HomeMy WebLinkAboutCampaign Finance Records - Statement of organization - Ray Malnar for a Better Glendale 2016 - 6/4/2015CITY / TOWN OF
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Titles 16 & 19 Arizona Revised Statutes CITY OF GLUIMALE
nnfinitions statutory references and important information on reverse.
2015 AIN,
[AInitial Registration FlOut of State Committee ❑Amended Statement
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NAME OF POLITICAL COMMITTEE
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ADDRESS (NUMBER & STREET) CITY
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MAILING ADDRESS (If different from above)
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COMMITTEE TELEPHONE It COMMITTEE FAX# COMMITTEE E-MAIL ADDRESS
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DOES THE POLITICAL COMMITTEE HAVE A SPONSORING ORGANIZATION? ❑YES NO
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If yes, please provide the following information:
NAME OF SPONSORING ORGANIZATION
TYPE OF ORGANIZATION
ADDRESS OF SPONSORING ORGANIZATION RELATIONSHIP TO POLITICAL COMMITTEE
TYPE OF POLITICAL COMMITTEE - Please check only one box:
CANDIDATE'S CAMPAIGN COMMITTEE COMMITTEE ORGANIZED FOR THE PURPOSE OF MAKING
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INDEPENDENT EXPENDITURES
OSEPARATE SEGREGATED FUND ESTABLISHED BY.A CORPORATION
OR LABOR ORGANIZATION COMMITTEE ORGANIZED IN SUPPORT OF OR OPPOSITION
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TO ONE OR MORE CANDIDATES
COMMITTEE IN SUPPORT OF OR OPPOSITION TO THE
QUALIFICATION, PASSAGE OR DEFEAT OF A BALLOT MEASURE POLITICAL ORGANIZATION (see A.R.S. § 16-823)
Petition Serial Number Support 0 Oppose EXPLORATORY COMMITTEE
COMMITTEE ORGANIZED TO CIRCULATE OR OPPOSE A RECALL OTHER TYPE OF COMMITTEE (please describe)
A RECALL ELECTION
PETITION OR TO INFLUENCE THE RESULT OF
❑POLITICAL PARTY see A.R.S. §§ 16-801, 16-804,16-821 and 16-825)
CHECK HERE IF REGISTERED WITH THE SECRETARY OF S -'ATE AS A STANDING POLITICAL COMMITTEE PURSUANT TO A.R.S. § 16-902.01.
(You must provide a copy of the statement of organization filed with the Secretary of State designating standing committee status)
EACH POLITICAL COMMITTEE SHALL HAVE A CHAIRMAN AND TREASURER. THE POSITION OF CHAIRMAN AND TREASURER OF A SINGLE
POLITICAL COMMITTEE MAY NOT BE HELD BY THE SAME INDIVIDUAL, EXCEPT THAT A CANDIDATE MAY BE CHAIRMAN AND TREASURER OF
HIS OR HER OWN CAMPAIGN COMMITTEE. A.R.S. §16-902(A).
NAME OF COMMITTEE CHAIRMAN
CHAIRMAN'S TELEPHONE #
CHAIRMAN'S FAX#
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CHE�MMS ADDRESS
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CHAIRMAN'S OCCUPATION
CHAIRMAN'S EMPLOYER
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CHAIRMAN'S E -MAIL ADDRESS
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NAME OF COMMITTEE TREASURER
TREASURER'S TELEPHONE #
TREASUWER'S FAX
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TREASURER'S ADDRESS
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STATE ZIP
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TREASURER'S OCCUPATION
TREASURER'S EMPLOYER
TREASURER'S Et -MAIL ADDRESS
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A POLITICAL COMMITTEE THAT ACCEPTS A CONTRIBUTION OR MAKES AN EXPENDITURE SHALL DESIGNATE AT LEAST ONE ACCOUNT AT A
QUALIFIED FINANCIAL INSTITUTION (A.R.S. § 16-902(C)). LIST THE NAMES OF ALL FINANCIAL INSTITUTIONS WITH WHICH THE COMMITTEE
MAINTAINS ACCOUNTS OR SAFETY DEPOSIT BOXES. (Do not list account numbers.)
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FOR AN EXPLORATORY COMMITTEE OR A CANDIDATE'S CAMPAIGN COMMITTEE, PROVIDE THE FOLLOWING INFORMATION:
(Office sought is optional for an Exploratory Committee.)
NAME OF DESIGNATING INDIVIDUAL (DI) OR CANDIDATE CANDIDATE'S OR DESIGNATING INDIVIDUAL'S E-MAIL ADDRESS
OFFICE SOUGHT
DI's OR CANDIDATE'S ADDRESS I CITY I STATE I ZIP
CANDIDATE'S (or DESIGNATING INDIVIDUAL'S) STATEMENT: I authorize the above-named political committee as my political committee to receive
Contributions and make expenditures on my behalf for the election in 2016.
Date: 3 ' Candidate's or D/1's signature:
CHAIRMAN'S AND TREASURER'S STATEMENT: We, the undersigned, pursuant to A.R.S. § 16-902.01(86) have read all the applicable laws relating to
campaign finance and reporting and have examined the information contained in this statement of organizatiogi, and, to the best of our knowledge and belief,
it is true, correct and complete_..
Date:' 3 ( Chairman's signature:
Date: Treasurer's signature:
DEFINITION OF POLITICAL COMMITTEE: A.R.S. § 16-901(19) "Political committee" means any of the following:
a) A candidate or a candidate's campaign committee.
b) A separate, segregated fund established pursuant to section 16-920, subsection A, paragraph 3.
c) An association or combination of persons that circulates petitions in support of the qualification of a ballot measure, question or proposition.
d) An association or combination of persons that circulates a petition to recall a public officer.
e) A political party.
f) An association or combination of persons that meets both of the following requirements:
i. Is organized, conducted or combined for the primary purpose of influencing the result of any election in this state or in any county, city, town or
other political subdivision in this state, including a judicial retention election.
ii. Knowingly receives contributions or makes expenditures of more than five hundred dollars in connection with any election during a calendar year,
including a judicial retention election.
g) A political organization.
h) An exploratory committee.
The types of political committees are listed on the front of this form.
NOTE FOR INDIVIDUALS INVOLVED IN POLITICAL ACTIVITIES: An individual acting alone, unless that individual is a candidate, is not a political committee
under Arizona law and need not file a statement of organization. If any additional person or persons join the effort begun by an individual and meets the
definition of a "political committee" in A.R.S. § 16-901(19) under Arizona law, the committee must register pursuant to A.R.S. § 16-902.01(A).
NOTE FOR THOSE INVOLVED IN INITIATIVE, REFERENDUM AND RECALL EFFORTS: Before circulating initiative, referendum or recall petitions, a political
committee must file its statement of organization with the appropriate filing office. Signatures obtained on petitions prior to the filing of the statement of
organization are void and shall not be counted in determining the legal sufficiency of the petition. A.R.S. §§ 19-114(8) and 19-202(C). Even though an individual,
acting alone, may begin the initiative, referendum or recall effort, as soon as other persons join the effort to circulate petitions in support of the effort, the
association of persons must register as a political committee.