HomeMy WebLinkAboutMelanie Barrett for Mayor - Statement of Organization - 3/3/20260 Initial Application STATE OF ARIZONA COMMITTEE ID NUMBER
O Amended Application COMMITTEE STATEMENT (office use only)
Date: 6 OF ORGANIZATION OvTc a6-off
COMMITTEE TYPE (choose one):
Candidate
Committee Name (required):
(first or last name & office) Candidate Information: Candidate's Name (required): 1 r ty� toil
Candidate's mailing address (required): jS+13 N. SI
Candidate's email address (required): Me_lan1 i?,
Candidate's phone number (required): t520 - 222
Candidate's website (if any): Mf ay%
Office Sought (choose one): O County Office: ODistrict (if a
)kCity/rown Office: [\1( y OV ODistrict (if applicable):
T
O School Board Office: 0 District (if applicable):
13 Special District Board: ^17District (if applicable):
G( J Election Cycle for Office Sought (year the election will take place) (required): ZYI
Party Affiliation: O Democrat 13 Green O Libertarian 17 Republican 0 Other: NA
(required for partisan offices)
O 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:
(if applicable)
Special Status
(if applicable)
Sponsors name or nickname (required):
Sponsors mailing address (required): _
Sponsors email address (required):
Sponsors phone number (if any):
Sponsors "belle (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 riling officer) (amended applications only)
O Political Party
Committee Name (required):
(must include party affiliation)
Jurisdiction:
17 State Party (must include proof of qualification pursuant to A.R.S. § 16-801 or § 16-804)
O County Party (must Include proof of qualification pursuant to A.R.S. § 16-802 or § 16-804)
17 Legislative District Party (must include proof of organization pursuant to A.R.S. § 16-823)
10 City or Town Party (must include proof of qualification pursuant to A.R.S. § 16-802 or § 16-804)
Special Status
El Standing Committee (must also complete separate standing committee registration)
(if applicable)
)
Arizona Secretary of State Revision 7R92021
13 Initial Application STATE OF ARIZONA COMMITTEE ID NUMBER
o Amended Application COMMITTEE STATEMENT (office use only)
Date: 0 OF ORGANIZATION ovrc 26-oo
COMMITTEE INFORMATION:
Contact/nformation: Committee's mailing address (required): 13y43 s, SiIveir cmib, PG oyo UQtI ebN
Committee's email address (required): 1�1P�AhIZ�Qi MP.�Qnf�l�i�7llYY?•OY�I
Committee's phone number (if any): 1j 10 - 2 ZZ — 73 9, Cl1
Committee's website (if any): 1 , mdanfebarreff-
• Olf
Chairpersons Information: Chairperson's name (required): _ _YY\P, 111 e/ R i ,,
Chairperson's physical address (required): mils s N. Silver l /�pn=4 T1• aro Ua
Chairperson's mailing address (if different): —1 As F
Chairperson's email address (required): Y'!�Q\Q 111 e pfi m� W 1�j Q. bQ:YC�IT• OYQ
Chairperson's phone number (required): 520 -222., — 73V
Chairperson's employer (required): MWn OF' OYO Ill
Chairperson's occupation (required): TO W n Mllrc l mew,\ Pr
Treasurers Information: Treasurer's name (required): 9milijeki V.- Q trlrs Mr. A
Treasurer1 s physical address 111 N• _Coy! Fa(ih �• 0Y0 UQ mrA
Bank or Financial Institution:
(do not list sect numbers)
DECLARATION AND SIGNATURES:
Treasurer's mailing address (if different): —""' //��
TreasurerY Y's email address (required): c Oyor 14 lY Q MST), CAM
Treasurer's phone number (required):
Treasurer's employer (required): —
Treasurer's occupation (required):
Bank name (required):?¢yW
Additional bank name (if applic i Ylble):
Additional bank name Cif applicable):
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 receivelmake contributionstexpenditures 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: I (K. Wxt &WA Date: ma 2 20 G(,
Treasurers signature: 29WZ61- 4 e� Date: 3 IT
Candidate's signature (if applicable): ! f �P�WIA(.( (�"1(I/VA Date: t riaxdl 21 Z:
,+2
9573
Arizona Secretary of State Revision 729/2021