HomeMy WebLinkAboutStatement of OrganizationSTATE OF ARIZONA
-y POLITICAL COMMITTEE
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❑ ReglslraCion as Standing Poll�lcal Committee {'(�,�j)��-/.' �
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�.1Y�IDATE 5 GAIJPFIGN CONC�IiTEE
❑ t%VIOR�TOMG0�1p�liTEE
❑ CONAfITTEE ORGANI2ED IN Sl1PFORT OF OR OPPOSITIOAI
i0 ONF OR MORE GANI]IDA I FS
❑ COMA9 � I EE IN SUPPORT �F ON OPPOSRION 1 O I IiE
OUi1LIFIC4110N, PAS&�GF OR DFFEAT OF A BALl.01 VAFASURE
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❑ sup0o^ or ❑ copo.ation Io lM1i6 Callol nmasPn
❑ cULII.IITTEE ORGANIZED TO GIRGl1L4TE OR OPPOSC 4 RK�Ll
PETITION OR TO INFL�JEACE THE RES�JL� OF r; RECdLL
rvHE oF oacnr�iznrion
RELAilOMSHIP I O POLITIGL GOAIMI I I EE
0 STnN�InIG POLITICAI CO1dA11TTEE (SiaG annnal fee
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pUHPOHqTIOR OR LPBOF ONGAMZAiION
❑ CO`I:.IIIIEEORGANHEOFORI'HEPURPOSEO:`.IFKING
iuo_r�r�oeNrex� er�oiruR�s
� Pe111iON ❑ �'OIITIC>LORGAWZATION h�riprgai'.i�Imrlha:¢'orn�ally
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❑ PULITICA� PARII' Imtly sinlc ur counry cannnM1tcux nf an j
nrp:n ; uuon loal mqqls Ihn ra�juirFmonLs [or rerngmunn as o �
h. .ic�al Gany IA.R5.4 �6.90�, t�gU6. i&82t antl 16-625)� '
I EACH POLITICAI GOM1IMITTEE SHALL H.1VC H GH4IRI.I�1N AND TP.CASURCR. TH@ POSITIUN O� CHFIRD.IAV AND iP.EFSURER OF A SIV6LE �
� POLITICA� COAIAIITTEE \tAY NOT pE IIELO BV THE �nLIE IN�IVIGIInL EXCEPT TINi;, c>1NplpAtE LLtt OE CI1,\IP0.fAN AN� TREASUREP OF
HISOP.HERO'/INGAMPAIGNCOPJM1IIIiEE �iR5.310-302�Aj. .
NAME OF CO�dA11I I t'c CHAIRh1AV�L d
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BEFORE A POUTICAL COMMITTEE ACCEPTS A CONTRIBUTION OR AIAKES AN EXPENDITURE IT SHALL DESIGNATE AT LEAST ONE
ACCOUNT AT A QUALIFIEO FINANCIAI INSTITUTION. A.R.S. § 10-902(C). UST THE NAAIES OF ALL FINANCIAL INSTITUTIONS WITH WHICH
THE COMMITTEE NAINTAINS ACCOUNTS OR SAFETY DEPOSIT BOXES. (Do not list account numbers.)
i. / 1` oL �„R` f�_ 2. 3.
FOR AN EXPLORATORY COMMITTEE OR A CANDIDATE'S CAMPAIGN COh1MITTEE, PROVIDE THE FOLLOWING INFORMATION:
(Partv AHiliaUon and O(hce ScuCht are opUonal lor Exploratory Committees.l
NA�1E OF DESIGNATING INDIVIDU L"DI") OR CANDIDATE
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PARTY AFFILIATION
OFFICE SQUGHT
I �►Ay��t rr��� < <� p�-
Dll's OR CANDIDATE'S ADDRESS CITY STATE ZIP
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DESIGNATING INDIVIDUAL QR CANDIDATE'S STATEMENT: I aulhorize lhe above-named political cammdtecs as my pdibcal committee to receive
ccntnbutions and ake expendiW�es on my behalf.
Ddle: � �� D/I's or Candidale's signatur
CHAIRMAN'S AND TREASURER'S STATEMENT: We, dersigned, have examined the information c Iained in Ihis statement of arganizalion and,
to the besl o ou�owledge and behel, it is true, corre and mplete. �
Date./ O�S� olGl/ Chaurnan's signature. ��� ���
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Date: �/� ( ��� Treasurer's slgnat / ��� ./� /
. �
Fdl ou! lh�s box onfy rf the ccmmrttea has Deen �n rs�ence lor mcre than one Year and rs Irling `or Standing Commdlee S�atus.
STANOINf3 POUTICAL COMMI7TEE'S STATEME (ii appllcable) (AR.S. §16-902.1): Ifwo hereby declare the status of thls paltUcal commlttee as
a stending political eommittee.
Datc:
Date:
State of Arizona
County of
Chalrman's slgnature:
COUNN OF RESIDENCE
Tre�su►er's slgnature:
1
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State oi Arlsono
Ccunty of
1
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SUBSCRIBED AND SWORN TO bcforo mo this
My Commlaslon Explres:
NoWry Publle
SUBSCRIBED AND SWORN TO botoru mo thls
Notary Publlc
My Commisslon Explres:
DEFINITION OF POLITICAL COMMITTEE: /IR.S. § 16-901(19)
-Political camm�qee" means a candidate or any assnciation or combination of persons thal is organized, conducted or cambined for the purpose of
in0uencing the result of any election ar lo delemiine whether an individual w�ll become a candidate (�r election in this stato ar in any county, cdy, town,
dislrict or precinct in this stale, thal engages in political acUvily in behalf of or against a candidate for eleclion or retenban a� in suppnrt of or opposilion tv an
initiative, referendum or recall or any other measure or proposition and that applies for a serial number and circulates petitions and, m the case of a
candidate for public oifice except those exempl pursuant to seclion 16-903, Ihat receives contributions or makes expenditures in connection therewith,
ratwithsland�ng Ihat the assoc�ation or combination of persons may be a part of a larger associat�on, combination of persons or sponsoring organization not
primanly organized, conducted ar combmsd for the purpose of influencing Ihe result of any election in lh�s state ur in any county. cily, town or precinct in
th�s state. Examples of types oi po�iucal cumrtuttees are listed on the Iront o( this (orm.
NOTE FOR INDIVI�UALS INVOLVEO IN POLITICAL ACTIVITIES:
An md�v�dual. actmg alone, is not a paliucal comm�ttee under Arizona law and need not file a statement af arganizat�on. N any addrt�anal persan or pe�sa�s
jan the eHort (as defined above �n A.R.S. § 16-901(19)) begun by an individual, the association of persons has become a'polilical committee" under
Anzona law, anE must file a statement of urganizalion before accepting contributions, making expendilu�es, distnbuling IileraWre or GrCulation petitions.
A.R.S. § 16-302.01(A).
NOTE FOR THOSE INVOLVED IN INITIATIVE, REFERENDUM AND RECALL EFFORTS:
Belore urwlaung imUalwe, referendum or recall pelilions, a political committee must file its slaiement of orgarnzatian vnth the appropnate filing o�ce.
Sig�atures a�tained on petitio�s pnar to the fibng af the statement of organization are void and shall not be counted �n determ�ning the legal suffiaency of
the peUt,on. A.R.S. §§ 19-114(B) and 19-202(C). Even though an ind�vidual, acting alene. may begin the in�Uative, referendum er recall effort, as soan as
cther persons �an Ihe efior,, the assouauon of persons must reg�ster as a pcht�cal ccmm�ttee. The statement of crgarnzaticn rnust be filed regardless of
whether the cammittee mtends to acc�pt contnbut�ons ar make expe�diwres. Ottice Re�siun 6J03