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HomeMy WebLinkAboutCampaign Finance Records - Statement of organization - Best of the West - 7/2/2020❑Initial Application STATE OF ARIZONA E]Amendea Application COMMITTEE STATEMENT Date A -R-9020 OF ORGANIZATION COMMITTEE TYPE (choose one): Q Candidate ` Committee Name (required): BEST OF THE WEST (first or last name & office) Candidate information: Candidate's Name (required): Candidate's mailing address (required): Candidates email address (required): Candidate's phone number (required): _ Candidate's website (if any). Office Sought (choose one): ❑ Governor ❑ Secretary of State ❑ Superintendent of Public Instruction i COMMITTEE ID NUMBER (office use only) 119-04 ❑ Attorney General 0 State Treasurer ❑ State Mine Inspector ❑ Corporation Commissioner ❑ State Senate ❑ State House of Representatives ❑ District (required): ❑ County Office: — ❑ District (if applicable): n CitylTown Office: _. E)Districl (if applicable): Election Cycle for Office Sought (year the election will take place) (required): Party Affiliation: ❑ Democrat ❑ Green ❑ Libertarian ❑ Republican ❑ Other: (required for partisan offices) ❑✓ Political Action Committee (PAC) Committee Name (required). BEST OF THE WEST (if sponsored, must include sponsor's name) Political Function (optional): Contributions Candidate -Related Independent Expenditures (select any that apply) Ballot Measure Expenditures ❑ Recall Expenditures Sponsorship Information: Sponsor's name or nickname (required): Diane B. McCarthy _ _ _ (it applicable) Sponsor's mailing address (required): 5835 W. Belmont Ave Glendale, AZ Sponsor's email address (required): d ane.mccafthy(Ct)West-mec.Ot"4 _ Sponsors phone number (if any): 602-315-3517 Sponsor's website (if any): Special Status []Separate Segregated Fund of a Corporation, LLC, Partnership, or Union (if applicable) Standing Committee (must also complete separate standing committee registration) 0 Mega PAC (must provide proof of Mega PAC status to filing officer) (amended applications only) ElPolitical Party BEST OF THE WEST Committee Name (required): _ _ - (must include party affiliation) Jurisdiction. E] State Party (must include proof of qualification pursuant to A-R.S. § 16-801 or § 16-604) County Party (must include proof of qualification pursuant to A.R.S. § 16-802 or § 18-804) 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) (it applicable) Arizona Secretary of State Revision 11/55116 ❑ Initial Application Amended Application Date: A_-$-2020 COMMITTEE INFORMATION: STATE OF ARIZONA COMMITTEE STATEMENT OF ORGANIZATION COMMITTEE ID NUMBER (office use only) 19-04 Contact Information: Committee's mailing address (required): 5835 W. Belmont Ave Glendale, AZ Committee's email address (required): — Committee's phone number (if any): Committee's website (if any): Chairperson's Information: Chairperson's name (required): Diane B. McCarthy Chairperson's physical address (required): 5835 W. Belmont Ave Glendale, AZ Treasurer's Information: Bank or Financial Institution: (do not list acct numbers) DECLARATION AND SIGNATURES: Chairperson's mailing address (if different): Chairperson's email address (required): dlane.mccarthy@West-mec.org Chairperson's phone number (required): _602-31 5-3517 Chairperson's employer (required): retired Chairperson's occupation (required): retired Treasurer's name (required): Diane B. McCarthy Treasurer's physical address (required): 5835 W. Belmont Ave Glendale, AZ Treasurer's mailing address (if different): Treasurer's email address (required): diane.mccarthy@West-mec.org Treasurer's phone number (required): 602-315-3517 Treasurer's employer (required): retired Treasurer's occupation (required): retired Bank name (required): BMO Harris Bank Additional bank name (ifapplicable): Additional bank name (if applicable): 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) agree to comply with Arizona election law, including campaign finance laws codified at A.R.S. §§ 16-901 to 16-938; and (5) agree to accept all notifications and legal service of process for campaign finance purposes via the email address(es) provided he/re'!'!2. Chairperson's signature. V Date: (Az'�, a Treasurer's signature: _ Date: Candidate's signature (if applicable): Date: Arizona Secretary of State Revision 11/5/16