responsible leadership for az · responsible leadership for az 516 east willetta st. phoenix az...

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


Responsible Leadership for AZ

516 East Willetta Street Phoenix AZ 85004

Tom Farley [email protected]

$5,250.00 Barton/Support11/3/2016




$5,250.00 Barton/Support11/3/2016

Name:



!"#"$%&'(!)%*&(%)%!#"+&'(!+,,"''"+&("-./0/-./-1(%20/-.3145/(6/0751(( (






05/2016

!""#$#%& '() !*&+







Brophy McGee/Support$5,250.00 Hamway/Support

11/3/2016 $5,250.0011/3/2016

11/3/2016 $5,250.00 Pratt/Support




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:



CITIZENS CLEAN ELECTIONS COMMISSION Independent Expenditure Report




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:


05/2016

OFFICIAL USE ONLY

□ Received _______





Robson & Norgaard/Support

9280.00 Barton & Allen/Support

10/27/2016 9800.26

10/27/2016

Name:



!"#"$%&'(!)%*&(%)%!#"+&'(!+,,"''"+&("-./0/-./-1(%20/-.3145/(6/0751(( (






05/2016

!""#$#%& '() !*&+





516 East Willetta St. Phoenix AZ 85004


Norgaard/Support$375.00 Robson/Support

10/24/2016 $375.0010/24/2016

10/24/2016 $750.00 Kate Brophy McGee/Support




Norgaard/Support

$375.00 Robson/Support

10/24/2016 $375.00

10/24/2016

10/24/2016 $750.00 Kate Brophy McGee/Support

Name:



!"#"$%&'(!)%*&(%)%!#"+&'(!+,,"''"+&("-./0/-./-1(%20/-.3145/(6/0751(( (






05/2016

!""#$#%& '() !*&+







Brenda Barton/Support$4640.00 Sylvia Allen/Support

10/18/2016 $4640.0010/18/2016

10/18/2016 $2764.68 Frank Pratt/Support




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:



!"#"$%&'(!)%*&(%)%!#"+&'(!+,,"''"+&("-./0/-./-1(%20/-.3145/(6/0751(( (






05/2016

!""#$#%& '() !*&+







Shope/Support$2764.66 Cook/Support

10/18/2016 $2764.6610/18/2016

10/18/2016 4900.13 Norgaard/Support




Shope/Support

$2764.66 Cook/Support

10/18/2016 $2764.66

10/18/2016

10/18/2016 4900.13 Norgaard/Support

Name:









05/2016

OFFICIAL USE ONLY






$4900.13 Robson/Support10/18/2016

Name:









05/2016

OFFICIAL USE ONLY






Support/Barton

4640.00 Support/ Allen

10/8/2016 4640.00

10/8/2016

10/8/2016 2764.68 Support/Pratt

Name:









05/2016

OFFICIAL USE ONLY






Support/Cook

2764.66 Support/Shope

10/8/2016 2764.66

10/8/2016

10/8/2016 4900.00 Support/Norgaard

Name:



!"#"$%&'(!)%*&(%)%!#"+&'(!+,,"''"+&("-./0/-./-1(%20/-.3145/(6/0751(( (






05/2016

!""#$#%& '() !*&+







Support/Brophy McGee13,500.00 Support/Robson

10/8/2016 10,000.0010/8/2016

10/8/2016 10,000.00 Support/Hamway




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:



!"#"$%&'(!)%*&(%)%!#"+&'(!+,,"''"+&("-./0/-./-1(%20/-.3145/(6/0751(( (






05/2016

!""#$#%& '() !*&+







Support/Pratt750.00 Oppose/Bagley

10/8/2016 750.0010/8/2016

10/8/2016 750.00 Support/Brophy McGee




Support/Pratt

750.00 Oppose/Bagley

10/8/2016 750.00

10/8/2016

10/8/2016 750.00 Support/Brophy McGee

Name:



!"#"$%&'(!)%*&(%)%!#"+&'(!+,,"''"+&("-./0/-./-1(%20/-.3145/(6/0751(( (






05/2016

!""#$#%& '() !*&+







Support/Brophy McGee4900.00 Support/Robson

10/8/2016 6090.0010/8/2016

10/8/2016 6090.00 Support/Hamway




Support/Brophy McGee

4900.00 Support/Robson

10/8/2016 6090.00

10/8/2016

10/8/2016 6090.00 Support/Hamway

Name:



!"#"$%&'(!)%*&(%)%!#"+&'(!+,,"''"+&("-./0/-./-1(%20/-.3145/(6/0751(( (






05/2016

!""#$#%& '() !*&+







Support/Barton11,000 Support/Allen

10/8/2016 11,00010/8/2016

10/8/2016 6666.68 Support/Pratt




Support/Barton

11,000 Support/Allen

10/8/2016 11,000

10/8/2016

10/8/2016 6666.68 Support/Pratt

Name:



!"#"$%&'(!)%*&(%)%!#"+&'(!+,,"''"+&("-./0/-./-1(%20/-.3145/(6/0751(( (






05/2016

!""#$#%& '() !*&+







Support/Shope6666.66 Support/Cook

10/8/2016 6666.6610/8/2016

10/8/2016 13,500 Support/Norgaard




Support/Shope

6666.66 Support/Cook

10/8/2016 6666.66

10/8/2016

10/8/2016 13,500 Support/Norgaard

responsible leadership for az · responsible leadership for az 516 east willetta st. phoenix az...

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