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Home My WebLink AboutMarx - Form 410_2024-05-20_Amendment No. 1 (SOS Copy)_RedactedStatement of Organization Uses S'ama Recipient Committee RE CEIVED AND FILED Statement Type Oinitial ®Amendment ❑.Termination —See partaid eo8ice of the Secretary of Slate Q Not yetquatifietl of the State of California or MAY 0 6 2024 Q Data qualification threshold met Date qualification threshold met Date M terminatlOn 05( 03 2024 ..1 .R . � • E . u - .. I LD. Number 1469002 a E R e NBROOMMIM Jan Marx for City Council 2024 Gregory Ty CLitsn STREET ADDRESS (NO P.O. BOX) CITY - San Luis Obispo San Luis Obispo FULL MAILINGADDRESS (IF DIFFERENT) same E-MAILADDRESS OF COMMITTEE IREQI janmatx@stanfordalumni.org COUNTYOFDOMICILE San Luis Obispo STATE ZIP CODE AREA CODE/PHONE Jan Mart CA 93405 (805)541-2716 City of San Luis Obispo on appropriately labeled continuation sheets. For om<IN Use only CA' 93401 4REACODE/PHONE — San Luis Obispo CA 93405 EMAIL ADDRESS OF ASSISTANT TREASURER(REQUIRED) AREA CODE/PHONE janmarxestanfordahminaLorg (801 NAME OF PRINCIPAL OFFICER(S) Jan Marx STREET ADDRESS (NO P.O.BO) CITY STATE ZIP CODE - San Luis Obispo CA 93405 EMAIL ADDRESS OF PRINCIPAL OFFICER(S)(REQUIRED) AREACODF/PHONE janmarx@stanfordaltnmlf.org (805)541-2716 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 States eRranfnrnla rhar rho fnmenirla k true and Correct. Executed an 5 / r ✓ By MTf SIGNATURE UP TREASURER OR ASSISTANT TREASURER RECEIVED EXMUIId On �� DATE SIGNATUREA�NTROLUNG OFFICEHOLDER CLNDIDPTE, OR STATE MEASURE PROPONENT IYIFI MAY 6 n 62024 [,OSLO Executed an DATE �' CITY CLERK SIGNATURE OFCONTRO:LINGOFFICEHOLDER, CANIUDen,ORSTATE NUMSUREPROPONENT ExecNLed on BY DATE SIGNATURE OF CONTROLLING OFFICEHOLDER. CANDIDATE, OR STATE MEASURE PROPONENT FPPC Form 410 10CtObar/201' ... Statement of Organization • w Ifil, Recipient Committee • - INSTRUCTIONS ON REVERSE Page] COMMITTEE NAME I.NUMBER tan Mamx for City Coundi 2024 14690(12 All committees must list the financial institution where the Campaign bank account is located and the person(s) authorized to obtain bank records. NAME OFFINANCIAL INSTITUTION AND PERSON(S) AUTHORIZED TO OBTAIN BANK RECORDS AREA CODE/PHONE BAN Bank of the Sierra (805) 541-0400 ADDRESS OF FINANCIAL INSTITUTION 500 Marsh Street CITY STATE ZIP Cook 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 YOUR OF PARTY NAME OF CANDIDATE/OFFICEHOLDERISTATE M EA51) RE PROPON ENT INCLUDE DISTRI CT NUMBER IF APPLICABLE) ELECTION CHECK ONE ]an Marx San Luis Obispo City Coundl 2024 NonpaNsan PaTain - ft"IFOMl party beb ) NonpaI PaMI IIhA PoNGI parry below) iW�WlYikiiYYYYikii Primarily formed to support or oppose Specific candidates or measures In a single election. List below: CANDI CATTLE) NAME OR MEASURES)FULL TITLE (INCLUDE BALL$ NO, OR LETTER) CANDIDATITa OFnCE SOUGHT OR HELD OR MEASU REIS)IURI IF A RECALL. STATE -RECALL IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO.. CITY OR COUNTY. AS APPLICAB SUVPoIR I OPPOSE FPPC Form 41010ctober/202i Statement of Organization we* Recipient Committee INSTRUCTIONS ON REVFRSF • Page 3 COMMITTEE NAME I.D. NUMBER Jan Marx for City Council 2024 1469002 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 List additional sponsors cn an attachment. NAME OF SPONSOR STREET ADDRESS NO. AND 51 REET City INDUSTRY GROUP OR AFFILIATION OF SPONSOR SIATE ZIPCUUE AREA CODE/PHONE 5. Ti1flIna—floe Reglirements By signing the verification, the treasurer, assistant treasurer and/or candidate, officeholder, or ponent certify that all of the following conditions have been met: • 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 dispos;lion of surplus campaign funds held by elected officers who are leaving office and by defeated candidates. Refer to Government Code Section 89S19. — 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