumni.org
STATE ZIP CODE AREA CODE/PHONE
CA 93405 (805)541-2716
COUNTYOF DOMICILE JURISDICTION WHERE COMMITTEE IS
San Luis Obispo City of San Luis Obispo
Attach additional information on appropriately labeled continuation sheets.
❑ Termination — See Part 5
Date of termination
NAME OF TREASURER
Gregory Ty Griffith
STREET ADDRESS (NO P.O.
Date Stamp
APR A 8 2024
SW CITY CLERK
F MAIL ADDRESS OF TREASURER ( REQUIRED)
NAME OF ASSISTANT TREASURER, IF ANY
Jan Marx
For Official Use Only
CITY STATE ZIP COD
San Luis Obispo CA 93401
AREA CODE/PHONE
<r ' BOX) CITY STATE ZIP CODE
San Luis Obispo CA 93405
tMAILAUDRESS OF ASSISTANT TREASURER (REQUIRED) AREA CODE/PHONE
janmarx@stanfordalumni.org
NAMt UI- PRINCIPAL OFFICER(S)
Jan Marx
STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE
San Luis Obispo CA 93405
EMAIL ADDRESS OF PRINCIPALOFFICER(S) (REQUIRED) AREACODE/PHONE
janmarx@stanfordalumni.org
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 laws of the St nd correct.
Executed on .— By
DATE 51 NATURE OF TREASURER OR ASSISTANT TREASLRER
Executed on + Z� By
:0
DATE
Executed on gy
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT
FPPC Form 410 (October/202?
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Statement of Organization we
Recipient Committee
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME I.D. NUMBER
Jan Marx for City Council 2024
All committees must list the financial institution where the campaign bank account is located and the person(s) authorized to obtain bank records.
NAME OF FINANCIAL INSTITUTION AND PERSON(S) AUTHORIZEDTO OBTAIN BANK RECORDS AREA CODE/PHONE
Bank of the Sierra Jan Marx Gregory Ty Griffith 1 (805) 541-0400
ADDRESS OF FINANCIAL INSTITUTION CITY
500 Marsh Street San Luis Obispo
• 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.
BANK ACCOUNT
/NUMBER
/
J 4J 0
STATE ZIPCODE
CA 93401
• 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.
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT
ELECTIVE OFFICE SOUGHT OR HELD YEAR OF PARTY
(INCLUDE DISTRICT NUMBER If APPLICABLE) ELECTION rwcrrntic
Jan Marx
San Luis Obispo City Council
2024
Nonpartisan
Or
Partisan
(list political party below)
Nonpartisan
Partisan
(list political party below)
Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATES) NAME OR MEASURES) FULL TITLE (INCLUDE BALLOT NO, OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION
IF A RECALL, STATE "RECALL" IN FRONTOF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE
FPPC Form 410 (October/202:
Statement of Organization
Recipient Committee
INSTRUCTIONS ON RFVERSE
Page 3
COMMITTEE NAME
LD. NUMBER
Jan Marx for City Council 2024
General Purpose Committee 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
5pon5ured Committee List additional sponsors on an attachment.
NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR
STREETADDRESS NO. AND STREET OIIY STATE LIP CODE AREA CODE%PHONF
Date qualifie i
• 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 (October/202