HomeMy WebLinkAboutTermination Statement"� - '� ' i - 1 �� f' : 1 0 � � C ';� : )
CITY / T01NN OF FOUNTAIN HILLS, AZ
POLITICAL COMMITTEE
TERMINATION STATEMENT
A. R. S. §§ 16-994 and 96-995.09 i�
PC2011-07
NAME OF POLITICAL C�MMITTEE
Dennis Brown for Town Council
ADDRESS (NUMBER � STREET) CtTY STATE ZIP
9624 E. Monterrey, Ste. E Fountain Hills AZ 85268
MAILING ADDRESS (IF DIFFERENT FROM ABOVq CITY STATE ZIP
COMMITTEE TELEPHONE # COMMITTEE FAX # COMMITTEE E-MAIL ADDRESS
480-816-1244 480-837-5599 I votedennisbrown2012@yahoo.com
NAME OF SPONSORING ORGANIZATION OR CANDIDATE AND OFFICE
Dennis Brown, Town Council
ADDRESS OF SPONSORING �RGANIZATION I EMAIL ADDRESS AND FAX #
Select the boxes thai apply:
A. Q This is to certify that all contributions received and all expenditures made on behalf of the political committee
indicated above have been reported as required by A.R.S. § 16-913. We further certify that the political committee
will no longer receive any contributions or make any disbursements, that the committee has no outstanding debts
or obligations, and that any surplus monies have been disposed of pursuant to A.R.S. § 16-915.01.
Please mark the appropriate statement below to indicate which campaign finance report states the disposition
of any surplus monies.
❑ The disposition of surplus monies was submitted on the campaign finance report filed on:
0 The disposition of surplus monies is reported on the attached campaign finance report.
B. � This committee has terminated its activities in the above-named jurisdiction. The undersigned chairman and
treasurer hereby attest that it is the intent of this committee to remain active in other jurisdictions and that ail
remaining monies of this committee shall be used in other jurisdictions.
C. � This committee has transferred the committee's debts and obligations to a subsequent committee.
Please enter the #ull name and ID# of the committee into which debts and obligations have been transferred.
Name of Committee:
We, Michael Archambault
Printed name of Chainnan and
ID#
Phillip Blackerby certifjl under
,
PriRted name of Treasurer
penalty of perjury that this statement of tennination pursuant to A.R.S. § 16 -914 is true and complete.
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Signa�ure o Chairman `� Signature of Tr asurer