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HomeMy WebLinkAboutCampaign Finance Records - Statement of organization - No on Prop 499 – Sponsored by Arizona Free Enterprise Club - 10/16/2024Docusign Envelope ID: CB6E7A2C-8FAE-4222-BD3B-D2C64D9E5C74 F Initial Application _ STATEA12MZC�NA ® Amended Application COMMITTEE STATEMENT Date: 1u1 Iat OF ORGANIZATION COMMITTEE TYPE moose one): R ® Candidate Corrtrttrtti;+e Narrie triequlred): _. first or last name S office) Ca to inlonnaWn, Candidate's Name (required): Candidate's mailing address (required): Candidate's email address (required): _ Candidate's phone number (required): _ Candidate's website (if any): tea Sought (choose one): O County Offioe: OCitylTown Office: ® School Board Office: ® Special District Board: Ellecsibri Cyde for Office Sought (year the election will take place) (required): P"Aff'ittibff, ® Democrat © Green M Libertarian (required for partisan offices) ®District (If applicable): ©District (if applicable): 13 District (if applicable): ©District (if applicable)' C Republican 93 Other: COMMITTEE ID NUMBER (uffice use only) ~0 e Potttical Action Committee (PAC) Committee Name (required): t+Ci M i�Y7Si7 4Vt -,-Oal�:cikelA 04 ft Df �V" .,C O (if sponsored, must include sponsor's name) 000 POhWGW Function (optional): ❑ Contributions ❑ Candidate -Related Independent Expenditures (select any that apply) CFBallot Measure Expenditures ❑ Recall Expenditures Sponsorsfrgp Infa motion: Sponsor's name or nickname (required):&& "iYVI� 3ke- YV• Qy-t 14 0109 ('d applicable) Sponsor's mailing address (required):?Q ZZ.X sqG 3 C, Sponsor's email address (required): IYT(i ? fi1'?- oe- - 6 �'(4 I� Sponsor's phone number (if any): Sponsor's website (if any): • '&% Spedel Status 0 Separate Segregated Fund of a Corporation, LLC, Partnership, or Union (if appk") ❑ Standing Committee (must also complete separate standing committee registration) p Mega PAC (must provide proof of Mega PAC status to filing officer) (amended applications only) r r�n Powkcal PWtV i j CoMWee INerne (required): ovist indude party 0%360n) 1 J&Nbdk w' O State Party (must include proof of qualification pursuant to A.R,S. § 18-801 or § 16-804) O County Party (must Include proof of qualification pursuant to A.R.S. § 16-802 or § 16-804) O Legislative District Party (must include proof of organization pursuant to A.R.S. § 16.823) O City or Town Party (must Include proof of qualification pursuant to A.R,S. § 1tt-802 or § 16-04) Stat" 0 Stan4niP Committee (must also complete separate standing committee registration) Arizona Mary of Slats Revision 712W2021 Docusign Envelope ID: CB6E7A2C-8FAE-4222-BD3B-D2C64D9E5C74 b Initial Application STATE OF ARIZONA COMMITTEE ID NUMBER 13 Amended Ap I' 'on COMMITTEE STATEMENT (office use only) Date: Ilr L ;.,..— OF ORGANIZATION COMMITTEE INFORMATION: Contact information: Committee's mailing address (required): �2 ftut6 1, < Committee's email address (requiredy Committee's phone number (if any): Committee's website (if any): Chairperson's Information: Chairperson's name (required):']X�]Il Chairperson's physical address (required): 5 a (da k , A01-ff1 t � � t Z.J(ZC Chairperson's mailing address (if different): Chairperson's email address (required): V-e , 0( Chairperson's phone number (required): to l J — 5 -6 3 Chairperson's employer (required): t g► i'2ui a:l ).c1? _ � U!(�I,I�I�rG. &io Chairperson's occupation (required)!­*10,.1fiCU ��Y=C' �y' t— \ UCLA Treasurer's Information: Treasurer's name (required): 5 Treasurer's physical address (required): Qlu Treasurer's mailing address (if different): Treasurer's email address (required): l%W Q _ Treasurer's phone number (required): �G" 3� Treasurer's employer (required): n n _ �Y�t�1 1 ` �'� Cti1 XW Treasurer's occupation (required): �kr� Bank orRfnancialInstitution: Bank name (required):(]�_ (do not list acd numbers) Additional bank name (if applicable): Additional bank name (if applicable): DECLARATION AND SIGNATURES: 1 declare under penalty of perjury that the foregoing information Is true and correct. I further declare that is (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 contributionslexpenditures 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. Sig -by: Chairperson's nature:' Treasurers signature: Candkh te's signature (ff applicable): Date: 10/16/2024 Date: 10 1 Date: Arlxona 80=181Y of State Revtslon 7129/2021