HomeMy WebLinkAboutJan Marx - Form 410 - Termination - 12-21-2010Statement of Organization STATEMENT OF ORGANIZATION
Type or print in Ink Date stamp
Recipient Committee . - • Ms
Statement Type ❑ Initial
Not yet qualified ❑ or
❑ Amendment
List I.D. number:
® Termination - See Part 5
List I.D. number:
#.1327506
REGtIV��
DEC 21. 2010
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Date qualified as committee Date qualified as committee Date of Termination
(I( applicable)
1. Committee Information 2. Treasurer and Other Principal Officers
NAME OF COMMITTEE NAME OF TREASURER
Elect Jan Marx Mayor 2010
STREETADDRESS(NO P.O. BOX)
CITY STATE ZIP CODE AREA CODEIPHONE
San Luis Obispo
MAILING ADDRESS (IF
CA 93405
OPTIONAL: FAX /E -MAIL ADDRESS
TY WHERE COMMITTEI
COUNTY OF DOMICILE
San Luis Obispo
Attach additional information on appropriately labeled continuation sheets.
Gregory Ty Griffin
STREETADDRESS(NO P.O. BOX)
CITY
STATE
ZIP CODE
AREACODE /PHONE
San Luis Obispo
CA
93401
NAME OF ASSISTANT TREASURER, IFANY
Jan Howell Manx
STREETADDRESS(NO P.O. BOX)
CITY
STATE
ZIP CODE
AREACODE /PHONE
San Luis Obispo
CA
93405
NAME OF PRINCIPAL OFFICER(S)
Jan Howell Marx (candidate)
STREETADDRESS(NO P.O. BOX)
CITY
STATE
ZIP CODE
AREACODE/PHONE
San Luis Obispo
CA
93405
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
perjury under the laws of the State of California that the foregoing is true and correct.
Executed on �2. _�/ 70 1 D By
ASSISTANT TREASURER
Executed on 1 - t ., 10 t
By
Executed on g
DATE y 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(Juneli
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