HomeMy WebLinkAboutCampaign Finance Records - Statement of organization - Weiers 2020 - 6/1/2017CITY OF GLENDALE
gWal Application STATE OF WIVZCM X COMMITTEE ID NUMBER
[�Amende A lication CO�iINIIT i5' (office use only)
Date: OF O C
�YAZA 10 �17-
ff T 1:
COMMITTEE TYPE (choose one):
0 Candidate
Committee Name (required): WEIERS 2020
(first or last name & office)
Candidate Information: Candidate's Name (required): JERRY WEIERS
Candidate's mailing address (required): 5025 N. 81 ST DR. GL_ENDALE, AZ 8rd
CandleWA'S email adaress (required): S_91_L.Z £.':9 rg, 669, m
�hj �11 C, 9
Candidate's phone number (required): �r�� -"11 � ,o ��a-- ��
u o��—,r-o
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: ❑ District (if applicable):
Q Cityrrown Office: MAYOR []District (if applicable): ry r)
Election Cycle for Office Sought (year the election will take place) (required): 2020 -1 "_q
=„ _< t 9
MP
Party Affiliation: N/A 11 Democrat ❑ Green ❑ Libertarian 13 Republican ❑ Other: C7#�
(required for partisan offices)j.
C -
r"
Political Action Committee (PAC)
`
Committee Name (required): WEIERS 2020 �
(if sponsored, must include r
sponsor's name)
Political Function (optional): Contributions []Candidate -Related Independent Expenditures
(select any that apply) 11 Ballot Measure Expenditures [] Recall Expenditures
Sponsorship Information: Sponsor's name or nickname (required):
(if applicable) Sponsor's mailing address (required):
Sponsor's email address (required):
Sponsor's phone number (if any):
Sponsor's website (if any):
Special Status Separate Segregated Fund of a Corporation, LLC, Partnership, or Union
(if applicable) HStanding Committee (must also complete separate standing committee registration)
0 Mega PAC (must provide proof of Mega PAC status to filing officer) (amended applications only)
Political Party
Committee Name (required): WEIERS 2020
(must include party affiliation)
Jurisdiction: ❑ State Party (must include proof of qualification pursuant to A.R.S. § 16-801 or § 18-604)
County Party (must include proof of qualification pursuant to A.R.S. § 16-802 or § 16-Bo4)
Legislative District Party (must include proof of organization pursuant to A.R.S. § 1e-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 1115116
COMMITTEE INFORMATION:
CITY CLERK
CITY CI° CLErr>-LF
STATE OF A"N� h — I
COMMITTEE STATEMENT
OF ORGANIZATION
PM 3; L., COMMITTEE ID NUMBER
(af9ce use only)
DECLARATION AND SIGNATURES:
I declare under penalty of
chairperson or Uessurer a
committee and authorize i
campaign tlnenee rep
rd
if
prov[ded
Chairperson's signature:
Tresswers signature:
Candidate's signature Of
iry tot the foregoing Wwmation Is true and oonvot, h further declare that 1: (1) consent to serve as
committee named herein. N applicable: (2) designate the above-named committee as my onhdel Candidate
welvalmake oontrlbuilonaWpoulturoa an my behalf, If applicable: (3) have read the Secretary of State's
I gee: (4) agree to comply wYh Arizona etectlon law, Wudhrg campaign finance laws codified at A.R.S.
F" Io ■peW a1 notifications and *0 IteMoe of process for campaign Anerroe purposes Wa the email
Arizona Secretary of Slate ReWalon 11&16
N. 81 St Dr. Glendale, AZ 85303
Confect rnformarloon:
CommNtee's mallhng address (required): .5025
ComndGee's emall address #04(iiiid
Committee's phone number (if arry):
Committee's website (if any):
Chakpemn's Information:
Chairperson's name (required): JERRY WEIERS
Chalrparwri'sphysical address (mqulrad): 5025 N. 81St Dr. Glendale, AZ 85303
Chairperson's mailing address {ddnfaraM)
Chalrperson'a email address * 3' °''�"-'3 - CA `"iq �
Chkrperson'a phone numbefjf&4 14)):
Chairperson's employer trageDfiratlj' ;r• is t, do e
Chalrperson's oecupetlani(mf�ll 86.
Treasurer's Information:
Treasurer's name (required): MICHAEL W. LAW
Treasurers physical address 0equited): 6955 E. Baseline 107 Mesa, AZ 85209
Treasurers mailing address Of different):
Treasurers email address (required): rnike@lawreed.mm
Treasurers phone number (required): 480-827-0370
Treasurers employer (required): LAW $ REED
Treasurers occupation (required): CPA
Bankarftandef institudlarr:
Bank name (required): AAMO
(do not list soot numbers)
Additional bank name (lapplieable):
Additional bank name (If applicable):
DECLARATION AND SIGNATURES:
I declare under penalty of
chairperson or Uessurer a
committee and authorize i
campaign tlnenee rep
rd
if
prov[ded
Chairperson's signature:
Tresswers signature:
Candidate's signature Of
iry tot the foregoing Wwmation Is true and oonvot, h further declare that 1: (1) consent to serve as
committee named herein. N applicable: (2) designate the above-named committee as my onhdel Candidate
welvalmake oontrlbuilonaWpoulturoa an my behalf, If applicable: (3) have read the Secretary of State's
I gee: (4) agree to comply wYh Arizona etectlon law, Wudhrg campaign finance laws codified at A.R.S.
F" Io ■peW a1 notifications and *0 IteMoe of process for campaign Anerroe purposes Wa the email
Arizona Secretary of Slate ReWalon 11&16