HomeMy WebLinkAboutTermination Statement PC 2016-02Date:b-/$</J COMMITTEE ID NUMBER
COMMITTEE INFORMATION:
STATE OF ARIZONA
COMMITTEE TERMINATION
STATEMENT
06-15-17 A11:01 RCVD
Committee name:To i-1 S f=0*s'Icu^J Cj3o O <_\
Mailing address:/IOCS'£.£NTtEAP&\^^f^o o /u m /^/•/-'/1 <?,AZ
Email address:ftAT-,To/-}S.@ V.4 140(5 ,COt^\
Phone number:qgo -Z7o -9 z vv
Website:
Chairperson name:Gr^ifc:6-(_3t>lu C <C /
Treasurer:l~rr~>T\-+vr~>r r~/**>O ^£-/-/'/O
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DECLARATION AND SIGNATURES:
I declare under penalty of perjury that the foregoing information is true and correct.I further declare that: (1)the committee willno longer
receive any contributions or make any disbursements;(2) the committee either (a)has no outstanding debts or obligations,or (b)has
outstanding debts or obligations that are all more than five years old,and the committee's creditors have agreed to discharge the debts
and obligations and have agreed to the termination of the committee;(3)any surplus monies have been disposed of and that the
committee has no cash on hand;and (4) all contributions and expenditures have been reported,including any disposal of surplus monies.
Chairperson's signature:Date:
Treasurer's signature:
Candidate's signature (if applicable)?G-/3 */~7
Arizona Secretary of State Revision 11/5/16