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HomeMy WebLinkAboutCampaign Finance Records - Statement of organization - Conchas for Glendale City Council - 3/28/202413 Initial Application STATE OF ARIZONA AAmended Ap lication COMMITTEE STATEMENT Date: OF ORGANIZATION COMMITTEE TYPE (choose one): © Candidate Committee Name (required): Conches for Glendale City Council MAR 2 8 2024 COMMITTEE ID NUMBER (office use only) acf-01 (first or last name & office) Candidate Information: Candidate's Name (required): Jose Guadalupe Conchas Jr. Candidate's mailing address (required): 4529 West Ocotillo Road Apt #211 Glendale, AZ 85301 Candidate's email address (required): lupe@lupeoonchas.com Candidate's phone number (required): (602) 312-5908 Candidate's website (if any): Office Sought (choose one): 0 County Office: DDlstrict f applicable): ®Cityrrown Office: Glendale ODistrict (if applicablpl Cactus District 0 School Board Office: 0 District (if applicable) 0 Special District Board: Wistrfct (if applicable): Election Cycle for Office Sought (year the election will take place) (required): Party Affiliation: 0 Democrat 0 Green 0 Libertarian 0 Republican ® ether: Nonpartisan (required for partisan offices% r0 Political Action Committee (PAC) mmittee 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: Sponsors name or nickname (required): (if applicable) Sponsors mailing address (required): Sponsors email address (required): Sponsor's phone number (if any): Sponsor's website (if any). Special Status (if applicable) 0 Political Party Committee Name (required): (must include party affiliation) ❑ 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 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) 0 Legislative District Party (must include proof of organization pursuant to A.R.S. § 16-823) 0 City or Town Party tmust include proof of qualification pursuant to A.R.S. § 16-802 or § 16-804) SSpecial Status —0 Standing Committee (must also complete separate standing committee registration) f applicable) Arizona Secretary of State Revision 7/29/2021 U Initial Application STATE OF ARIZONA COMMITTEE ID NUMBER El Amended Application COMMITTEE STATEMENT (office use only) Date: OF ORGANIZATION • 4 COMMITTEE INFORMATION: Contact Information: Committee's mailing address (required): Jose Guadalupe Conchas Jr. Committee's email address (required): lupe@lupeconchas-Corn Committee's phone number (if any): (602) 312-5908 Committee's website (if any): Chairperson's Information: Chairperson's name (required): Treasurer's Information: Bank or Financial Institution: (do not list acct numbers) DECLARATION AND SIGNATURES: Jose Guadalupe Conchas Jr. Chairperson's physical address (required): 4529 W Ocotillo Road Apt #211 Glendale 85301 Chairperson's mailing address (if different): 4529.W Ocotillo Road Apt #211 Glendale AZ 85301 Chairperson's email address (required), lupe@lupeconchas.com Chairperson's phone number (required): (602) 312-5908 Chairperson's employer (required): ONE Campaign Chairperson's occupation (required): Regional Organizing Manager Treasurers name (required): Jose Guadalupe Concha$ Jr. Treasurers physical address (required): 4529 W Ocotillo Road Apt #211 Glendale AZ 85301 Treasurers mailing address (if different): 4529 W Ocotillo Road Apt #211 Glendale AZ 85301 Treasurers email address (required): lupe@lupeconchas.com Treasurers phone number (required): (602) 312-5908 Treasurers employer (required): ONE Campaign Treasurers occupation (required): Regional Organizing Manager Bank name (required): MidFirst Bank Additional bank name (if applicable): None Additional bank name (if applicable): None 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 contributionstexpenditures 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: Treasurers signature: YA Candidate's signature (if applicable): u Date: 3<a&-% Date: 3 ` a 4 Date: Arizona Secretary of Slate Revision 7129/2021