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HomeMy WebLinkAboutCampaign Finance Records - Statement of organization - Glendale Chamber PAC - 12/14/2021O Initial Application M Amended Application Date: 12/13/2021 COMMITTEE TYPE (choose one): O Candidate Committee Name (required): (first or last name & office) _3 DP STATE OF ARIZONA COMMITTEE ID NUMBER COMMITTEE STATEMENT (office use only) OF ORGANIZATION V7— 01 x Candidate Information: Candidate's Name (required): Candidate's mailing address (required): Candidate's email address (required): _ Candidate's phone number (required): _ Candidate's website (if any): Office Sought (choose one): O County Office: OCity/Town Office: O School Board Office: O Special District Board: Election Cycle for Office Sought (year the election will take place) (required): ODistrict (if applicable): ODistrict (if applicable): O District (if applicable): ODistrict (if applicable): Party Affiliation: O Democrat O Green O Libertarian 0 Republican O Other: (required for partisan offices) 0 Political Action Committee (PAC) Committee Name (required): Glendale Chamber PAC (if sponsored, must include sponsor's name) Political Function (optional): M Contributions 8 Candidate -Related Independent Expenditures (select any that apply) N Ballot Measure Expenditures B Recall Expenditures Sponsorship Information: (if applicable) Special Status (if applicable) El Political Party Committee Name (required): (must include party affiliation) Jurisdiction: Special Status (if applicable) Sponsor's name or nickname (required): NIA Sponsors mailing address (required): N/A Sponsor's email address (required): N/A Sponsor's phone number (if any): Sponsors website (if any): NIA ❑ Separate 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) O State Party (must include proof of qualification pursuant to A.R.S. § 16-801 or § 16-804) O County Party (must include proof of qualification pursuant to A.R.S. § 16-802 or § 16-804) El Legislative District Party (must include proof of organization pursuant to A.R.S. § 16-823) Cl City or Town Party (must include proof of qualification pursuant to A.R.S. § 16-802 or § 16-804) El Standing Committee (must also complete separate standing committee registration) Arizona Secretary of State Revision 7/29/2021 El Initial Application STATE OF ARIZONA COMMITTEE ID NUMBER M Amended Applicationgo COMMITTEE STATEMENT (office use only) Date: lzna/zo21 OF ORGANIZATION COMMITTEE INFORMATION: Contact information: Committee's mailing address (required): 5800 W. Glenn Dr., Ste. 275, Glendale AZ 85301 1 Committee's email address (required): rheidt@glendaleazchamber.org Committee's phone number (if any): (623) 937-4754 Committee's website (if any): glendaleazchamber.org Chairpersons information: Chairperson's name (required): Yvonne Knaack Chairperson's physical address (required): 5314 W. Whispering Wind Dr., Glendale AZ 85310 Chairperson's mailing address (if different): Same as Above Chairperson's email address (required): yvonne.knaack@hotmail.com Chairperson's phone number (required): (602) 319-2010 Chairperson's employer (required): Retired Chairperson's occupation (required): Downtown Business Owner Treasurer's information: Treasurer's name (required): Amber Wilson Treasurer's physical address (required): 2738 E. Decatur St. Treasurer's mailing address (if different): Same as Above Treasurer's email address (required): awilson@glendaleazchamber.org Treasurer's phone number (required): (602) 510-5375 Treasurer's employer (required): Glendale Chamber of Commerce Treasurer's occupation (required): Senior Director of Public Policy, Education, & Workforce Bank or Financial institution: Bank name (required): BMO Harris Bank (do not list acct numbers) Additional bank name (if applicable): 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) 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: T[rn n _ O 1ti 4 Amber Wilson Digitally signed by Amber Wilson Treasurer's signature: Date: 2021.12.1316:11:28-07'00' Candidate's signature (if applicable): Date: 12/13/2021 Date: 12/13/2021 Date: Arizona Secretary of State Revision 7/29/2021