HomeMy WebLinkAboutJosh Nicolson for Oro Valley Town Council 2018 - Statement of Organization - 5/8/2018 ' � T9 TOWN OF ORO VALLEY COMMITTEE ID NUMBER
Initiai Application (office use only)
� Amended Ap licati `.��� COMMITTEE STATEMENT .�,.���
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�ate: � � O F O RGAN IZATI O N
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COMMITTEE TYPE(choose one):
�Candidate
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Committee Name(required): N cO� OY�
(first or last name&office) .
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Candidat
e Information: Candidate's Name(required): -.�OS1� 1V i�o Sd�'1
Candidate's mailin address required): ro �3�
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Candidate's email address(required):
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Candidate's phone number(required): y gd' 'rJ$�"�SQ�1
Candidate's website(if any):
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Office Sought(choose one): ❑Governor ❑Secretary of State ❑Attorney General ❑State Treasurer
�Superintendent of Public Instruction ❑State Mine Inspector ❑Corporation Commissioner
❑State Senate ❑State House of Representatives ❑District(required):
❑County Office: ❑District(if applicable):
Cit /Town Office:�ar�r► CncarlCi'rrltw►�72r❑District(if applicable):
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Election C cle for Office Sought(year the election will take place)(required): d 0�g
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Party Affiliation: ❑Democrat ❑Green ❑Libertarian ❑Republican �Other: ` t �
(required for partisan offices)
❑ Political Action Committee(PAC)
Committee Name(required):
(if sponsored,must include
sponsor's name)
Political Function(optional): ❑Contributions ❑Candidate-Related Independent Expenditures
(select any that apply) ❑Ballot Measure Expenditures �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)
' ❑ Political Party
Committee Name(required):
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(must include party affiliation)
Jurisdiction: ❑State Party(must include proof of qualification pursuant to A.R.S.§16-801 or§16-804)
, ❑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)
�City or Town Party(must include proof of qualification pursuant to A.R.S.§16-802 or§16-804)
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Special Status ❑Standing Committee(must also complete separate standing committee registration)
(if applicable)
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Arizona Secretary of State Revision 11/5/16
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❑ Initial Application
T TOWN OF ORO VALLEY COMMITTEE ID NUMBER
❑ Amended A Iication �� � � ITTE E STATE M E NT (office use only)
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�ate: � OF ORGANIZATION
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COMMITTEE INFORMATION:
Contact Information: Committee's mailing address(required): r val �?3�
Committee's email address(required): ' rOrb 't
Committee's phone number(if any):��,'�'�- �$�'gQ��
Committee's website(if any):
Chairperson's Information: Chairperson's name(required): Jc��n �tc�c��S_oh
Chairperson's physical address(required): �
Chairperson's mailing address(if different):
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Chairperson's email address(required): Q
Chairperson's phone number(required): �"'�S'O` �����4� �
Chair erson's emplo er(required): �C'�Qra� f-tViQ��c�►� �'1r��S�q��ioh
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Chairperson's occupation(required):�� �ra���t i�� C-4r1iY���Q+r'�
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Treasurer's Information: Treasurer's name(required): �.�
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Treasurer's physical address(required): Q Or� �
Treasurer's mailing address(if different):
Treasurer's email address(required): � � Qt •
Treasurer's phone number(required): �$'b'�FS'�-� FS'q�+
Treasurer's employer(required): �c 1 ��d ' � ��
Treasurer's occupation(required): ��r' ��'a��ri� Con�ro�IQ�
. dBank or Financial Institution: Bank name(required):
(do not list acct numbers) Additional bank name(ifapplicable):
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.
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Chair erson's signature: � Date: � � "
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Treasurer's signature: Date:
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Candidate's signature(if applicable): ` Date:
Arizona Secretary of State Revision 11/5/16