HomeMy WebLinkAboutCampaign Finance Records - Statement of organization - Tolmachoff 2018 - 6/13/2017Qlnitial Application
❑Amended Application
Date:
COMMITTEE TYPE (choose one):
❑✓ Candidate
Committee Name (required):
(first or last name & office)
Candidate Information:
CITY OF GLENDALE
STATE OF ARIZONA
COMMITTEE STATEMENT
OF ORGANIZATION
x x
Candidate's Name (required): Lauren Tolmachoff
COMMITTEE ID NUMBER
(office use only)
17-OY
Candidate's mailing address (required): P.O. BOX 10072 Glendale, 85318
Candidate's email address (required): Tolmachoff20l8@gmall.com
Candidate's phone number (required):
Candidate's website (if any):
Office Sought (choose one): ❑ Governor ❑ Secretary of State ❑ Attorney General ❑ State Treasurer
❑ Superintendent of Public Instruction ❑ State Mine Inspector ❑ Corporation Commissioner
❑ State Senate ❑ State House of Representatives ❑ District (required):
❑ County Office:
❑✓ Cdyrrown office: Glendale
Election Cycle for Office Sought (year the election will take place) (required):
Party Affiliation: N/A
(required for partisan offices)
❑ Democrat ❑ Green ❑ Libertarian
Political Action Committee (PAC)
Committee Name (required):
(if sponsored, must include
sponsor's name)
❑ District (if applicable):
❑✓ District (if applicable): Cholla
❑ Republican ❑ Other:
Political Function (optional): []Contributions ❑Candidate -Related Independent Expenditures
(select any that apply) 11 Ballot Measure Expenditures ❑ Recall Expenditures
Sponsorship Information:
(if applicable)
Sponsor's name or nickname (required):
Sponsor's mailing address (required): _
Sponsor's email address (required):
Sponsor's phone number (if any):
Sponsor's website (if any):
Special Status
(if applicable)
USeparate
Segregated Fund of a Corporation, LLC, Partnership, or Union
Standing Committee (must also complete separate standing committee registration)
Mega PAC (must provide proof of Mega PAC status to filing officer) (amended applications only)
Political Party
Committee Name (required):
(must include party affiliation)
Jurisdiction:
❑ State Party (must include proof of qualification pursuant to A.R-S- § 16-801 or § 16-804)
❑ County Party (must include proof of qualification pursuant to A.R.S. § 16-802 or § 16-804)
❑ Legislative District Party (must include proof of organization pursuant to A.R.S. § 16-823)
[]City or Town Party (must include proof of qualification pursuant to A.R.S. § 16-802 or § 16-804)
Special Status
❑ Standing Committee (must also complete separate standing committee registration)
(if applicable)
Arizona Secretary of State Revision 11/5/16
Initial Application STATE OF ARIZONA COMMITTEE ID NUMBER
E] Amended Application , COMMITTEE STATEMENT (office use only)
Date: OF ORGANIZATION
COMMITTEE INFORMATION:
Contact Information: Committee's mailing address (required): P.0. BOX 10072 Glendale, 85318
Committee's email address (required): Tolmachoff20l8@gma:ll.com
Committee's phone number (if any):
Committee's website (if any): Tolmachoff2018.com
Chairperson's Information: Chairperson's name (required): Lauren Tolmachoff
Chairperson's physical address (required): 6820 W Sonnet Dr
Chairperson's mailing address (if different):
Chairperson's email address (required): Tolmacchoff20l8@_qmail.com
Chairperson's phone number (required): 602-421-2194
Chairperson's employer (required): Self RE/Century 21 Northwest
Chairperson's occupation (required): Realtor
Treasurers Information: Treasurer's name (required): Joyce Terrell
Treasurer's physical address (required): 24639 N. 105th Ave
Treasurer's mailing address (if different):
Treasurer's email address (required):
Treasurer's phone number (required): 602-989-5403
Treasurer's employer (required): Self/Anasazi Door , Inc.
Treasurer's occupation (required): owner
Bank or Financiai Institution: Bank name(required): BMO Harris
(do not list acct numbers) Additional bank name (ifapplicable):
_ Additional bank name (if applicable):
DECLARATION AND SIGNATURES:
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 the above-named committee as my official candidate
committee and authorize it to receive/make contributions/expenditures on my behalf, if applicable; (3) have read the Secretary of State's
campaign finance and reporting guide; (4) a ee to comply with Arizona election law, including campaign finance laws codified at A.R.S.
§§ 16-901 to 16-938; ark. (5) ee to a pt al tions and legal service of process for campaign finance purposes via the email
address(es) provided her
Chairperson's signature Date: r 11
Treasurer's signature:
Candidate's signature (if
Date:
Date:
Arizona Secretary of State Revision 11/5/16