HomeMy WebLinkAboutCharlie Hurt for OV - Statement of Organization - 1/27/2022 w�1�.� q�': �` �i r�""� �.�r�R
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Ini� � �on STATE OF ARIZONA ; cOMMITTEE ID NUMBER
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Amende ` � TEMEIUT ; toffice use on�y}
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�ate: 01/1 2 � -� ;��1�� .Z•�--"�Z-.
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OF ORGANIZATION
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COMMITTEE TYPE(choose one):
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f°� � Candidate
;� �
f Commrttee�vame(required): Charlie HUrt f01'OV ;
�
1 (first or last name&office) �
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�
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Candidate Informarion: Candidate's Name(required): Charlie Nut't :
;
� i ' m iiin address re uired : 1�144 N Ei ht Iron Ln Oro Vaile AZ 85737 '
, Cand date s a g ( q ) �
;
Candidate's email address(required): charl�ehurtov�qmail.001"1'1
Candidate's phone number(required): 520.427.7302
Candidate's website(if any): ____
Office Sought(choose one): 0 County Office: pDistrict (if applicable):
OCity/Town Office: Oro Valley Town Council �District(if applicable):
� �School Board Office: 0 District(if applicable):
f
�
�Special District Board: ODistrict(if applicable):
Election Cycle for Office Soughi(year the election will take place}(required}: 2022
Party Affiliation: �Democrat �Green 0 Libertarian �Republican 0 Other:
(required for partisan offices)
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0 Political Action Committee(PAC)
Committee Name(required):
; (if sponsored,must include
� sponsor's name)
Poticical Function(optional): C7 Contributions ❑Candidate-Related Independent Expenditures
(select any that apply) ❑Ballot Measure Expenditures ❑Recall Expenditures
Sponsorship Jnformation: 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 af a Corporation,LLC,Partnership,or Union
(if applicable) D Standing Committee(must also complete separate standing committee registration)
❑Mega PAC(must provide proof of Mega PAC status to filing officer)(ame�ded applications only}
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E� Political Party
Committee Name(required):
(must include party a�liation)
Jurrsdicfion: �State Party(must include proof of qualification pursuant to A.R.S.§ifi-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)
_ [J City or Town Party(must include proof of qualification pursuant to A.R.S.§16-802 or§16-804)
Special Sratus �Standing Committee(must also complete separate standing committee registration)
(if applicable)
Ariiona Secretary of State Revision 7/29/2021
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�._.^ ^. ��.r ��r.�^y����.-.�' STATE UF ARIZONA ' COMMITTEE ID NUM6ER
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{ ended ��cati � �� ��� � COMMITTEE STATEMENT � (office use on�y)
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Dat . ' �'�= �� ��� ��''d
� �F ORGANIZATI�N
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CO E IN OR ATION:
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Contacr Informarion: Committee's mailing address(required}; �0144 N Eight iron Ln Oro Valley,AZ 85737
� charliehurtov mail.com �
Committee's email address(required). a
Committee's phone number(if any):
Committee's website(if any):
.
Chairperson's Infamation: Chairperson's name(required): C h c�rI I e . U I� �
. � 10144 N Eight Iron Ln Oro Valley, AZ 85737 i
Chairperson s physical address(required).
Chairperson's mailing address(if different): �
. .
Chairperson's email address(required}: ch arl i e h u rtov g I�1 c�l�.C�11�1 #
Chairperson`s phone number(required): 520.427.7302
Chairperson's employer(required): n o n e
.
Chairperson's occupation(required): retl re
,
rreasurer's�nformation: Treasurer's name(required): C h r�l'I 1 e D. H U I�
Treasurer's physical address(required): �0144 N Eight Iron Ln Or0 Valley,AZ 85737
Treasurer's mailing address(if different):
. .
Treasurer's ema+l address(required): Ch a rI I e I'1 U I'�OV C�I'Yl al .C01�1'1
Treasurer's phone numbe�(required): 520.427.73�2
� Treasurer's employer(required): n O n e
.
Treasurer's occupation(required): retl re
Bank or Financial Instituiion: Bank name(required): N� ��
(do not list acct numbers) Additional bank name(if applicable):
Additional bank name(if applicable): ff
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 receivelmake contributionslexpenditures on my behalf,if applicable;(3)have read the Secretary of State's
campaign finance and report� guide;(4)agree to comply with Arizona elec� n law,including campaign finance laws codified at A.R.S.
§§16-901 to 16-938;and gr o accept all notifications and le I serv� e of process for campaign finance purposes via the email
! address(es)provided h in.
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� Chairperson s signatur � Date. ��,��"�---
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� Treasurer's signatu : Date: .�� �
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� Candidate's signature(if applica e): Date:
,
,
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Arizona Secretary of State Revision 7/29/2021
