HomeMy WebLinkAboutJake 4 Oro Valley - Statement of Organization - 2/3/2026 (2)Ills
Initial Application
E3 Amended Application
Date:
COMMITTEE TYPE (choose one):
STATE OF ARIZONA
COMMITTEE STATEMENT
OF ORGANIZATION
COMMITTEE ID NUMBER
(office use only)
G 21l
WCandidate
Jo.40oroaltem
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Committee Name (required):
first or last name & office
Candidate Information:
Candidate's Name (required):
Candidate's mailing address (required):
E 0 �jt AZ 9,57 /
Candidate's email address (required): 0LC0
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Candidate's phone number (required): ,-U-9_70-(i Q
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Candidate's website (if any):
Office Sought (choose one):
Ell Office:
ElDistrict (if applicable):
�County
City/To n Office: Orb VOL ��
ElDistrict (if applicable):
El School Board Office:
E3 District (if applicable):
M Special District Board:
ElDistrict (if applicable):
Election Cycle for Office Sought (year the election will take place) (required):
1;W9W
Party Affiliation:
El Democrat El Green El Libertarian
El Republican El Other:
(required for partisan offices)
,
Cl Political Action Committee (PAC)
Committee Name (required):
(if sponsored, must include
sponsor's name)
Political Function (optional): ❑ Contributions ❑ Candidate -Related Independent enditures
(select any that apply) , ❑ Ballot Measure Expenditures ❑ Recall E ditures
Sponsorship Information:
(if applicable)
Special Status
(if applicably
Sponsor's name or nickname (re(
Sponsor's mailing address (re 'i
Sponsor's email addre equire
Sponsor's pho umber (if any):
Spongy 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 applicati
El Political Party
Committee Name (required):
(must include party affiliation)
Jurisdiction: E3 State Party (must include proof ualification pursuant to A.R.S. § 16-801 or § 16-804)
El County Party 2u-b-t
st i e proof of qualification pursuant to A.R.S. § 16-802 or § 16-804)
El Legislative Party (must include proof of organization pursuant to A.R.S. § 16-823)
M qi1yorTown Party (must include proof of qualification pursuant to A.R.S. § 16-802 or § 16-804)
Special Statute El Standing Committee (must also complete separate standing committee registration)
Arizona Secretary of State Revision 7/29/2021
13 Initial Application STATE OF ARIZONA
0 Amended Application COMMITTEE STATEMENT
Date: OF ORGANIZATION
COMMITTEE INFORMATION:
Contact Information: Committee's mailing address (required):
Committee's email address (required):
Committee's phone number (if arty):
Committee's website (if any):4121
Chairperson's Information: Chairperson's name (required): —
Chairperson's physical address (required):
Chairperson's mailing address (if different):
Chairperson's email address (required): I
Chairperson's phone number (required): _
Chairperson's employer (required):
Chairperson's occupation (required): "
Treasurer's Information: Treasurer's name (required): �a
Treasurer's physical address (required): _
Treasurer's mailing address (if different): _
Treasurers email address (required): t (�
Treasurer's phone number (required): —Jr_
Treasurer's employer (required):
Treasurer's occupation (required):
Bank or Financial Institution: Bank name (required): Y
(do not list acct numbers) Additional bank name (if applicable):
Additional bank name (if applicable): _
DECLARATION AND SIGNATURES:
COMMITTEE ID NUMBER
(office use only)
oft
I 2ito-oI
I declare under penalty of pedury 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; an ee to accept all notifications and legal service of process for campaign finance purposes via the email
address(es) provided eretn.
Chairperson's signa Date: n
Treasurer's signatur : Date: Owl 1� �,-,
Candidate's signatur if a ca ): Date: a ( i/Tt�a(c:�
37
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Arizona Secretary of State Revision 7/29/2021