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Name:
Address: City State Zip
Pursuant to A.R.S. §§16-941(D),-956, -958, and A.A.C. R2-20-109(F)
!"#"$%&'(!)%*&(%)%!#"+&'(!+,,"''"+&("-./0/-./-1(%20/-.3145/(6/0751(( (
Name of Authorized Agent: Telephone Number: E-mail Address:
Telephone Number: Fax Number:
Authorized Agent Address (if different from above): City State Zip
*88(0/597-9:(3-;84.3-<(;75075=137-9:(83>31/.(83=?3831@(;7>0=-3/9:(=-.(8=?75(75<=-3A=137-9:(=5/(5/B435/.(17(C38/(3-./0/-./-1(/20/-.3145/(5/07519(4-./5(*D6D'D(EE(FGHIJFKLMN(HIOP(Q(*53AD(*.>3-D(!7./(6RHRSHFSIKTMD((U8/=9/(C388(741:(9;=-(=-.(5/145-(17(1V/(*53A7-=(!313A/-9(!8/=-(%8/;137-9(!7>>39937-:([email protected](Forms received within 24 hours of the date of expenditure will be considered timely. Failure to file the form and submit the information required subjects an entity that makes independent expenditures to penalties under the Clean Elections Act unless the entity receives an exemption from the Commission. Exemption forms are available at www.azcleanelections.gov. Please contact [email protected] or 602-364-3477 with questions. I, the undersigned, certify that the above statements are true and accurate to the best of my knowledge and belief:
__________________________________________________________ Signature of Authorized Agent
05/2016
!""#$#%& '() !*&+
□(6/;/3W/.(XXXXXXX(
Date of Expenditure (i.e. 5/30/2016) Amount of Expenditure (i.e. $5,000.00) Candidate Supported /Opposed
__________________________________________________________ Signature of Authorized Agent
Responsible Leadership for AZ
516 East Willetta Street Phoenix AZ 85004
Tom Farley [email protected]
$5,250.00 Barton/Support11/3/2016
Responsible Leadership for AZ
516 East Willetta Street Phoenix AZ 85004
Tom Farley [email protected]
$5,250.00 Barton/Support11/3/2016
Name:
Address: City State Zip
Pursuant to A.R.S. §§16-941(D),-956, -958, and A.A.C. R2-20-109(F)
!"#"$%&'(!)%*&(%)%!#"+&'(!+,,"''"+&("-./0/-./-1(%20/-.3145/(6/0751(( (
Name of Authorized Agent: Telephone Number: E-mail Address:
Telephone Number: Fax Number:
Authorized Agent Address (if different from above): City State Zip
*88(0/597-9:(3-;84.3-<(;75075=137-9:(83>31/.(83=?3831@(;7>0=-3/9:(=-.(8=?75(75<=-3A=137-9:(=5/(5/B435/.(17(C38/(3-./0/-./-1(/20/-.3145/(5/07519(4-./5(*D6D'D(EE(FGHIJFKLMN(HIOP(Q(*53AD(*.>3-D(!7./(6RHRSHFSIKTMD((U8/=9/(C388(741:(9;=-(=-.(5/145-(17(1V/(*53A7-=(!313A/-9(!8/=-(%8/;137-9(!7>>39937-:([email protected](Forms received within 24 hours of the date of expenditure will be considered timely. Failure to file the form and submit the information required subjects an entity that makes independent expenditures to penalties under the Clean Elections Act unless the entity receives an exemption from the Commission. Exemption forms are available at www.azcleanelections.gov. Please contact [email protected] or 602-364-3477 with questions. I, the undersigned, certify that the above statements are true and accurate to the best of my knowledge and belief:
__________________________________________________________ Signature of Authorized Agent
05/2016
!""#$#%& '() !*&+
□(6/;/3W/.(XXXXXXX(
Date of Expenditure (i.e. 5/30/2016) Amount of Expenditure (i.e. $5,000.00) Candidate Supported /Opposed
__________________________________________________________ Signature of Authorized Agent
Responsible Leadership for AZ
516 East Willetta Street Phoenix AZ 85004
Tom Farley [email protected]
Brophy McGee/Support$5,250.00 Hamway/Support
11/3/2016 $5,250.0011/3/2016
11/3/2016 $5,250.00 Pratt/Support
Responsible Leadership for AZ
516 East Willetta Street Phoenix AZ 85004
Tom Farley [email protected]
Brophy McGee/Support
$5,250.00 Hamway/Support
11/3/2016 $5,250.00
11/3/2016
11/3/2016 $5,250.00 Pratt/Support
Name:
Address: City State Zip
Pursuant to A.R.S. §§16-941(D),-956, -958, and A.A.C. R2-20-109(F)
CITIZENS CLEAN ELECTIONS COMMISSION Independent Expenditure Report
Name of Authorized Agent: Telephone Number: E-mail Address:
Telephone Number: Fax Number:
Authorized Agent Address (if different from above): City State Zip
All persons, including corporations, limited liability companies, and labor organizations, are required to file independent expenditure reports under A.R.S. §§ 16-941(D); -958 & Ariz. Admin. Code R2-20-109(F). Please fill out, scan and return to the Arizona Citizens Clean Elections Commission, [email protected]. Forms received within 24 hours of the date of expenditure will be considered timely. Failure to file the form and submit the information required subjects an entity that makes independent expenditures to penalties under the Clean Elections Act unless the entity receives an exemption from the Commission. Exemption forms are available at www.azcleanelections.gov. Please contact [email protected] or 602-364-3477 with questions. I, the undersigned, certify that the above statements are true and accurate to the best of my knowledge and belief:
__________________________________________________________ Signature of Authorized Agent
05/2016
OFFICIAL USE ONLY
□ Received _______
Date of Expenditure (i.e. 5/30/2016) Amount of Expenditure (i.e. $5,000.00) Candidate Supported /Opposed
Responsible Leadership for AZ
516 East Willetta Street Phoenix AZ 85004
Tom Farley [email protected]
Robson & Norgaard/Support
9280.00 Barton & Allen/Support
10/27/2016 9800.26
10/27/2016
Name:
Address: City State Zip
Pursuant to A.R.S. §§16-941(D),-956, -958, and A.A.C. R2-20-109(F)
!"#"$%&'(!)%*&(%)%!#"+&'(!+,,"''"+&("-./0/-./-1(%20/-.3145/(6/0751(( (
Name of Authorized Agent: Telephone Number: E-mail Address:
Telephone Number: Fax Number:
Authorized Agent Address (if different from above): City State Zip
*88(0/597-9:(3-;84.3-<(;75075=137-9:(83>31/.(83=?3831@(;7>0=-3/9:(=-.(8=?75(75<=-3A=137-9:(=5/(5/B435/.(17(C38/(3-./0/-./-1(/20/-.3145/(5/07519(4-./5(*D6D'D(EE(FGHIJFKLMN(HIOP(Q(*53AD(*.>3-D(!7./(6RHRSHFSIKTMD((U8/=9/(C388(741:(9;=-(=-.(5/145-(17(1V/(*53A7-=(!313A/-9(!8/=-(%8/;137-9(!7>>39937-:([email protected](Forms received within 24 hours of the date of expenditure will be considered timely. Failure to file the form and submit the information required subjects an entity that makes independent expenditures to penalties under the Clean Elections Act unless the entity receives an exemption from the Commission. Exemption forms are available at www.azcleanelections.gov. Please contact [email protected] or 602-364-3477 with questions. I, the undersigned, certify that the above statements are true and accurate to the best of my knowledge and belief:
__________________________________________________________ Signature of Authorized Agent
05/2016
!""#$#%& '() !*&+
□(6/;/3W/.(XXXXXXX(
Date of Expenditure (i.e. 5/30/2016) Amount of Expenditure (i.e. $5,000.00) Candidate Supported /Opposed
__________________________________________________________ Signature of Authorized Agent
Responsible Leadership for AZ
516 East Willetta St. Phoenix AZ 85004
Tom Farley [email protected]
Norgaard/Support$375.00 Robson/Support
10/24/2016 $375.0010/24/2016
10/24/2016 $750.00 Kate Brophy McGee/Support
Responsible Leadership for AZ
516 East Willetta St. Phoenix AZ 85004
Tom Farley [email protected]
Norgaard/Support
$375.00 Robson/Support
10/24/2016 $375.00
10/24/2016
10/24/2016 $750.00 Kate Brophy McGee/Support
Name:
Address: City State Zip
Pursuant to A.R.S. §§16-941(D),-956, -958, and A.A.C. R2-20-109(F)
!"#"$%&'(!)%*&(%)%!#"+&'(!+,,"''"+&("-./0/-./-1(%20/-.3145/(6/0751(( (
Name of Authorized Agent: Telephone Number: E-mail Address:
Telephone Number: Fax Number:
Authorized Agent Address (if different from above): City State Zip
*88(0/597-9:(3-;84.3-<(;75075=137-9:(83>31/.(83=?3831@(;7>0=-3/9:(=-.(8=?75(75<=-3A=137-9:(=5/(5/B435/.(17(C38/(3-./0/-./-1(/20/-.3145/(5/07519(4-./5(*D6D'D(EE(FGHIJFKLMN(HIOP(Q(*53AD(*.>3-D(!7./(6RHRSHFSIKTMD((U8/=9/(C388(741:(9;=-(=-.(5/145-(17(1V/(*53A7-=(!313A/-9(!8/=-(%8/;137-9(!7>>39937-:([email protected](Forms received within 24 hours of the date of expenditure will be considered timely. Failure to file the form and submit the information required subjects an entity that makes independent expenditures to penalties under the Clean Elections Act unless the entity receives an exemption from the Commission. Exemption forms are available at www.azcleanelections.gov. Please contact [email protected] or 602-364-3477 with questions. I, the undersigned, certify that the above statements are true and accurate to the best of my knowledge and belief:
__________________________________________________________ Signature of Authorized Agent
05/2016
!""#$#%& '() !*&+
□(6/;/3W/.(XXXXXXX(
Date of Expenditure (i.e. 5/30/2016) Amount of Expenditure (i.e. $5,000.00) Candidate Supported /Opposed
__________________________________________________________ Signature of Authorized Agent
Responsible Leadership for AZ
516 East Willetta Street Phoenix AZ 85012
Tom Farley [email protected]
Brenda Barton/Support$4640.00 Sylvia Allen/Support
10/18/2016 $4640.0010/18/2016
10/18/2016 $2764.68 Frank Pratt/Support
Responsible Leadership for AZ
516 East Willetta Street Phoenix AZ 85012
Tom Farley [email protected]
Brenda Barton/Support
$4640.00 Sylvia Allen/Support
10/18/2016 $4640.00
10/18/2016
10/18/2016 $2764.68 Frank Pratt/Support
Name:
Address: City State Zip
Pursuant to A.R.S. §§16-941(D),-956, -958, and A.A.C. R2-20-109(F)
!"#"$%&'(!)%*&(%)%!#"+&'(!+,,"''"+&("-./0/-./-1(%20/-.3145/(6/0751(( (
Name of Authorized Agent: Telephone Number: E-mail Address:
Telephone Number: Fax Number:
Authorized Agent Address (if different from above): City State Zip
*88(0/597-9:(3-;84.3-<(;75075=137-9:(83>31/.(83=?3831@(;7>0=-3/9:(=-.(8=?75(75<=-3A=137-9:(=5/(5/B435/.(17(C38/(3-./0/-./-1(/20/-.3145/(5/07519(4-./5(*D6D'D(EE(FGHIJFKLMN(HIOP(Q(*53AD(*.>3-D(!7./(6RHRSHFSIKTMD((U8/=9/(C388(741:(9;=-(=-.(5/145-(17(1V/(*53A7-=(!313A/-9(!8/=-(%8/;137-9(!7>>39937-:([email protected](Forms received within 24 hours of the date of expenditure will be considered timely. Failure to file the form and submit the information required subjects an entity that makes independent expenditures to penalties under the Clean Elections Act unless the entity receives an exemption from the Commission. Exemption forms are available at www.azcleanelections.gov. Please contact [email protected] or 602-364-3477 with questions. I, the undersigned, certify that the above statements are true and accurate to the best of my knowledge and belief:
__________________________________________________________ Signature of Authorized Agent
05/2016
!""#$#%& '() !*&+
□(6/;/3W/.(XXXXXXX(
Date of Expenditure (i.e. 5/30/2016) Amount of Expenditure (i.e. $5,000.00) Candidate Supported /Opposed
__________________________________________________________ Signature of Authorized Agent
Responsible Leadership for AZ
516 East Willetta Street Phoenix AZ 85004
Tom Farley [email protected]
Shope/Support$2764.66 Cook/Support
10/18/2016 $2764.6610/18/2016
10/18/2016 4900.13 Norgaard/Support
Responsible Leadership for AZ
516 East Willetta Street Phoenix AZ 85004
Tom Farley [email protected]
Shope/Support
$2764.66 Cook/Support
10/18/2016 $2764.66
10/18/2016
10/18/2016 4900.13 Norgaard/Support
Name:
Address: City State Zip
Pursuant to A.R.S. §§16-941(D),-956, -958, and A.A.C. R2-20-109(F)
CITIZENS CLEAN ELECTIONS COMMISSION Independent Expenditure Report
Name of Authorized Agent: Telephone Number: E-mail Address:
Telephone Number: Fax Number:
Authorized Agent Address (if different from above): City State Zip
All persons, including corporations, limited liability companies, and labor organizations, are required to file independent expenditure reports under A.R.S. §§ 16-941(D); -958 & Ariz. Admin. Code R2-20-109(F). Please fill out, scan and return to the Arizona Citizens Clean Elections Commission, [email protected]. Forms received within 24 hours of the date of expenditure will be considered timely. Failure to file the form and submit the information required subjects an entity that makes independent expenditures to penalties under the Clean Elections Act unless the entity receives an exemption from the Commission. Exemption forms are available at www.azcleanelections.gov. Please contact [email protected] or 602-364-3477 with questions. I, the undersigned, certify that the above statements are true and accurate to the best of my knowledge and belief:
__________________________________________________________ Signature of Authorized Agent
05/2016
OFFICIAL USE ONLY
□ Received _______
Date of Expenditure (i.e. 5/30/2016) Amount of Expenditure (i.e. $5,000.00) Candidate Supported /Opposed
Responsible Leadership for AZ
516 East Willetta Street Phoenix AZ 85004
Tom Farley [email protected]
$4900.13 Robson/Support10/18/2016
Name:
Address: City State Zip
Pursuant to A.R.S. §§16-941(D),-956, -958, and A.A.C. R2-20-109(F)
CITIZENS CLEAN ELECTIONS COMMISSION Independent Expenditure Report
Name of Authorized Agent: Telephone Number: E-mail Address:
Telephone Number: Fax Number:
Authorized Agent Address (if different from above): City State Zip
All persons, including corporations, limited liability companies, and labor organizations, are required to file independent expenditure reports under A.R.S. §§ 16-941(D); -958 & Ariz. Admin. Code R2-20-109(F). Please fill out, scan and return to the Arizona Citizens Clean Elections Commission, [email protected]. Forms received within 24 hours of the date of expenditure will be considered timely. Failure to file the form and submit the information required subjects an entity that makes independent expenditures to penalties under the Clean Elections Act unless the entity receives an exemption from the Commission. Exemption forms are available at www.azcleanelections.gov. Please contact [email protected] or 602-364-3477 with questions. I, the undersigned, certify that the above statements are true and accurate to the best of my knowledge and belief:
__________________________________________________________ Signature of Authorized Agent
05/2016
OFFICIAL USE ONLY
□ Received _______
Date of Expenditure (i.e. 5/30/2016) Amount of Expenditure (i.e. $5,000.00) Candidate Supported /Opposed
Responsible Leadership for AZ
516 East Willetta St. Phoenix AZ 85021
Tom Farley [email protected]
Support/Barton
4640.00 Support/ Allen
10/8/2016 4640.00
10/8/2016
10/8/2016 2764.68 Support/Pratt
Name:
Address: City State Zip
Pursuant to A.R.S. §§16-941(D),-956, -958, and A.A.C. R2-20-109(F)
CITIZENS CLEAN ELECTIONS COMMISSION Independent Expenditure Report
Name of Authorized Agent: Telephone Number: E-mail Address:
Telephone Number: Fax Number:
Authorized Agent Address (if different from above): City State Zip
All persons, including corporations, limited liability companies, and labor organizations, are required to file independent expenditure reports under A.R.S. §§ 16-941(D); -958 & Ariz. Admin. Code R2-20-109(F). Please fill out, scan and return to the Arizona Citizens Clean Elections Commission, [email protected]. Forms received within 24 hours of the date of expenditure will be considered timely. Failure to file the form and submit the information required subjects an entity that makes independent expenditures to penalties under the Clean Elections Act unless the entity receives an exemption from the Commission. Exemption forms are available at www.azcleanelections.gov. Please contact [email protected] or 602-364-3477 with questions. I, the undersigned, certify that the above statements are true and accurate to the best of my knowledge and belief:
__________________________________________________________ Signature of Authorized Agent
05/2016
OFFICIAL USE ONLY
□ Received _______
Date of Expenditure (i.e. 5/30/2016) Amount of Expenditure (i.e. $5,000.00) Candidate Supported /Opposed
Responsible Leadership for AZ
516 East Willetta St. Phoenix AZ 85021
Tom Farley [email protected]
Support/Cook
2764.66 Support/Shope
10/8/2016 2764.66
10/8/2016
10/8/2016 4900.00 Support/Norgaard
Name:
Address: City State Zip
Pursuant to A.R.S. §§16-941(D),-956, -958, and A.A.C. R2-20-109(F)
!"#"$%&'(!)%*&(%)%!#"+&'(!+,,"''"+&("-./0/-./-1(%20/-.3145/(6/0751(( (
Name of Authorized Agent: Telephone Number: E-mail Address:
Telephone Number: Fax Number:
Authorized Agent Address (if different from above): City State Zip
*88(0/597-9:(3-;84.3-<(;75075=137-9:(83>31/.(83=?3831@(;7>0=-3/9:(=-.(8=?75(75<=-3A=137-9:(=5/(5/B435/.(17(C38/(3-./0/-./-1(/20/-.3145/(5/07519(4-./5(*D6D'D(EE(FGHIJFKLMN(HIOP(Q(*53AD(*.>3-D(!7./(6RHRSHFSIKTMD((U8/=9/(C388(741:(9;=-(=-.(5/145-(17(1V/(*53A7-=(!313A/-9(!8/=-(%8/;137-9(!7>>39937-:([email protected](Forms received within 24 hours of the date of expenditure will be considered timely. Failure to file the form and submit the information required subjects an entity that makes independent expenditures to penalties under the Clean Elections Act unless the entity receives an exemption from the Commission. Exemption forms are available at www.azcleanelections.gov. Please contact [email protected] or 602-364-3477 with questions. I, the undersigned, certify that the above statements are true and accurate to the best of my knowledge and belief:
__________________________________________________________ Signature of Authorized Agent
05/2016
!""#$#%& '() !*&+
□(6/;/3W/.(XXXXXXX(
Date of Expenditure (i.e. 5/30/2016) Amount of Expenditure (i.e. $5,000.00) Candidate Supported /Opposed
__________________________________________________________ Signature of Authorized Agent
Responsible Leadership for AZ
516 East Willetta St. Phoenix AZ 85021
Tom Farley [email protected]
Support/Brophy McGee13,500.00 Support/Robson
10/8/2016 10,000.0010/8/2016
10/8/2016 10,000.00 Support/Hamway
Responsible Leadership for AZ
516 East Willetta St. Phoenix AZ 85021
Tom Farley [email protected]
Support/Brophy McGee
13,500.00 Support/Robson
10/8/2016 10,000.00
10/8/2016
10/8/2016 10,000.00 Support/Hamway
Name:
Address: City State Zip
Pursuant to A.R.S. §§16-941(D),-956, -958, and A.A.C. R2-20-109(F)
!"#"$%&'(!)%*&(%)%!#"+&'(!+,,"''"+&("-./0/-./-1(%20/-.3145/(6/0751(( (
Name of Authorized Agent: Telephone Number: E-mail Address:
Telephone Number: Fax Number:
Authorized Agent Address (if different from above): City State Zip
*88(0/597-9:(3-;84.3-<(;75075=137-9:(83>31/.(83=?3831@(;7>0=-3/9:(=-.(8=?75(75<=-3A=137-9:(=5/(5/B435/.(17(C38/(3-./0/-./-1(/20/-.3145/(5/07519(4-./5(*D6D'D(EE(FGHIJFKLMN(HIOP(Q(*53AD(*.>3-D(!7./(6RHRSHFSIKTMD((U8/=9/(C388(741:(9;=-(=-.(5/145-(17(1V/(*53A7-=(!313A/-9(!8/=-(%8/;137-9(!7>>39937-:([email protected](Forms received within 24 hours of the date of expenditure will be considered timely. Failure to file the form and submit the information required subjects an entity that makes independent expenditures to penalties under the Clean Elections Act unless the entity receives an exemption from the Commission. Exemption forms are available at www.azcleanelections.gov. Please contact [email protected] or 602-364-3477 with questions. I, the undersigned, certify that the above statements are true and accurate to the best of my knowledge and belief:
__________________________________________________________ Signature of Authorized Agent
05/2016
!""#$#%& '() !*&+
□(6/;/3W/.(XXXXXXX(
Date of Expenditure (i.e. 5/30/2016) Amount of Expenditure (i.e. $5,000.00) Candidate Supported /Opposed
__________________________________________________________ Signature of Authorized Agent
Responsible Leadership for AZ
516 East Willetta St. Phoenix AZ 85021
Tom Farley [email protected]
Support/Pratt750.00 Oppose/Bagley
10/8/2016 750.0010/8/2016
10/8/2016 750.00 Support/Brophy McGee
Responsible Leadership for AZ
516 East Willetta St. Phoenix AZ 85021
Tom Farley [email protected]
Support/Pratt
750.00 Oppose/Bagley
10/8/2016 750.00
10/8/2016
10/8/2016 750.00 Support/Brophy McGee
Name:
Address: City State Zip
Pursuant to A.R.S. §§16-941(D),-956, -958, and A.A.C. R2-20-109(F)
!"#"$%&'(!)%*&(%)%!#"+&'(!+,,"''"+&("-./0/-./-1(%20/-.3145/(6/0751(( (
Name of Authorized Agent: Telephone Number: E-mail Address:
Telephone Number: Fax Number:
Authorized Agent Address (if different from above): City State Zip
*88(0/597-9:(3-;84.3-<(;75075=137-9:(83>31/.(83=?3831@(;7>0=-3/9:(=-.(8=?75(75<=-3A=137-9:(=5/(5/B435/.(17(C38/(3-./0/-./-1(/20/-.3145/(5/07519(4-./5(*D6D'D(EE(FGHIJFKLMN(HIOP(Q(*53AD(*.>3-D(!7./(6RHRSHFSIKTMD((U8/=9/(C388(741:(9;=-(=-.(5/145-(17(1V/(*53A7-=(!313A/-9(!8/=-(%8/;137-9(!7>>39937-:([email protected](Forms received within 24 hours of the date of expenditure will be considered timely. Failure to file the form and submit the information required subjects an entity that makes independent expenditures to penalties under the Clean Elections Act unless the entity receives an exemption from the Commission. Exemption forms are available at www.azcleanelections.gov. Please contact [email protected] or 602-364-3477 with questions. I, the undersigned, certify that the above statements are true and accurate to the best of my knowledge and belief:
__________________________________________________________ Signature of Authorized Agent
05/2016
!""#$#%& '() !*&+
□(6/;/3W/.(XXXXXXX(
Date of Expenditure (i.e. 5/30/2016) Amount of Expenditure (i.e. $5,000.00) Candidate Supported /Opposed
__________________________________________________________ Signature of Authorized Agent
Responsible Leadership for AZ
516 East Willetta St. Phoenix AZ 85021
Tom Farley [email protected]
Support/Brophy McGee4900.00 Support/Robson
10/8/2016 6090.0010/8/2016
10/8/2016 6090.00 Support/Hamway
Responsible Leadership for AZ
516 East Willetta St. Phoenix AZ 85021
Tom Farley [email protected]
Support/Brophy McGee
4900.00 Support/Robson
10/8/2016 6090.00
10/8/2016
10/8/2016 6090.00 Support/Hamway
Name:
Address: City State Zip
Pursuant to A.R.S. §§16-941(D),-956, -958, and A.A.C. R2-20-109(F)
!"#"$%&'(!)%*&(%)%!#"+&'(!+,,"''"+&("-./0/-./-1(%20/-.3145/(6/0751(( (
Name of Authorized Agent: Telephone Number: E-mail Address:
Telephone Number: Fax Number:
Authorized Agent Address (if different from above): City State Zip
*88(0/597-9:(3-;84.3-<(;75075=137-9:(83>31/.(83=?3831@(;7>0=-3/9:(=-.(8=?75(75<=-3A=137-9:(=5/(5/B435/.(17(C38/(3-./0/-./-1(/20/-.3145/(5/07519(4-./5(*D6D'D(EE(FGHIJFKLMN(HIOP(Q(*53AD(*.>3-D(!7./(6RHRSHFSIKTMD((U8/=9/(C388(741:(9;=-(=-.(5/145-(17(1V/(*53A7-=(!313A/-9(!8/=-(%8/;137-9(!7>>39937-:([email protected](Forms received within 24 hours of the date of expenditure will be considered timely. Failure to file the form and submit the information required subjects an entity that makes independent expenditures to penalties under the Clean Elections Act unless the entity receives an exemption from the Commission. Exemption forms are available at www.azcleanelections.gov. Please contact [email protected] or 602-364-3477 with questions. I, the undersigned, certify that the above statements are true and accurate to the best of my knowledge and belief:
__________________________________________________________ Signature of Authorized Agent
05/2016
!""#$#%& '() !*&+
□(6/;/3W/.(XXXXXXX(
Date of Expenditure (i.e. 5/30/2016) Amount of Expenditure (i.e. $5,000.00) Candidate Supported /Opposed
__________________________________________________________ Signature of Authorized Agent
Responsible Leadership for AZ
516 East Willetta St. Phoenix AZ 85021
Tom Farley [email protected]
Support/Barton11,000 Support/Allen
10/8/2016 11,00010/8/2016
10/8/2016 6666.68 Support/Pratt
Responsible Leadership for AZ
516 East Willetta St. Phoenix AZ 85021
Tom Farley [email protected]
Support/Barton
11,000 Support/Allen
10/8/2016 11,000
10/8/2016
10/8/2016 6666.68 Support/Pratt
Name:
Address: City State Zip
Pursuant to A.R.S. §§16-941(D),-956, -958, and A.A.C. R2-20-109(F)
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Name of Authorized Agent: Telephone Number: E-mail Address:
Telephone Number: Fax Number:
Authorized Agent Address (if different from above): City State Zip
*88(0/597-9:(3-;84.3-<(;75075=137-9:(83>31/.(83=?3831@(;7>0=-3/9:(=-.(8=?75(75<=-3A=137-9:(=5/(5/B435/.(17(C38/(3-./0/-./-1(/20/-.3145/(5/07519(4-./5(*D6D'D(EE(FGHIJFKLMN(HIOP(Q(*53AD(*.>3-D(!7./(6RHRSHFSIKTMD((U8/=9/(C388(741:(9;=-(=-.(5/145-(17(1V/(*53A7-=(!313A/-9(!8/=-(%8/;137-9(!7>>39937-:([email protected](Forms received within 24 hours of the date of expenditure will be considered timely. Failure to file the form and submit the information required subjects an entity that makes independent expenditures to penalties under the Clean Elections Act unless the entity receives an exemption from the Commission. Exemption forms are available at www.azcleanelections.gov. Please contact [email protected] or 602-364-3477 with questions. I, the undersigned, certify that the above statements are true and accurate to the best of my knowledge and belief:
__________________________________________________________ Signature of Authorized Agent
05/2016
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Date of Expenditure (i.e. 5/30/2016) Amount of Expenditure (i.e. $5,000.00) Candidate Supported /Opposed
__________________________________________________________ Signature of Authorized Agent
Responsible Leadership for AZ
516 East Willetta St. Phoenix AZ 85021
Tom Farley [email protected]
Support/Shope6666.66 Support/Cook
10/8/2016 6666.6610/8/2016
10/8/2016 13,500 Support/Norgaard
Responsible Leadership for AZ
516 East Willetta St. Phoenix AZ 85021
Tom Farley [email protected]
Support/Shope
6666.66 Support/Cook
10/8/2016 6666.66
10/8/2016
10/8/2016 13,500 Support/Norgaard