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GEORGE, LAN - FORM 410 - AMENDMENT Statement of Organization RECEIVED CALIFORNIA A 1 o Recipient Committee FORM `f Statement Type -Wawa XAmendment 0 Termination—See Part 5 JU� 2i 1 2020 For Official Useonry or (rifillfied l. CITY CLERK'S OFFICE Q Date qualification threshold met Date quallflcatlon threshold met• Cate of termination CIN OF ARROYO GRANGE LI(Committee Information;' I.D.Number =»•2 Treasurer and Other Principal Officers* NAME OF COMMITTEE"•' - 1 NAME-OF TREASURER- ',. Elect Lan George City Council 2020 t' Tarp Conaway • t:. STREEIADDRESS(NO P.O.BOX) °I. 430 STREET ADDRESS(NO P.O.BOx) - - fiCITY STATE - ZIP CODE .AREA CODE/PHONE •i i Arroyo Grande. CA 93420 8055749912. )- Y. CITY STATE ZIP CODE AREA CODE/PHONE t'NAME OF ASSISTANT TREASURER,IF ANY Arroyo Grande CA 93420 4'. FULL MAILING ADDRESS(IF DIFFERENT) `STREET ADDRESS(NO P.O.BOX) i'i E•MAIL ADDRESS(REQUIRED)/FAX(OPTIONAL) CITY STATE ZIP CODE AREACODE/PHONE , ji� COUNTY OF DOMICILE JURISDICTION WHERE COMMITTEE IS ACTIVE l NAME OF PRINCIPAL.OFFICER(S) San Luis Obispo I City of Arroyo Grande j Lan George - - - r,STREET ADDRESS(NO P.O.BOX) I i 501 . 1•CIN STATE ZIP CODE AREA CODE/PHONE E P Attach additional Information on appropriately labeled continuation sheets. •lArroyo Grande CA 93420 8054596212 • f3 Verification .I'''' -r' • , .} , .� "` ';1.t J I ave used all reasonab e diligence in preparing this statement an•to the best of my knowledge the in ormation contained herein is true and complete. I certify under penalty of perjury under,the laws of the State of California that the foregoing istrueand correct. Executed on 1/I 1 A 20 By OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT 0' Executed on By DATE SIGNATURE OF CONTROLLING OFFICEHOLDER,CANDIDATE,OR STATE MEASURE PROPONENT 1 FPPC Form 410(August/2018) FPPC Advice:advice@fppc.ca.kov(866/275-3772) www.fpnc.ca.gov Statement of Organization CALIFORNIA 41 Recipient Committee FORM INSTRUCTIONS ON REVERSE Page 2 I,D.NUMBEfl COMMITTEE NAME Elect Lan George City Council 2020 • All committees must list the financial institution where the campaign bank account is located. AREA CODE/PHONE , BANK ACCOUNT NUMBER NAME OF FINANCIAL INSTITUTION i. Mechanics Bank 805-473-6875 3505134695 A ADDRESS CITY 4 STATE ZIP CODE Grande I.' 1026 East Grande Avenue Arroyo. .. . .. c, .. . CA 93420 . .`T a of.Committee`.Complete the applicable sections , _4 YP. Controlled Committee • List the name of each controlling officeholder,candidate,orstate 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 - - r, - - -Nonpartisan Partisan (list political party below) City Council k 2020 'Lan George Nonpartisan Partisan (list political party below) Primarily Formed eommiftee Primarily formed to support or oppose specific candidates or measures In a single election. List below: �CANDIDATE(S)OFFICE SOUGHT OR HELD OR MEASURE(S)JURISDICTION CHECK ONE CANDIDATE(S)NAME OR MEASURES) RONTITLE(IN OFFICEHOLDER'S BALLOT ORLETTER) (INCLUDE DISTRICT NO.,CITY OR COUNTY AS APPLICABLE) IFARECALL,STATE"RECALL"INF.AONTOFTHE NAME. t SUPPORT OPPOSE I 4 1 FSUPPORT OPPOSE t t tt 1 FPPC Form 410(August/2018) FPPC Advice:advice Pio pc.ca.gov(866/275.3772) www.fppc.ca.gov Statement of Organization CALIFORNIA A 1 O Recipient Committee FORM �F INSTRUCTIONS ON REVERSE Page 3 NUMBER COMMITTEE NAME Elect Lan George-City-Council 2020 COI1tIN000I):% i ': - .+•tr` � X d3,.:• a s•.., �, • e 4 Type of,Committee' i a,=c. i_,ft, - _ ` • ,.:. General Purpose Committee Not formed to support or oppose specific candidates or measures in a single election. Check only one box:COUNTY Committee 0 STATE Committee ❑ CITY Committee 0 aROVIDE BRIEF DESCRIPTION OF ACTIVITY Sponsored Committee List additional sponsors on an attachment. NAME OF SPONSOR INDUSTRY GROUP OR AFFILIATION OF SPONSOR STREET ADDRESS NO:AND STREET CITY STATE ZIP CODE AREA CODE/PHONE "'Small ContributorCOmmittee • 0 Date qualified • • •Ti?rr178t1O12eIe7ae �{ 4ry ta. •aloftewi 'condbns havc�ben rriet�1.0'8the rast. ted/ r t irig • 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:advicefafoec.ca.eov(865/275-3772) www.fppC.ca.Kov