HomeMy WebLinkAboutCampaign Finance Records - Statement of organization - Bart Turner for Glendale City Council 2022 - 1/18/20220 Initial Application
13 Amended Application
Date:
COMMITTEE TYPE (choose one):
0 Candidate
r Committee Name (required):
+ (first or last name & office)
STATE OF ARIZONA
COMMITTEE STATEMENT
I. OF ORGANIZATION
COMMITTEE ID NUMBER
(office use only)
Candidate information: Candidate's Name (required): /
Candidate's mailing address (required): 7>
Candidate's email address (required):
Candidate's phone number (required): �/7 '/27 - 5 SQ%--
Candidate's website (if any): _
Office Sought (choose one): 0 County Office:
ODistrict (if applicable):
ty/Town Office:6 Ef lDistnct (if applicable):�-
0 School Board Office:
0 Special District Board:
0 District (if applicable):
ODistrict (if applicable):
Election Cycle for Office Sought (year the election will take place) (required): 26 Z-2
Party Affiliation: 0 Democrat 0 Green 0 Libertarian 0 Republican 0 Other:
(required for partisan offices)
0 Political Action Committee (PAC)
Committee Name (required):
(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:
(if applicable)
Special Status
1 (if applicable)
0 Political Party
Committee Name (required):
(must include party affiliation)
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):
17 '1
I'1]
❑ 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)
Jurisdiction: 0 State Parry (must include proof of qualification pursuant to A.R.S. § 16-801 or § 16-804)
0 County Party (must include proof of qualification pursuant to A.R.S. § 16-802 or § 16-804)
0 Legislative District Party (must include proof of organization pursuant to A.R.S. § 16-823)
0 City or Town Party (must include proof of qualification pursuant to A.R.S. § 16-802 or § 16-804)
Special Status El Standing Committee (must also complete separate standing committee registration)
(if applicable)
Arizona Secretary of State Revision 7/29/2021
® Initial Application STATE OF ARIZONA COMMITTEE ID NUMBER
0 Amended Application -= COMMITTEE STATEMENT (office use only)
Date: OF ORGANIZATION
r
COMMITTEE INFORMATION:
Contact Information: Committee's mailing address (required):
Committee's email address (required):
Committee's phone number (if any): 6 2- -
Committee's website (if any):
Chairperson's Information: Chairperson's name (required):
Chairperson's physical address (required): S'4 -J7 - — ✓ '�� '`
Chairperson's mailing address (if different): y
Chairperson's email address (required):Ai r 1 04.4— t
Chairperson's phone number (required):
Chairperson's employer (required): ev�- [�
Chairperson's occupation (required):
Treasurer's Information: Treasurer's name (required): T
Treasurer's physical address (required): "-",-7 /7
Treasurer's mailing address (if different)/: /y
Treasurer's email address (required): !6&4 4� A (!J'
Treasurer's phone number (required): KZ W
Treasurer's employer (required): d..
Treasurer's occupation (required): TG
Bank or Financial Institution: Bank name (required): %I [D rI L 4-27, P-1 S
(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. 1 -
Chairperson's signatun
Treasurer's signature:
Candidate's signature 1
Date: a t —/.5, zz.
Date 1 J Z?
Date:
Arizona Secretary of State Revision 7/29/2021