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HomeMy WebLinkAboutCampaign Finance Records - Statement of organization - Conchas for Glendale City Council - 1/19/20244 _jpj%j -j f=i pm-1 r 41 � :I T Y C':._EPK Initial Application STATE OF ARIZONA El Amy COMMITTEE STATEMENT Dam ! OF ORGANIZATION COMMfTTEE TYPE (chose one): COMMITTEE ID NUMBER (office use only) o9LA' CA ® Candidate Co►rrmittee Name (requirady Conchas for Glendale City Council (first or last name & office) Candidate !nkwnw tam. Candidate's Name (sequined): Jose Guadalupe Congas Jr. Candidate's maTwg address (required): 4529 west Ocktillo Road Apt #211 Glendale, AZ 85301 Candid'ate°s emal address (nxpriredy lupe@lupeconchas.00m CandidgWs phone number (required): (602) 312-59N Candidate's website (if any): Office Sought (choose ones 0 County Office: ®District (iapplicable): 93Cityrrown Office: Glendale ®District (if applicable): Callus District 0 School Board Office: p District (if appicablek Geet� 13 Special District Board: aDistric (if applicable): GooluBiaMet Becton Cycle far Office Sought (year the election will take place) (required): ParlyAfhlratiorr. 19 Democrat 13 Green M Libertarian (required for partisan offices) 13 Political Action Committee (PAC) Corru►irttee Name (required): (if sponsored, must include sponsor's name) 13 Republican B 01he Piordical Function (optional): ❑ Contributions ❑ Candidate -Related Independent Expenditures (select any that apply) ❑ Ballot Measure Expenditures ❑ Recall FIendihxes Sponsorship IrA n at iow Cif applicable) (d applicable) B Political Party Cormniffee Wame (requiredy (must include party affiliation) Jurisadion. SpecW Status (if apples) Sponsors name or nickname (required _ Sponsors mailing address (required): Sponsors email address (required): Sponsors phone number (if any): Sponsors website (if any): ❑ 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 fling officer) (amended applications only) 10 State Party (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. § 164302 or § 16-804) 13 Legislative District Party (must kx*We proof of organization pursuant to A.R.S. § 164123) 13 City or Town Party (must include proof of qualification pursuant to A.R.S. § 16.802 or § 16-804) 13 Standing Committee (must also complete separate standing committee registration) Arizona Secretary of State Revision 7/29/2021 ® 6ilial Application STATE OF ARIZONA COMMITTEE ID NUMBER 13 Ameiided Application COMMITTEE STATEMENT (off use only) Date: OF ORGANIZATION aL(- D\ _i [0 X �7711aItd1ZI-f.,i FAIiVI"Q Conmd hrba naftr Comnittee's mailing address (required): Jose Guadalupe Conchas Jr. Committee's email address (required): lupe@lupeconchas.com Committee's phone number (d anyr (602) 312-59M Commmmittee's website (if any): Chairpersons Infonnaffor Chairperson's name (required): Jose Guadalupe Conchas Jr. Chairperson's physical address (required): 4529 W Ocotillo Road Apt #211 Glendale 85301 Chairperson's mailing address (d different): 4529 W Ocatgo Road Apt #211 Glendale AZ 85301 Chairperson's email address (required): lupe@lupeconchas.00m Chaxpersois phone number (mquiredr (602) 312-5908 Chairperson's employer (required): ONE Campaign Chakperson s,cc upation (mquiredr Regional Organizing Manager Treasurer's hfomaborr Treasurers name (required): Jose Guadalupe Condlas Jr. — Treasurer's physical address (required): 4529 W Ocotillo Road Apt #211 Glendale AZ 85301 Treasurers mailing address (d different): 4529 W Ocotillo Road Apt #211 Glendale AZ 85301 Treasurers email address (required): lupe@lupeconchas.com Treasurer's phone number (required): (602) 312-5908 - --- - Treasurers employer (required): ONE Campaign Treasurers occupation (required): Regional Organizing Manager Bank or Fimmial Iruhiutiar Bank name (required): Chase Bank (do not ist act nmbeis) Additional bank name (if applicable): None Additional bank name (d applicable): None DECLARATION Arm SW -A AIURES. I declare minder penally of perjury that the foregoing irdorrnation is true and correct I firttmer declare that 1: (1) consent to serve as chairperson or treasurer of the commilee named herein, if a ppk able; (2) desigiate the above -named committee as my official candidate committee and authorize it to receimveJmake contributiomsfexpendihires on my behalf. if appicable; (3) have read the Secretary of State's campaign fnarce and reporting glide; (4) agree to comply with Arizona election 12W. including campaign finaree laws codified at A.R.S. §§ 1 ti 901 to 16a38; and (5) agree to accept all notifications and legal service of process for campaign finance purposes via the email address(es) provided hareirL Chairperson's signraftm n d•0 Treasurers signature: 44 Ca didale's signat re (d appficabler llutd- Daw !.-/Y aaaq Date. l 1 Loa N Date. Arizona Secretary of State Revision 7/29/2021