HomeMy WebLinkAboutOro Valley First - Statement of Organization - 12/6/2022 � Initial A lication STATE OF ARIZONA COMMITTEE ID NUMBER
pP � (office use only)
� Amended Application -r:J��;�-: COMMITTEE STATEMENT ,. �
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OF ORGANIZATION
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COMMITTEE TYPE(choose one): - '� '' � �
� Candidate
i Committee Name(required):
(first or last name&office)
Candidate Information: Candidate's Name(required):
Candidate's mailing address(required):
Candidate's email address(required):
Candidate's phone number(required):
Candidate's website(if any):
Office Sought(choose one): � County Office: ODistrict (if applicable):
�City/Town Office: ODistrict(if applicable):
0 School Board Office: p District(if applicable):
0 Special District Board: 0 District(if applicable):
Election Cycle for Office Sought(year the election will take place)(required):
��. Affiliation: � Democrat �Green �Libertarian 0 Republican �Other: �
� Party ;
�� (required for partisan offices) '
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' � Political Action Committee(PAC)
Committee Name re uired : 0 ��5�
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(if sponsored,must include
sponsor's name)
Political Function(optional): ❑Contributions ❑Candidate-Related Independent Expenditures
(select any that apply) ❑Ballot Measure Expenditures 0 Recall Expenditures
Sponsorship Information: Sponsor's name or nickname(required):
(if applicable) Sponsor's mailing address(required):
Sponsor's email address(required):
Sponsor's phone number(if any):
Sponsor's website(if any):
Special Status ❑Separate Segregated Fund of a Corporation, LLC, Partnership,or Union '
,
(if applicable) ❑Standing Committee(must also complete separate standing committee registration) �
,
��� ❑Mega PAC(must provide proof of Mega PAC status to filing officer)(amended applications only) ;�
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;
,
� 0 Political Party
Committee Name(required): __
(must include party affiliation)
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Jurisdiction: 0 State Party(must include proof of qualification pursuant to A.R.S.§ 16-801 or§16-804)
0 County Party(must include proof of qualification pursuant to A.R.S.§16-802 or§ 16-804)
� Legislative District Party(must include proof of organization pursuant to A.R.S. §16-823) i
�City or Town Party(must include proof of qualification pursuant to A.R.S.§16-802 or§16-804) ;
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Specia/Status �Standing Committee(must also complete separate standing committee registration)
� (if applicable)
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Arizona Secretary of State Revision 7/29/2021
e1 Initial Application
r STATE OF ARIZONA COMMITTEE ID NUMBER
� Amended Application `��' COMMITTEE STATEMENT (office use on�y)
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�ate: i� / 6 �.� OF ORGANIZATION
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COMMITTEE INFORMATION: a"•�:�°"° "'a-'"' -�"���k
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, Contact Information. Committee s mailing address(requ ) �.., �
Committee's email address(required): �' _ �� - � ��l '� �
Committee's phone number(if any): _
Committee's website(if any):
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Chairperson's Information: Chairperson's name(required): K� �
Chair erson's h sical address re uired): V � � t�I�� v
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Chairperson's mailing address(if different):
Chair erson's email address(required): � �S����"��J C�-� f f
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Chairperson's phone number(required): �� �C'IA� S� �
Chair erson's employer(required): �� �
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Chairperson's occupation(required): ��//'�L--�
Treasurer's Information: Treasurer's name(required): �
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Treasurer's physical address(required): 5
Treasurer's mailing address(if different):
Treasurer's email address re uired : ���b���'"S S ��I ��b�l
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Treasurer's phone number(required): ��� ��� �"`���7
Treasurer's employer(required): � ! � _
Treasurer's occupation(requi d): �-��� �—.b
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' In i ution: Bank name re uired : =-�'��� s
Bank or Financial st t ( q )
\, (do not list acct numbers) Additional bank name(if applicable): �
��\ Additional bank name(if applicable): i
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DECLARATION AND SIGNATURES:
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I declare under penalty of perjury that the foregoing information is true and correct. I further declare that I: (1)consent to serve as
chairperson or treasurer of the committee named herein, if applicable; (2)designate the above-named committee as my official candidate
committee and authorize it to receive/make contributions/expenditures on my behalf, if applicable; (3)have read the Secretary of State's
campaign finance and reporting guide; (4)agree to comply with Arizona election law, including campaign finance laws codified at A.R.S.
§§ 16-901 to 16-938;and(5)agree to accept all notifications and legal service of process for campaign finance purposes via the email
address(es)provided herein.
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Chairperson s signature: Date.
� Date: f `
Treasurer s signature. ���
Candidate's signature(if applicable): Date:
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Arizona Secretary of State Revision 7/29/2021
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