Loading...
HomeMy WebLinkAboutCC2021-04 - Biermann - Statement of Organization� Initiai Appllcation 0 Amended Application Date: COMA+iITTEE iYPE (ctioose one): � � O Gandidaie l { Commltlee Name (required): {flrst or last name 8 office� STATE OF ARIZONA COMMITTEE I� NUMBER COMMITTEE STATEMENT (a�ice use on�y) OF ORGANIZATION � � — . . 5 ;' - ' t — _ - i� t.-�--., C�{ ,r �' �,�.. rf h�Yl � s �Vl �r � !` ��1.�.'�l { +U�e.�r-k � t l 1 Candidafe lnfarmatian: Candidate's Name (required): �.� �t. �c ��`y��"1 �f�l Candidate's mailing addrass (required): t S'�,{�� ����y�*������ �.v��u��y,���'. ��+ g� � Candidate's amall address (requtred): �`.� rrl ��� ri� Candidates phone number(required): �r,�� '���-� L -•��iZ� "��,�T Candidate's wehsHe Qf any): ����� i"D��f �� uYi .� fl � OKce Soughf (choase one): � County Offica: � istrid (if a�plica6le): �itylTown OHice: � ;� � �� � �Dislricl Qf applicable): � School Board OKce: � Dlslrict (if applicable): fl 5pecial Dislrict Board: � �istricl (if applicable): Elecfion Cycle for Offrce 5ought (ysar the election will take place) {required): z.Q�.v 4 PartyAtfiliatlo�; � Demacrat 0 Green O Libertarian � (required for part9san offices) � � � Political Actian Committee {pACj Comrnlftee Nams (required)� (if sponsared, must include sponsors name) O Republican O Other. Politica! Function (oplional): � Contribulions O Cartdidate-Relaled Independsnt E�enditures {seled any that a�ply) ❑ BaAot Measure Ex�enditures 0 Racall Expenditures 5po�sorship l�formation: (if applicable} Special Stalus (d applicable) � � Palitical Party Commitfee Name (re4uired): (must inGude party affiliatlon) Jurisdicttpn- �Speciaf Slafus (if applicable) Sponsor's name or nickname (required): Sponsors mailing address �required): Sponsors email address (required): 5ponsor s phone number (If any) 5ponsar's website {if any): O 5eparale 5egregated Fund of a Carporation, LLC, Parinership, or Union ❑ Standing Cammittse (musl a[so complele se�aral8 slanding committee registraUon) ❑ Mega PAC {must provide proof af Mega PAC status to fi[ing officer) (amended applica8ans anly) O 5tate Party (musl include proof o( qualificatian pursuanl lo A.R.S. § 15-801 ar § 16-804) 0 Gounty Parly (musl include proof of qualiBcalipn pursuant to A.R.S. § 1$-$42 or § 16-804) O Legislative �istrid Party {must include proof af arganization pursuank lo A.R.S. § i6-823) � Cily arTown Party (must inGude proof of qualificalian pursuant lo A.R.S, § 16-802 or § 16-804) � Standing Commitlee (must also complete separale standing commiitee registration} �. � � � _� Arizana 5ecretary oF Staie Rsvision 7I2912021 O Inilial Application STATE OF ARIZONA COMMIifEE ID IVUMBEF2 � Amended Application COMMITTEE STATEMENT fo��e use on�y) aate: OF ORGANIZATION �,_ _ ,, . , COMMI'ITEE INFORMATiDN: Cantact !nlormatfan: � �, Chafrperson's l�lormafion: Treasurer's lnfp�ma�ion� 8ank or FFnanclal Instifutlon: (do not Iist accl numbers} Committee's maiting address {required j: ,����-� �.,�.. �4 , �'� t^� rs+ 4 {,� i,k. �{ + �j'f-� �s�fo b � Cammittee's email address (required). � �'�., �� 1} �rd� i' �� �nrt .� e�Yv� Committee's phone number (if any): � i���,� �I � fi {7 Z__ ,! Committee's website {if any): � , C- �7y� Chairperson'sname{requiredj� � ��� f"-� � P � ,mC� ,r.,� / Chalrpersan's physical address (raquiradj: ����� ! . �;'!�A �f� � � i h �.rv��Ulp�'f � ��� ���"^� Chairperson's mailing address (if diHerenl} � �v7[l � Chairperson's emai! address (required)� �,�1 ��� � w's 1� ��C���' L� �l��l, rn Chafrperson's phone number (required}; ���C�� � � _ Chairperson's employer (required): � � C'�'i � ti ��� �lYl � � �. � �(Y� , Chairperson's accupalion (required): �� ���,��� ,]�� ��, � � � Treasurers name (requirad): �,-•4 r4 Cx �-� F �� t� mr � w, r, � �5�� Traasurersphysicaladdress(required): ,�"�ll�l �.. *�„� [L:C� f fi�,n�t�G�r�V}o Treasurer's mailing address (if different): �� �i' � Treasurer's email address (required): �•ry , �� Z-t�� � fiC��{ �{ �lY� � t.l.�rr-x Treasurers phone numher(requiredj; ���`� "���� Treasurers emptoyar(required�: ���� �#'r��C., 4� [�z. �� �ri1�. � � , Treasurer's nccupation (requiredp L:� ��4a �r� ti-�'ti� �.,r�� Bank name (required): �� tif1 � Additlonal bank name (if applicable); � Addilional bank name (if applicable}� DECLARATI�N AIVD SIGNATURES: ��er� �.� � �declare under penalty of perjury tfiat the faregoing in(artnatian is Vue and correct. I turlher declare thal L(1) consenl la serve as chairperson or treasurer of the cammittee named herein, if applicabls; (2) designale Iha abave-named commillee as my affiaal candidate commiqee and aulharize it to rece9velmake contribWionslexpenditures on my behali, if applicable; (3� have read �he Seustary of Stale's campaign finance and reporlEng guide; (4) agree to comply wilh Arizona eleclion law, including campaign finance laws codifisd at A.R.S, §§ 16-901 to 1fi-938; and (5) agree ta accepk aq noGfitations and legal service oF process for campaign finance purposes via the email address(es) provided harein. Chairperson's signakure. , Dale� .�� � �~?/ Treasurer's signature .,�,�� � �andidate's signalure (if applicable): Date: � Z�i'.Z� Date: �O�..Ti��z/ � Arizona SecreWry of S1ale Revision 7/29/2021