HomeMy WebLinkAboutPC2022-02 - Reclaim Our Town (ROT) - Statement of Organization - AmendedFILED IN PERSON
TOWN CLERKS OFFICE
JANUARY 23, 2024 2:42 PM
El Initial Application CJ Amended Application
Date; _____ _
COMMITTEE INFORMATION:
Contact lnfonnation;
STATE OF ARIZONA
COMMITTEE STATEMENT OF ORGANIZATION
COMMITTEE 10 NUMBER (afftoe use only)
Committee's mailing address (required): 10417 N. Nelson Or. Fountain Hills, AZ 85268
Committee's email address (required): ROT092858@gmail.com
Committee's phone number (If any): ___________________ _
Committee's website (if any): _____________________ _
Chairperson's lnfonnation: Chairperson's name (required): _C _ry.;;._st_a_l _C_a_v_a_n_a_u""g:....h _____________ _
Chairperson's physical address (required): 13 855 N Sunset D. rFountain Hills, AZ 85268
Treasurer's Information:
Bank or Financial Institution:
(do not list acct numbers)
DECLARATION AND SIGNATURES:
Chairperson's malling address (if different): _________________ _
Chairperson's email address (required): crystal .cavanaugh@ymail.com
Chairperson's phone number (required): _(3_1_9 __ )_4_3_1_-8_0_1_0 ___________ _
Chairperson's employer (required): _n_o_n_e __________________ _
Chairperson's occupation (required): _re_t_ir_e_d _________________ _
Treasurer's name (required): _L_a_w_r_e_n_c _e_E_._M_e.;..y_e_rs _____________ _
Treasurer's physical address (required): 10417 N. Nelson Dr. Fountain Hills, AZ 85268
Treasurer's malling address (if different): __________________ _
Treasurer's email address (required): _la_r __ ry_1 _0_6_1 __ @ __ co_x_._n_e_t ___________ _
Treasurer's phone number (required): _(4_8_0_)_3_3_2_-_8_9_2 _2 ____________ _
Treasurer's employer (required): _n_o_n_e ___________________ _
Treasurer's occupation (required): _re_t_ir_e_d __________________ _
Bank name (required): _c_h_a _se _____________________ _
AddlUonel bank name (If appllcable): ___________________ _
Additional bank name (if 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 Iha above-named committee as my official candidate committee and authorize ii lo 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 notif1Cations and legal service of process for campaign finance purposes via the emailaddress(es) provided herein.
Candidate's signature (if applicable): _____________ _
Dale; 04/1 4/2022
Date: 04/14/2022
Date: ______ _
Arizona Secretary of State Revision 7/29/2021
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