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HomeMy WebLinkAboutElizabeth Robb OV Town Council - Statement of Organization - 1/3/2024Rr Initial Application STATE OF ARIZONA COMMITTEE ID NUMBER 0 Amended Application h COMMITTEE STATEMENT (office use only) Date: OF ORGANIZATION cv rc av --c I COMMITTEE TYPE (choose one): E3 Candidate R.Pe, Committee Name (required): C., �-1�` (first or last name & office) Candidate Information: Candidate's Name (required): L► L� M �� +J G—TH t 4 C3 e, Candidate's mailing address (required): 1,, ,�t Y nS i�},C � 1 /1r` (__A_-L-L� "tom. 0 U,4LLC-,�, j-�-Z Candidate's email address (required):-R00j3364WcQ CS • CZ re--, Candidate's phone number (required): '- 2 Q - - 4/Z-7G Candidate's website (if any): Office Sought (choose one): © County Office: ®District (if applicable): ®City/Town Office: ILW ;v 0c_),..:fQCjL_ ®District (if applicable): E3 School Board Office: 0 District (if applicable): 0 Special District Board: E3District (if applicable): Election Cycle for Office Sought (year the election will take place) (required): 2,0 Z-14 Party Affiliation: © Democrat 0 Green 0 Libertarian E3 Republican ® Other: (required for partisan offices) 0 Political Action Committee (PAC) Committee Name (required): (if sponsored, must include sponsor's name) Political Function (optional) (select any that apply) Sponsorship Information: (if applicable) Special Status (if applicable) 13 Political Party Committee Name (required): (must include party affiliation) ❑ Contributions ❑ Candidate -Related Independent Expenditures ❑ Ballot Measure Expenditures ❑ Recall Expenditures Sponsor's name or nickname (required): Sponsor's mailing address (required): _ Sponsor's email address (required): _ Sponsor's phone number (if any): Sponsor's website (if any): ❑ Separate Segregated Fund of a Corporation, LLC, Partnership, or Union ❑ Standing Committee (must also complete separate standing committee registration) ❑ Mega PAC (must provide proof of Mega PAC status to filing officer) (amended applications only) Jurisdiction: ® State Party (must include proof of qualification pursuant to A.R.S, § 16-801 or § 16-804) E3 County Party (must include proof of qualification pursuant to A.R.S. § 16-802 or § 16-804) E3 Legislative District Party (must include proof of organization pursuant to A.R.S. § 16-823) E3 City or Town Party (must include proof of qualification pursuant to A.R.S. § 16-802 or § 16-804) Special Status 0 Standing Committee (must also complete separate standing committee registration) (if applicable) Arizona Secretary of State Revision 7/29/2021 Ir initial Application STATE OF ARIZONA COMMITTEE ID NUMBER ® Amended Application COMMITTEE STATEMENT (office use only) Date: OF ORGANIZATION COMMITTEE INFORMATION: Contact Information: Committee's mailing address (required): Ito 1 d OALI_L a 1f 1 S T -N, Committee's email address (required): F 01sn ivi t- Committee's phone number (if any): Committee's website (if any): Chairperson's Information: Chairperson's name (required): E l- l Z-44-f&_7W * 1?-N © 9 ; Chairperson's physical address (required): 92-101 IV CALF Chairperson's mailing address (if different): Chairperson's email address (required): &i.1f+tic'7hcA+gA��! wntC=004-a «m Chairperson's phone number (required): S Z O - 8-T-0 - 412 -� O Chairperson's employer (required): Str LF EL t�t3c "1� 5 (a ✓-�)�"N Chairperson's occupation (required): Agg-mM ary�-�,, Treasurer's Information: Treasurer's name (required): C--L 14_-igi3 c TN "Ro e e Treasurer's physical address (required): �Zul/V, 9(fu'u-W ;"7.J0 (i _s72q, 01� Treasurer's mailing address (if different): Sffm C- T r e a s u re r's email address (required): El-/4A-tiIL-TN_WC8P;O 101" 1,J&N-X.JC_I(--& ,C'-l"tH L.[tM Treasurer's phone number (required): 5 ZO 5S7j-- z/ Z 7-0, Treasurer's employer (required): 54�LF � C L t-Z:/V(3&7H S' GWrtOc: W Treasurer's occupation (required):0Qg- Bank or Financial Institution: Bank name (required): Ws'=1-LS 1-t-(L&p (do not list acct numbers) Additional bank name (if applicable): Additional bank name (if applicable): DECLARATION AND SIGNATURES: 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. Chairperson's signature: Date: Treasurer's signature: Date: Candidate's signature (if applicable): Date: -S/ Z Arizona Secretary of State Revision 7/29/2021