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HomeMy WebLinkAboutCampaign Finance Records - Statement of organization - Preserve Our Parks and Open Spaces - 10/22/2020❑ Initial Application Amended Application Date: COMMITTEE TYPE (choose one): �1 VF. OLENDALE 7?0 t Et, _ °l `��►'� ARIZONA COMMITTEE STATEMENT OF ORGANIZATION 0 Candidate Committee Name (required): S !r E O u R PA fL K S Ani c> ©PC �5 PA G C S (first or last name & office) Candidate Information: Office Sought (choose one): Candidate's Name (required): Candidate's mailing address (required): Candidate's email address (required): _ Candidate's phone number (required): _ Candidate's website (if any): ❑ Governor ❑ Secretary of State Q Superintendent of Public Instructipn ❑ State Senate ❑ County Office: 0 City/Town Office: COMMITTEE ID NUMBER (office use only) -D5- ❑ Attorney General ❑ State Treasurer ❑ State Mine inspector ❑ Corporation Commissioner ❑ State House of Representatives ❑ District (required): Election Cycle for Office Sought (year the election will take place) (required): PertyA1i4llation: N/A ❑ Democrat ❑ Green ❑ Libertarian (required for partisan offices) ❑ District (if applicable): []District (if applicable): ❑ Republican ❑ Other: Political Action Committee (PAC) Committee Name (required): OU, PARK 5 OPEN S 4 6 E S (if sponsored, must include sponsor's name) Political Function (optional): Contributions []Candidate -Related Independent Expenditures (select any that apply) DBailot Measure Expenditures Recall Expenditures Sponsorship information: (if applicable) Special Status (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): ❑Separate Segregated Fund of a Corporation, LLC, Partnership, or Union OStanding 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): (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) E] 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 1115116 Initial Application ` STATE OF ARIZONA COMMITTEE ID NUMBER Amended Application COMMITTEE STATEMENT (office use only) Date: OF ORGANIZATION d —VV COMMITTEE INFORMATION: Contact Information: ja.r, t� %0Gtch0')an1,? Committee's mailing address (required): Y213 A% S'i srZW. G'JCyjafale, 1%Z �i.S3o2 Committee's email address (required): tAj71ra 6 eR r7-. /]e 7 - Committee's phone number (if airy): & 2 3 - 13 -1/ - /o.5-3 Committee's website (if any): Chairperson's Information: Chairperson's name (required): ` Y e llo Chairperson's physical address (required); 30a? n V x G /�rj r /, f?Z ��� 0� •�7 Chairperson's mailing address (if different): _ Chairperson's email address (required): a- r tr' // Chairperson's phone number (required): 0;7 - -5`7 7 - OX Chairperson's employer (required): Chairperson's occupation (required): C C r)_7-, %1 C Treasurer's Information: Treasurer's name (required): iS H 9 &Z ,,e- ME Treasurer's physical address (required): le ga 7 Al a � ��L u Treasurer's mailing address (it different): Treasurer's email address (required): e 0� 2 Treasurer's phone number (required): l 00? - 6 ,�3 - �' 2 Treasurer's employer (required): WeA/l ciC G fyu Treasurer's occupation (required): if 0-( ,12 - Bank or Financial Institution: Bank name (required): (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 receivelmake 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 herein. Chairperson's signature: G D,W Date- lO Treasurer's signature: Date. Candidate's signature (If applicable): Date: Arizona Secretary of State Revision 1115116