HomeMy WebLinkAboutCampaign Finance Records - Statement of organization - Aldama for Mayor - 5/16/2023D Initial Application
Ill Amended A pplication
STATE OF ARIZONA
COMMITTEE STATEMENT
OF ORGANIZATION
COMMITTEE ID NUMBER
(office use only)
Date : _____ _
COMMITTEE TYPE (choose one):
Ill Cand idate
Committee Name (required): ~\ ~°'-b?'< Mi½( o..r
(first or last name & office)
Candidate Information : Candidate's Name (re quired): ::S:o..~ C. \.t.lG..VV\O\..
Candidate's ma iling address (required ): {J,$4,\ I.U · fDltA-~t-M-\2$" c;{e..J.i:k fn. 3"S',.S'), \ ..
Candidate's email address (requ ired ): ~ o..\.clc.m.4-. 2olo ti) 'ta.bee? ·CDIIY\ c~:
Cand id ate 's phone n umber (required): (j,2,'3 -2.olp -1 %IP 7 :Q
Candidate's website (if any): _______________________ _
Office Sought (choose one): Eil Cou nty Office : ~District (if applicable): ________ _
¢city/Town Office : G\e.,wl r.\e.,. !llDistri ct (if applicable): ---------
Cl School Board Office : 1:1 D istrict (if applicable):
Cl Special District Bo ard : _________ Cl D istrict (if applicab le): _______ _
Election Cycle for Office Sought (year the election will take place) (requi red ): ----"2 _0:._'2..;_~-L----
Party Affiliation : Cl Democrat CJ Green [!J Libertarian Cl Re p ubl ican C!I Other: _______ _
(required for partisan offices)
Cl Po li tica l Act ion Comm ittee (PAC)
Committee Name (required):
(if sponsored , m ust include
sponsor's name)
Political Function (optional ):
(select any that a pply)
Sponsorship Information:
(if a pplicable)
Special Status
(if applicable)
Cl Polit ica l Pa rt y
Committee Name (required):
(must include party affiliation )
Jurisdiction :
Special Status
(if applicable)
□ Contributions □ Cand idate-Related Independent Expenditures
□ Ba ll ot Measure Expenditures □ Recall Exp enditures
Sponsor's name or nickname (required): ___________________ _
Sponsor's mailing address (req uired): ____________________ _
Sponsor's email add re ss (re qu ired): _____________________ _
Sponsor's phone number (i f any): ______________________ _
Sponsor's website (i f any): ________________________ _
□ Separate Segregated Fund of a Corporation , LLC , Partnersh ip , or Union
□ Standing Committee (must also complete separate stand ing committee registration )
□ Mega PAC (must provide proof of Mega PAC status to fili ng officer) (amended applications only)
C State Party (m ust include proof of qua lification pursuant to A .R .S . § 16-801 or§ 16-804)
D County Party (must include proof of qualification pursuant to A.R.S . § 16-802 or§ 16-804)
CJ Legislative District Party (must include proof of organization pursuant to A.R.S . § 16-823)
!ll City or Town Party (must include proof of qua lification pursuant to A .R .S . § 16-802 or§ 16-804)
D Standing Committee (must also complete separate standing committee registration)
Arizona Secretary of State Revisio n 7/29/2021
....,. er·,
:C• :::::
23-04
Cl Initial Application
Cl Amended Application
Date: _____ _
COMMITTEE INFORMATION:
Contact Information:
Chairperson 's Information :
Treasure r's Information :
Bank or Financial Institution:
(do not list acct numbers )
DECLARATION AND SIGNATURES:
STATE OF ARIZONA
COMMITTEE STATEMENT
OF ORGANIZATION
COMMITTEE ID NUMBER
(office use only}
Committee 's mailing address (required): l,S'Li. \ tJ · (cl""' ~-~ I 2..6'" G/J~k ~ ~l
Committee 's email address (requ ired ): • \'tlJ.&.\l\'1A.. '2{;;>l( G) ~ "-'1W · C.C .-v1
Committee 's phone number (if any): ____________________ _
Committee 's website (if any): ______________________ _
Chairperson 's name (required): _--S-=°""'acs.~·.J!...-._'A.~vlc..=~W\,=-''-C---------~----
Chairperson 's physical address (required):l6~\ tJ · foitl-~t:.-M I~ ~ l'Q_ ~C> \
Chairperson 's mailing address (if different):------~------------
Chairperson 's email address (required ): • ~ a~~oilt) Ip ;;) yt.tl-i oo • (,c '-'.'C}
Chairperson 's phone number (required): .,,.t,'-'2=--3--_,1.(;)(e""""=---7.!...J<~-'(p,::_7.L.._ _________ _
Chairperson 's employer (required):tr\l;ic~W>f toMW)\l~~kt C.ol\~e ~~s.\-..,lc:k-
Chairperson 's occupation (required): D \ :cB C,, ~.,.-D f '=:o..c:,.·, \ ~ \:-\<,..'$
Treasurer's name (required ): -Sa.vy{ 1 C:, l'\.\.olc..vn t,...
Treasurer's physical address (required):(oS'-l\ )J · l,7!A--1/lvl · P-t?~-1 ~ (Mtr-Jli.ll ~ ~\
Treasurer's mailing address (if different): __________________ _
Treasurer's email address (required):') a.\.<l.~n ~ Z.O\e ~ '4c;J;io,p · (.,wl1.
Treasurer's phone number (required ): ..,(""0""'2.""3:c..._-....,,2. ... £>:......,,(,pc...-_=J-LJ2'L-,:;b _l....:.... _________ _
Treasurer's employer (required):rf\c...--, w(?~ W2M MY Yl ~½{ C,p\~ ~l<;..\-f~J-
Treasurer's occupation (required): D,c e.c.A:e< O f F~:ic,;, \ \ 1/~ ~ 5
Bank name (required}: \,u t,.\\s t:0..-C'j 0
Additional bank name (if applicable}: ____________________ _
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) des ignate 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 compl · h Arizona election law , including campaign finance laws codified at A.RS .
§§ 16-901 to 16-938 ; and (5) agree to accept all notifi o and legal service of process for campaign finan e purposes via the ema il
address(es) provided herein .
Arizona Secretary of State Revision 7/29/2021
23-04