HomeMy WebLinkAboutNorth Tucson Fire Fighters - Statement of Organization - 10/19/2006 u
;r STATE OF ARIZONA
ii\ ,r.14 POLITICAL COMMITTEE
rSTATEMENT OF ORGANIZATION
' 1 JI Titles 16&19,Arizona Revised Statutes
Definitions,statutory references and important information on reverse.
• Initial Registration • •Out of State Committee KAmended Statement ID#
• 'Registration as Standing Political Committee Ov'PC 9R ooR
NAME OF POLITICAL COMMITTEE DATE
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ADDRESS(NUMBER&STREET) CITY STATE ZIP
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MAILING ADDRESS(if different from above) CITY STATE ZI P
COMMITTEE TELEPHONE# COMMITTEE FAX# COMMITTEE E-MAIL ADDRESS
DOES THE POLITICAL COMMITTEE HAVE A SPONSORING ORGANIZATION? YES NO
If yes,please provide the following information:
NAME OF SPONSORING ORGANIZATION TYPE OF ORGANIZATION
ADDRESS OF SPONSORING ORGANIZATION RELATIONSHIP TO POLITICAL COMMITTEE
TYPE OF POLITICAL COMMITTEE-Please check only one box:
• •STANDING POLITICAL COMMITTEE($250 annual fee required)
• • CANDIDATE'S CAMPAIGN COMMITTEE (A.R.S.§16-902.01)By selecting the above classification,the
• • EXPLORATORY COMMITTEE committee declares that it has been active in more than one reporting
jurisdiction in this state for more than one year AND is one of the
• • COMMITTEE ORGANIZED IN SUPPORT OF OR OPPOSITION TO ONE following:
OR MORE CANDIDATES (please check ONE of the four boxes below)
• • COMMITTEE IN SUPPORT OF OR OPPOSITION TO THE • •SEPARATE SEGREGATED FUND ESTABLISHED BY A
QUALIFICATION,PASSAGE OR DEFEAT OF A BALLOT ISSUE CORPORATION OR LABOR ORGANIZATION
• • COMMITTEE ORGANIZED TO CIRCULATE OR OPPOSE A RECALL • •COMMITTEE ORGANIZED FOR THE PURPOSE OF MAKING
PETITION OR TO INFLUENCE THE RESULT OF A RECALL ELECTION INDEPENDENT EXPENDITURES
• • OTHER COMMITTEE(please describe below) • •POLITICAL ORGANIZATION(an organization that is formally affiliated
with and recognized by a political party including a district committee
that is organized pursuant to A.R.S.§16-823)
• •POLITICAL PARTY[only state or county committees of an organization
Petition serial number Supports • • Opposes • • that meets the requirements for recognition as a political party. (A.R.S.
§16-801,16-804,16-821 and 16-825)]
EACH POLITICAL COMMITTEE SHALL HAVE A CHAIRMAN AND TREASURER. THE POSITION OF CHAIRMAN AND TREASURER OF A SINGLE
POLITICAL COMMITTEE MAY NOT BE HELD BY THE SAME INDIVIDUAL,EXCEPT THAT A CANDIDATE MAY BE CHAIRMAN AND TREASURER OF HIS
OR HER OWN CAMPAIGN COMMITTEE. A.R.S.§16-902(A).
NAME OF COMMITTEE CHAIRMAN CHAIRMAN'S TELEPHONE# CHAIRMAN'S FAX#
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CHAIRMAN'S ADDRESS CITY STATE ZIP
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CHAIRMAN'S OCCUPATION
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NAAE OF COMMITTEE TREASURER TREASURER'S TELEPHONE# TREASURER'S FAX#
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TREASURER'S ADDRESS CITY STATE ZIP
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TREASURER'S OCCUPATIOA TR SURER'S EMPLOYER
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*If committee is formed on ballot proposition,indicate petition serial number a whether the committee supports or opposes the proposition.
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BEFORE A POLITICAL COMMITTEE ACCEPTS A CONTRIBUTION OR MAKES AN EXPENDITURE IT SHALL DESIGNATE AT LEAST ONE ACCOUNT AT A
QUALIFIED FINANCIAL INSTITUTION,A.R.S.§16-902(C). LIST THE NAMES OF ALL FINANCIAL INSTITUTIONS WITH WHICH THE COMMITTEE
MAINTAINS ACCOUNTS OR SAFETY DEPOSIT BOXES. (Do not list account numbers.)
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FOR AN EXPLORATORY COMMITTEE OR A CANDIDATE'S CAMPAIGN COMMITTEE,PROVIDE THE FOLLOWING INFORMATION:
(Party Affiliation and Office Sought are optional for Exploratory Committees.)
NAME OF DESIGNATING INDIVIDUAL("di")OR CANDIDATE
PARTY AFFILIATION OFFICE SOUGHT COUNTY OF RESIDENCE
DI'S OR CANDIDATE'S ADDRESS CITY STATE ZIP
DESIGNATING INDIVIDUAL OR CANDIDATE'S STATEMENT:I authorize the above-named political committee as my political committee to receive contributions and
make expenditures on my behalf.
Date: DI's or Candidate's signature:
CHAIRMAN'S AND TREASURER'S STATEMENT:We,the undersigned,have examined the information contained in this statement of organization and,to the best of
our knowledge and belief,it is true,correct and complete.
Date: I Q 19-Q 6 Chairman's signature: �i\KVVLOl.,1
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Date: /0*""1/-2.0CZ Treasurer's signature: -
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STANDING POLITICAL COMMITTEE'S STATEMENT(if applicable)(A.R.S.§16-902.1):I/we hereby declare the status of this political committee as a standing political
committee.
Date: Chairman's signature:
Date: Treasurer's signature:
State of Arizona )
)ss.
County of )
SUBSCRIBED AND SWORN TO before me this day of .
My Commission Expires:
Notary Public
DEFINITION OF POLITICAL COMMITTEE:A.R.S.§16-901(19)
"Political committee"means a candidate or any association or combination of persons that is organized,conducted or combined for the purpose of influencing the result
of any election or to determine whether an individual will become a candidate for election in this state or in any county,city,town,district or precinct in this state,that
engages in political activity in behalf of or against a candidate for election or retention or in support of or opposition to an initiative,referendum or recall or any other
measure or proposition and that applies for a serial number and circulates pet tions and,in the case of a candidate for public office except those exempt pursuant to section
16-903,that receives contributions or makes expenditures in connection therewith,notwithstanding that the association or combination of persons may be a part of a larger
association,combination of persons or sponsoring organization not primarily organized,conducted or combined for the purpose of influencing the result of any election
in this state or in any county,city,town or precinct in this state. Examples of types of political committees are listed on the front of this form.
NOTE FOR INDIVIDUALS INVOLVED IN POLITICAL ACTIVITIES:
An individual,acting alone,is not a political committee under Arizona law and need not file a statement of organization. If any additional person or persons join the effort
(as defined above in A.R.S.§16-901(19))begun by an individual,the association of persons has become a"political committee"under Arizona law,and must file a
statement of organization before accepting contributions,making expenditures,distributing literature or circulating petitions. A.R.S.§16-902.01(A).
NOTE FOR THOSE INVOLVED IN INITIATIVE,REFERENDUM AND RECALL EFFORTS:
Before circulating initiative,referendum or recall petitions,a political committee must file its statement of organization with the appropriate filing office.Signature obtained
on petitions prior to the filing of the statement of organization are void and shall not be counted in determining the legal sufficiency of the petition. A.R.S.§§19-114(B)
and 19-202(C). Even though an individual,acting alone,may begin the initiative,referendum or recall effort,as soon as other persons join the effort,the association of
persons must register as a political committee.