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Keith Beauchamp (012434) James J. Belanger (011393) Roopali H. Desai (024295) COPPERSMITH SCHERMER & BROCKELMAN PLC 2800 North Central Avenue, Suite 1200 Phoenix, Arizona 85004 (602) 381-5490 (Direct) kbeauchamp@csblaw.com jbelanger@csblaw.com rdesai@csblaw.com Attorneys for Plaintiffs Arizona Green Party and Claudia Ellquist UNITED STATES DISTRICT COURT DISTRICT OF ARIZONA Arizona Green Party, an Arizona political party; ) and Claudia Ellquist, an individual, ) ) Plaintiffs, ) ) v. ) ) Ken Bennett, in his official capacity as ) Secretary of State for the State of Arizona; ) LeNora Johnson, in her official capacity as ) Recorder for Apache County; Jim Claw, R. John ) Lee and Tom White Jr., in their official capacity ) as members of the Board of Supervisors for ) Apache County; Christine Rhodes, in her ) official capacity as Recorder for Cochise ) County; Patrick Call, Ann English and Richard ) Searle, in their official capacity as members of ) the Board of Supervisors for Cochise County; ) Candace Owens, in her official capacity as ) Recorder for Coconino County; Elizabeth ) Archuleta, Lena Fowler, Mandy Metzger, Matt ) Ryan and Carl Taylor, in their official capacity ) as members of the Board of Supervisors for ) Coconino County; Sadie Dalton, in her official ) capacity as Recorder for Gila County; Shirley ) Dawson, Tommie Martin and Michael Pastor, in ) their official capacity as members of the Board ) of Supervisors for Gila County; Wendy John, in ) No.

VERIFIED COMPLAINT (42 U.S.C. § 1983 and § 1988 (First Amendment and Fourteenth Amendment); Ariz. Const. Art. 7, Sec. 12; A.R.S. §§ 16-1006, 16-1013, and Injunctive Relief)

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her official capacity as Recorder for Graham County; Mark Herrington, Drew John and James Palmer, in their official capacity as members of the Board of Supervisors for Graham County; Berta Manuz, in her official capacity as Recorder for Greenlee County; David Gomez, Richard Lunt, and Hector Ruedas, in their official capacity as members of the Board of Supervisors for Greenlee County; Shelly Baker, in her official capacity as Recorder for La Paz County; John Drum, Holly Irwin, and Sandy Pierce, in their official capacity as members of the Board of Supervisors for La Paz County; Helen Purcell, in her official capacity as Recorder for Maricopa County; Fulton Brock, Andrew Kunasek, Don Stapley, Mary Rose Wilcox and Max Wilson, in their official capacity as members of the Board of Supervisors for Maricopa County; Carol Meier, in her official capacity as Recorder for Mohave County; Buster Johnson, Tom Sockwell and Gary Watson, in their official capacity as members of the Board of Supervisors for Mohave County; Laurette Justman, in her official capacity as Recorder for Navajo County; Jerry Brownlow, J.R. Despain, Jonathan Nez, David Tenney and Jesse Thompson, in their official capacity as members of the Board of Supervisors for Navajo County; F. Ann Rodriguez, in her official capacity as Recorder for Pima County; Sharon Bronson, Raymond Carroll, Ann Day, Richard Elias and Ramon Valadez, in their official capacity as members of the Board of Supervisors for Pima County; Laura DeanLytle, in her official capacity as Recorder for Pinal County; Bryan Martyn, Pete Rios and David Snider, in their official capacity as members of the Board of Supervisors for Pinal County; Suzanne Sainz, in her official capacity as Recorder for Santa Cruz County; John Maynard Jr., Rudy Molera and Manuel Ruiz, in their official capacity as members of the Board of Supervisors for Santa Cruz County; Ana 2

) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) )

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Wayman-Trujillo, in her official capacity as Recorder for Yavapai County; Chip Davis, Carol Springer and Thomas Thurman, in their official capacity as official capacity as members of the Board of Supervisors for Yavapai County; Robyn Stallworth-Pouquette, in her official capacity as Recorder for Yuma County; and Greg Ferguson, Russell McCloud, Kathryn Prochaska, Marco Reyes and Lenore Stuart, in their official capacity as members of the Board of Supervisors for Yuma County; Ryan Blackman, an individual; Richard Grayson, an individual; Christopher Campbell, an individual; Anthony Goshorn, an individual; Matthew Shusta, an individual; Clint Clement, an individual; Andrew Blischak, an individual; Michelle Lochmann, an individual; Thomas Meadows, an individual; Theodore Gomez, an individual; Benjamin Pearcy, an individual; Defendants.

) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) )

The Arizona Green Party, an Arizona political party, and Claudia Ellquist allege for their Verified Complaint as follows: NATURE OF THE ACTION 1. The First and Fourteenth Amendments to the United States Constitution

guarantee the right of individuals to associate in a political party, the right of that party and its adherents to select their own nominees for partisan political office, and the right of that party and its adherents to limit nominees to those individuals who share the interests and ideologies of the party. 2. In ensuring the freedom of political parties to control and restrict their

associations, the First Amendment protects these parties from being “hijacked” by those adverse to those parties. 3. Arizona statutes governing political party affiliation and registration,

coupled with its laws governing write-in candidates for parties not qualified for continued representation on the official ballot, violate the association rights of the Arizona Green 3

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Party and its members by forcing the party to be publicly associated with candidates who have not been nominated by the party, who will alter the political message and agenda of the party, who will mislead the voting public with respect to what the party and its adherents believe, and who will cause party members to mistakenly vote for sham candidates. 4. Arizona’s statutory scheme also fosters deceptive schemes, such as the

scheme alleged upon information and belief herein, such that major political parties can manipulate minor political parties and thereby fraudulently affect the outcome of primary and general elections and corrupt the entire electoral process. JURISDICTION AND VENUE 5. Plaintiffs’ rights of political association and political expression are

guaranteed against abridgement by the State and those acting under color of its laws by the First and Fourteenth Amendments to the United States Constitution and by 42 U.S.C. § 1983. This Court has jurisdiction over these federal questions under 28 U.S.C. § 1331. 6. This Court has pendent jurisdiction over Plaintiffs’ state law claims

pursuant to 28 U.S.C. § 1367. 7. Venue is proper in this Court pursuant to 28 U.S.C. § 1391(b)(1) because

(i) all of the Defendants reside in, and may be found and served in, the District of Arizona; and (ii) all of the events or omissions giving rise to these claims arose in the District of Arizona. THE PARTIES The Plaintiffs 8. The Arizona Green Party (“AGP”) is a recognized political party in the

State of Arizona lacking continued representation on the official ballot. 9. Claudia Ellquist is a Co-Chair of the AGP. She resides and is a registered

voter in Pima County, Arizona. 10. The AGP and Ms. Ellquist are referred to here, collectively, as “Plaintiffs.”

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The Secretary of State Ken Bennett is the Secretary of State for the State of Arizona and is named

in his official capacity as a defendant in this action as the officer with whom write-in nomination papers are filed pursuant to A.R.S. §§ 16-311 and 312(C). The County Boards of Supervisors The members of the Board of Supervisors of Maricopa County are named

as defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board of Supervisors of Maricopa County is responsible for notifying the appropriate election board inspector of all candidates who have properly filed write-in nomination papers and, pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the election and issuing certificates of nomination to successful candidates. The Maricopa County Supervisors are Fulton Brock, Don Stapley, Andrew Kunasek, Max Wilson, and Mary Rose Wilcox. 13. The members of the Board of Supervisors of Apache County are named as

defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board of Supervisors of Apache County is responsible for notifying the appropriate election board inspector of all candidates who have properly filed write-in nomination papers and, pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the election and issuing certificates of nomination to successful candidates. The Apache County Supervisors are Jim Claw, R. John Lee, and Tom White Jr. 14. The members of the Board of Supervisors of Cochise County are named as

defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board of Supervisors of Cochise County is responsible for notifying the appropriate election board inspector of all candidates who have properly filed write-in nomination papers and, pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the election and issuing certificates of nomination to successful candidates. The Cochise County Supervisors are Patrick Call, Ann English, and Richard Searle.

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15.

The members of the Board of Supervisors of Coconino are named as

defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board of Supervisors of Coconino County is responsible for notifying the appropriate election board inspector of all candidates who have properly filed write-in nomination papers and, pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the election and issuing certificates of nomination to successful candidates. The Coconino County Supervisors are Elizabeth Archuleta, Lena Fowler, Mandy Metzger, Matt Ryan, and Carl Taylor. 16. The members of the Board of Supervisors of Gila County are named as

defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board of Supervisors of Gila County is responsible for notifying the appropriate election board inspector of all candidates who have properly filed write-in nomination papers and, pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the election and issuing certificates of nomination to successful candidates. The Gila County Supervisors are Shirley Dawson, Tommie Martin, and Michael Pastor. 17. The members of the Board of Supervisors of Graham County are named as

defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board of Supervisors of Graham County is responsible for notifying the appropriate election board inspector of all candidates who have properly filed write-in nomination papers and, pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the election and issuing certificates of nomination to successful candidates. The Graham County Supervisors are Mark Herrington, Drew John, and James Palmer. 18. The members of the Board of Supervisors of Greenlee County are named as

defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board of Supervisors of Greenlee County is responsible for notifying the appropriate election board inspector of all candidates who have properly filed write-in nomination papers and, pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the

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election and issuing certificates of nomination to successful candidates. The Greenlee County Supervisors are David Gomez, Richard Lunt, and Hector Ruedas. 19. The members of the Board of Supervisors of La Paz County are named as

defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board of Supervisors of La Paz County is responsible for notifying the appropriate election board inspector of all candidates who have properly filed write-in nomination papers and, pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the election and issuing certificates of nomination to successful candidates. The La Paz County Supervisors are John Drum, Holly Irwin, and Sandy Pierce. 20. The members of the Board of Supervisors of Mohave County are named as

defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board of Supervisors of Mohave County is responsible for notifying the appropriate election board inspector of all candidates who have properly filed write-in nomination papers and, pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the election and issuing certificates of nomination to successful candidates. The Mohave County Supervisors are Buster Johnson, Tom Sockwell, and Gary Watson. 21. The members of the Board of Supervisors of Navajo County are named as

defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board of Supervisors of Navajo County is responsible for notifying the appropriate election board inspector of all candidates who have properly filed write-in nomination papers and, pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the election and issuing certificates of nomination to successful candidates. The Navajo County Supervisors are Jerry Brownlow, J.R. Despain, Jonathan Nez, David Tenney, and Jesse Thompson. 22. The members of the Board of Supervisors of Pima County are named as

defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board of Supervisors of Pima County is responsible for notifying the appropriate election board inspector of all candidates who have properly filed write-in nomination papers and, 7

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pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the election and issuing certificates of nomination to successful candidates. The Pima County Supervisors are Sharon Bronson, Raymond Carroll, Ann Day, Richard Elias, and Ramon Valadez. 23. The members of the Board of Supervisors of Pinal County are named as

defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board of Supervisors of Pinal County is responsible for notifying the appropriate election board inspector of all candidates who have properly filed write-in nomination papers and, pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the election and issuing certificates of nomination to successful candidates. The Pinal County Supervisors are Bryan Martyn, Pete Rios, and David Snider. 24. The members of the Board of Supervisors of Santa Cruz County are named

as defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board of Supervisors of Santa Cruz County is responsible for notifying the appropriate election board inspector of all candidates who have properly filed write-in nomination papers and, pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the election and issuing certificates of nomination to successful candidates. The Santa Cruz County Supervisors are John Maynard Jr., Rudy Molera, and Manuel Ruiz. 25. The members of the Board of Supervisors of Yavapai County are named as

defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board of Supervisors of Yavapai County is responsible for notifying the appropriate election board inspector of all candidates who have properly filed write-in nomination papers and, pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the election and issuing certificates of nomination to successful candidates. The Yavapai County Supervisors are A.G. (“Chip” ) Davis, Carol Springer, and Thomas Thurman. 26. The members of the Board of Supervisors of Yuma County are named as

defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board 8

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of Supervisors of Yuma County is responsible for notifying the appropriate election board inspector of all candidates who have properly filed write-in nomination papers and, pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the election and issuing certificates of nomination to successful candidates. The Yuma County Supervisors are Greg Ferguson, Russell McCloud, Kathryn Prochaska, Marco Reyes, and Lenore Stuart. The County Recorders 27. LeNora Johnson is the Recorder for Apache County and is named in her

official capacity as a defendant in this action as the officer in charge of printing ballots for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to enjoin the Recorder from printing the names of certain sham candidates on the general election ballot. 28. Christine Rhodes is the Recorder for Cochise County and is named in her

official capacity as a defendant in this action as the officer in charge of printing ballots for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to enjoin the Recorder from printing the names of certain sham candidates on the general election ballot. 29. Candace Owens is the Recorder for Coconino County and is named in her

official capacity as a defendant in this action as the officer in charge of printing ballots for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to enjoin the Recorder from printing the names of certain sham candidates on the general election ballot. 30. Sadie Dalton is the Recorder for Gila County and is named in her official

capacity as a defendant in this action as the officer in charge of printing ballots for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to enjoin the Recorder from printing the names of certain sham candidates on the general election ballot.

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31.

Wendy John is the Recorder for Graham County and is named in her

official capacity as a defendant in this action as the officer in charge of printing ballots for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to enjoin the Recorder from printing the names of certain sham candidates on the general election ballot. 32. Berta Manuz is the Recorder for Greenlee County and is named in her

official capacity as a defendant in this action as the officer in charge of printing ballots for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to enjoin the Recorder from printing the names of certain sham candidates on the general election ballot. 33. Shelly Baker is the Recorder for La Paz County and is named in her official

capacity as a defendant in this action as the officer in charge of printing ballots for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to enjoin the Recorder from printing the names of certain sham candidates on the general election ballot. 34. Helen Purcell is the Recorder for Maricopa County and is named in her

official capacity as a defendant in this action as the officer in charge of printing ballots for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to enjoin the Recorder from printing the names of certain sham candidates on the general election ballot. 35. Carol Meier is the Recorder for Mohave County and is named in her

official capacity as a defendant in this action as the officer in charge of printing ballots for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to enjoin the Recorder from printing the names of certain sham candidates on the general election ballot. 36. Laurette Justman is the Recorder for Navajo County and is named in her

official capacity as a defendant in this action as the officer in charge of printing ballots for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to 10

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enjoin the Recorder from printing the names of certain sham candidates on the general election ballot. 37. F. Ann Rodriguez is the Recorder for Pima County and is named in her

official capacity as a defendant in this action as the officer in charge of printing ballots for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to enjoin the Recorder from printing the names of certain sham candidates on the general election ballot. 38. Laura Dean-Lytle is the Recorder for Pinal County and is named in her

official capacity as a defendant in this action as the officer in charge of printing ballots for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to enjoin the Recorder from printing the names of certain sham candidates on the general election ballot. 39. Suzanne Sainz is the Recorder for Santa Cruz County and is named in her

official capacity as a defendant in this action as the officer in charge of printing ballots for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to enjoin the Recorder from printing the names of certain sham candidates on the general election ballot. 40. Ana Wayman-Trujillo is the Recorder for Yavapai County and is named in

her official capacity as a defendant in this action as the officer in charge of printing ballots for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to enjoin the Recorder from printing the names of certain sham candidates on the general election ballot. 41. Robyn Stallworth-Pouquette is the Recorder for Yuma County and is

named in her official capacity as a defendant in this action as the officer in charge of printing ballots for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to enjoin the Recorder from printing the names of certain sham candidates on the general election ballot.

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The Sham Candidates Defendant Ryan Blackman is a write-in candidate purporting to be

affiliated with the AGP. Blackman is a write-in candidate for the U.S. House of Representatives in District 5. Blackman registered to vote for the first time on July 13, 2010. He registered as a Green. His voter registration is attached hereto as Ex. 1. Blackman filed as a write-in candidate on that same day, on July 13, 2010. His filing papers are attached hereto as Ex. 2. 43. Defendant Richard Grayson is a write-in candidate purporting to be

affiliated with the AGP. Grayson is a write-in candidate for the U.S. House of Representatives in District 6. Upon information and belief, he switched his political party from Republican to Green sometime in late 2009. Grayson filed as a write-in candidate on May 28, 2010. His filing papers are attached hereto as Ex. 3. 44. Defendant Christopher Campbell is a write-in candidate purporting to be

affiliated with the AGP. Campbell is a write-in candidate for State Senator in District 10. He switched his political party from Republican to Green on July 15, 2010. His voter registration is attached hereto as Ex. 4. Campbell filed as a write-in candidate that same day, July 15, 2010. His filing papers are attached hereto as Ex. 5. 45. Defendant Anthony Goshorn is a write-in candidate purporting to be

affiliated with the AGP. Goshorn is a write-in candidate for State Senator in District 17. He switched his political party from Libertarian to Green on May 17, 2010 when he attempted to gather sufficient signatures to qualify for the ballot as an AGP candidate for State Representative in District 17. His voter registration is attached hereto as Ex. 6. Having failed to qualify, Goshorn filed as a write-in candidate for State Senator on July 15, 2010. His filing papers are attached hereto as Ex. 7. 46. Defendant Matthew Shusta is a write-in candidate purporting to be

affiliated with the AGP. Shusta is a write-in candidate for State Senator in District 23. Upon information and belief, he changed his political party from Democrat to Green on

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or about July 1, 2010. Shusta filed as a write-in candidate on July 15, 2010. His filing papers are attached hereto as Ex. 8. 47. Defendant Clint Clement is a write-in candidate purporting to be affiliated

with the AGP. Clement is a write-in candidate for State Representative in District 17. He changed his political party from Republican to Green on July 13, 2010. His voter registration is attached hereto as Ex. 9. Clement filed as a write-in candidate that same day, July 13, 2010. His filing papers are attached hereto as Ex. 10. 48. Defendant Andrew (“Drew”) Blischak is a write-in candidate purporting to

be affiliated with the AGP. Blischak is a write-in candidate for State Representative in District 20. He changed his political party from Republican to Green on July 13, 2010. His voter registration is attached hereto as Ex. 11. Blischak filed as a write-in candidate that same day, July 13, 2010. His filing papers are attached hereto as Ex. 12. 49. Defendant Michelle Lochmann is a write-in candidate purporting to be

affiliated with the AGP. Lochmann is a write-in candidate for Secretary of State. She changed her political party from Republican to Green on July 15, 2010. Her voter registration is attached hereto as Ex. 13. Lochmann filed as a write-in candidate that same day, July 15, 2010. Her filing papers are attached hereto as Ex. 14. 50. Defendant Thomas Meadows is a write-in candidate purporting to be

affiliated with the AGP. Meadows is a write-in candidate for State Treasurer. He registered to vote for the first time on July 15, 2010. He registered as a Green. His voter registration is attached hereto as Ex. 15. Meadows filed as a write-in candidate the same day, July 15, 2010. His filing papers are attached hereto as Ex. 16. 51. Defendant Theodore Gomez is a write-in candidate purporting to be

affiliated with the AGP. Gomez is a write-in candidate for Corporation Commissioner. He registered to vote for the first time on July 14, 2010. He registered as a Green. His voter registration is attached hereto as Ex. 17. Gomez filed as a write-in candidate the very next day, July 15, 2010. His filing papers are attached hereto as Ex. 18.

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52.

Defendant Benjamin Pearcy is a write-in candidate purporting to be

affiliated with the AGP. Pearcy is a write-in candidate for Corporation Commissioner. He changed his political party from Republican to Green on July 14, 2010. His voter registration is attached hereto as Ex. 19. Pearcy filed as a write-in candidate the very next day, July 15, 2010. His filing papers are attached hereto as Ex. 20. GENERAL ALLEGATIONS 53. Upon information and belief, members of the Arizona Republican Party

have conspired to place fraudulent AGP candidates on the official general election ballot by encouraging members of their party, and others, to switch party affiliation and run as write-in candidates in the August 24, 2010 primary election. [See e.g. Facebook message from Matt Salmon attached hereto as Ex. 21.] 54. Ryan Blackman, Richard Grayson, Christopher Campbell, Anthony

Goshorn, Matthew Shusta, Clint Clement, Drew Blischak, Michelle Lochmann, Thomas Meadows, Theodore Gomez, and Benjamin Pearcy (collectively, the “Sham Candidates”) are all running as write-in AGP candidates without the endorsement of the AGP. Two other individuals, Gail Ginger and Tim Hensley filed paperwork to run as Green write-in candidates, and ran in the primary election, but did not qualify to advance to the general election as the AGP nominee for the office that they sought. 55. Of the eleven Sham Candidates, none were members of the AGP for more

than a few days before becoming AGP candidates. 56. Pursuant to A.R.S. § 16-312(A), the last day to file as a write-in candidate

for the August 24, 2010 primary election was July 15, 2010. 57. Upon information and belief, the Sham Candidates do not share in the

AGP’s values and ideologies and are seeking office to confuse the electorate and siphon votes, in violation of the Plaintiffs’ constitutional rights: a. Campbell admits that he was approached by the Republican Party to

run as a sham AGP candidate in District 10 with the specific intent to take votes away from the Democratic nominee. [See Transcript of phone conversation with Campbell 14

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attached hereto as Ex. 22; Declaration of Shawn Nelson attached hereto as Ex. 23; see also Mary Jo Pitzl, Arizona Democratic Party Alleges Fraud, The Arizona Republic, Aug. 31, 2010, attached hereto as Ex. 24.] b. Campbell has numerous ties to the Republican Party. Campbell

lives with the daughter of the Republican former speaker of the house, Jim Weiers, and is an acquaintance of Senator Linda Gray, the Republican incumbent in District 10. As noted above, Campbell was a registered Republican until the day he filed as a Green write-in candidate, which was on July 15, 2010, the last day to file as a write-in candidate. c. Campbell admits he supports Senate Bill (“SB”) 1070, a position in

direct conflict with the official position of the AGP, which strongly opposes SB 1070 and would not endorse a candidate who supported SB 1070, regardless of that candidate’s positions on other issues. [See Ex. 22.] d. Gail Ginger was approached by members of the Republican Party to

become a member of the AGP and to file as a write-in candidate in order to deceive voters into voting for her rather than the Democratic Party’s nominee. The purpose of this scheme was to ensure the re-election of Republican Senator Gray. However, by mistake, Ginger filed as a write-in candidate for State Senator in the same district as Campbell and, therefore, dropped out of the race. In a phone conversation, Ginger implicated Republicans as individuals with knowledge of the sham candidate scheme. [See Transcript of phone conversation with Ginger attached hereto as Ex. 25; see also Transcript of phone conversation with John Mills attached hereto as Ex. 26; see also Exs. 23-24.] e. Lochmann admitted that she was recruited by Derrick Lee, owner of

Campaign Finance Company, LLC and Lee Petition Management, who is linked to the campaigns of various Republican candidates, to obtain Clean Elections money. [See Declaration of Luisa Valdez attached hereto as Ex. 27.]

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f.

Matt Salmon, President of the Log Cabin Republicans sent a

Facebook message seeking to recruit AGP members to run in certain election races. In his message, Salmon stated that a Green candidate “would only need one write-in vote (themselves).” [See Ex. 21; see also Ex. 27.] g. Goshorn was approached by members of the Republican Party to

become a member of the AGP and to first attempt to gain access to the official general election ballot by gathering signatures to appear on the ballot for State Representative in Legislative District 17. After failing to gather a sufficient number of signatures, Goshorn filed to run as a write-in candidate. h. Steve May, a former two-term Republican State legislator, is the

driving force behind Goshorn’s nomination as an AGP nominee. [See Ex. 24; see also attached screenshot of May’s Facebook page showing a picture of Goshorn and May when Goshorn filed as a candidate attached hereto as Ex. 28.] May is a Republican candidate for the same office that Goshorn is running for in Legislative District 17. His filing papers are attached hereto as Ex. 29. i. The nomination papers of Goshorn, Meadows, Gomez, and Pearcy

are written in the same handwriting, which matches that of May, a Republican candidate for Legislative District 17. [See Exs. 7, 16, 18, 20 and 29.] j. Goshorn, Pearcy, Meadows and Gomez all use the same post office

box address for their campaign mailing addresses. k. Pearcy, Meadows, and Gomez all list a Starbucks coffee

establishment located at 420 S. Mill Avenue in downtown Tempe, Arizona as their campaign filing addresses. l. Goshorn, May, Pearcy, and Gomez filed their write-in nomination

papers at the exact same minute: 11:43 on July 15, 2010, the last day to file as a write-in candidate. m. nomination papers. 16 Goshorn, May, Pearcy, and Gomez used the same notary for their

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n.

Goshorn and perhaps several other Sham Candidates were recruited

by May to get on the ballot as Green candidates. [See Ex. 24; see also Ex. 28.] o. Members of the Republican Party have provided financial and in-

kind support to at least some, perhaps all, the Sham Candidates named in this Verified Complaint. p. The Sham Candidates switched their party affiliation to the AGP

despite the fact that the Sham Candidates do not subscribe to the AGP’s principles and ideologies. Further, they did not undergo the process to become an endorsed AGP candidate. [See Ex. 27.] 58. 59. Voters rely on political party designations in deciding for whom to vote. Upon information and belief, the scheme to place the Sham Candidates on

the ballot is intended to confuse voters and draw votes away from candidates affiliated with the Arizona Democratic Party: a. Campbell admitted that he is running as a Green candidate to take

votes away from the Democratic nominee in District 10. [Exs. 22-23.] b. In 2008, a sham Green candidate ran against Democrat Jackie

Thrasher for the same office and in the same district that Campbell is running. The sham Green candidate obtained over 2,000 votes, which caused Thrasher to lose the election to Jim Weiers by 553 votes. [See Declaration of Jackie Thrasher attached hereto as Ex. 30.] c. Republicans have used Sham candidates in prior elections to divert

votes away from Democratic candidates. [See, e.g. Mary Jo Pitzl, Dems see red as Republicans run as Greens, The Arizona Republic, Oct. 11, 2008, attached hereto as Ex. 31.] d. Angel Reyes, an East Coast political operative who frequently works

for the Republican Party or its members, has called registered members of the AGP and introduced himself as “Angel,” a representative calling on behalf of the AGP, to garner votes for the Sham Candidates. [See Ex. 27; Declaration of Jerry Joslyn attached hereto as Ex. 32).] The Co-Chair of the AGP is Angel Torres. 17

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e.

The Sham Candidates switched their party affiliation to the AGP for

the purpose of directing votes from Democratic Party candidates. 60. A.R.S. § 16-645(D), Arizona’s statutory framework for AGP write-in

candidates, (i) forces the AGP to associate with sham candidates in violation of their constitutional right to exclude individuals; and (ii) treats the AGP differently than the Republican, Democratic, and Libertarian Parties in violation of the Plaintiffs’ constitutional right to equal protection: a. Blackman secured the AGP nomination and will advance to the

general election as the Green candidate for the U.S. House of Representatives in District 5 with only four votes. [See 2010 Primary Election Official Write-In Results Summary attached hereto as Ex. 33.] A Republican write-in candidate would have had to obtain 739 votes, a Democratic write-in candidate would have had to obtain 559 votes, and a Libertarian write-in candidate would have had to obtain 17 votes. If the AGP was subject to the same statutory requirement for write-in candidates as the other parties, Blackman would have had to obtain 154 votes. [See Arizona Secretary of State minimum signature requirements for each party attached hereto as Ex. 34.] b. Grayson secured the AGP nomination and will advance to the

general election as the Green candidate for the U.S. House of Representatives in District 6 with only 3 votes. [See Ex. 33.] A Republican write-in candidate would have had to obtain 1,055 votes, a Democratic write-in candidate would have had to obtain 610 votes, and a Libertarian write-in candidate would have had to obtain 17 votes. If the AGP was subject to the same statutory requirement for write-in candidates as the other parties, Grayson would have had to obtain 154 votes. [See Ex. 34.] c. Campbell secured the AGP nomination and will advance to the

general election as the Green candidate for State Senator in District 10 with only one vote, presumably his own. [See Ex. 33.] A Republican write-in candidate would have had to obtain 262 votes, a Democratic write-in candidate would have had to obtain 251 votes, and a Libertarian write-in candidate would have had to obtain 9 votes. If the AGP 18

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was subject to the same statutory requirement for write-in candidates as the other parties, Campbell would have had to obtain 29 votes. [See Ex. 34.] d. Goshorn secured the AGP nomination and will advance to the

general election as the Green candidate for State Senator in District 17 with only four votes. [See Ex. 33.] A Republican write-in candidate would have had to obtain 264 votes, a Democratic write-in candidate would have had to obtain 312 votes, and a Libertarian write-in candidate would have had to obtain 12 votes. If the AGP was subject to the same statutory requirement for write-in candidates as the other parties, Goshorn would have had to obtain 37 votes. [See Ex. 34.] e. Shusta secured the AGP nomination and will advance to the general

election as the Green candidate for State Senator in District 23 with only five votes. [See Ex. 33.] A Republican write-in candidate would have had to obtain 441 votes, a Democratic write-in candidate would have had to obtain 522 votes, and a Libertarian write-in candidate would have had to obtain 10 votes. If the AGP was subject to the same statutory requirement for write-in candidates as the other parties, Shusta would have had to obtain 50 votes. [See Ex. 34.] f. Clement secured the AGP nomination and will advance to the

general election as the Green candidate for State Representative in District 17 with only two votes. [See Ex. 33.] A Republican write-in candidate would have had to obtain 264 votes, a Democratic write-in candidate would have had to obtain 312 votes, and a Libertarian write-in candidate would have had to obtain 12 votes. If the AGP was subject to the same statutory requirement for write-in candidates as the other parties, Clement would have had to obtain 37 votes. [See Ex. 34.] g. Blischak secured the AGP nomination and will advance to the

general election as the Green candidate for State Representative in District 20 with only one vote, presumably his own. [See Ex. 33.] A Republican write-in candidate would have had to obtain 409 votes, a Democratic write-in candidate would have had to obtain 324 votes, and a Libertarian write-in candidate would have had to obtain 9 votes. If the 19

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AGP was subject to the same statutory requirement for write-in candidates as the other parties, Blischak would have had to obtain 44 votes. [See Ex. 34.] h. Lochmann secured the AGP nomination and will advance to the

general election as the Green candidate for Secretary of State with only 17 votes. [See Ex. 33.] A Republican write-in candidate would have had to obtain 5,609 votes, a Democratic write-in candidate would have had to obtain 5,124 votes, and a Libertarian write-in candidate would have had to obtain 124 votes. If the AGP was subject to the same statutory requirement for write-in candidates as the other parties, Lochmann would have had to obtain 1231 votes. [See Ex. 34.] i. Meadows secured the AGP nomination and will advance to the

general election as the Green candidate for State Treasurer with only 21 votes. [See Ex. 33.] A Republican write-in candidate would have had to obtain 5,609 votes, a Democratic write-in candidate would have had to obtain 5,124 votes, and a Libertarian write-in candidate would have had to obtain 124 votes. If the AGP was subject to the same statutory requirement for write-in candidates as the other parties, Meadows would have had to obtain 1231 votes. [See Ex. 34.] j. Gomez secured the AGP nomination and will advance to the general

election as the Green candidate for Corporation Commissioner with only 13 votes. [See Ex. 33.] A Republican write-in candidate would have had to obtain 5,609 votes, a Democratic write-in candidate would have had to obtain 5,124 votes, and a Libertarian write-in candidate would have had to obtain 124 votes. If the AGP was subject to the same statutory requirement for write-in candidates as the other parties, Gomez would have had to obtain 1231 votes. [See Ex. 34.] k. Pearcy secured the AGP nomination and will advance to the general

election as the Green candidate for Corporation Commissioner with only 11 votes. [See Ex. 33.] A Republican write-in candidate would have had to obtain 5,609 votes, a Democratic write-in candidate would have had to obtain 5,124 votes, and a Libertarian write-in candidate would have had to obtain 124 votes. If the AGP was subject to the 20

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same statutory requirement for write-in candidates as the other parties, Pearcy would have had to obtain 1231 votes. [See Ex. 34.] ARIZONA’S STATUTORY FRAMEWORK RELATING TO POLITICAL PARTIES AND WRITE-IN CANDIDATES 61. In Arizona, a political party with continued representation is entitled to

representation as a political party on the official ballot for state and local officers. 62. Pursuant to A.R.S. § 16-804(A), a political party is qualified for continued

representation to appear on the official general election ballot if “[a] political organization that at the last preceding general election cast for governor or presidential electors[,] . . . whichever applies, not less than five per cent of the total votes cast for governor or presidential electors, in the state.” 63. Alternatively, under A.R.S. § 16-804(B), “a political organization is

entitled to continued representation as a political party on the official ballot . . . if . . . such party has registered electors in the party equal to at least two-thirds of one per cent of the total registered electors in such jurisdiction.” 64. The Arizona Democratic Party, the Arizona Republican Party, and the

Arizona Libertarian Party are entitled to continued representation. 65. The AGP failed to obtain the requisite number of votes in the 2008 general

election to be entitled to continued representation as a political party in Arizona. 66. Pursuant to A.R.S. § 16-803(A), a political party that is not entitled to

continued representation may become a recognized political party that can be represented by an official party ballot and have access to the statewide ballot if the political party files a petition for recognition not less than 140 days before the primary election. 67. 68. The AGP is a recognized political party with ballot access in Arizona. Under A.R.S. § 16-645(D), the State of Arizona permits a write-in

candidate for a party not qualified for continued representation to become the party’s nominee and to appear on the general election ballot by obtaining a plurality of the votes of the party for the office for which he or she is a candidate. 21

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69.

However, under A.R.S. § 16-645(E), a write-in candidate for a party

qualified for continued representation may become the party’s nominee and appear on the general election ballot only if he receives a number of votes equivalent to at least the same number of signatures required for nominating petitions for the same office. 70. Thus, A.R.S. § 16-645 permits an uncontested AGP write-in candidate to

qualify for the general election by virtue of a single vote, whereas Democrat, Republican, and Libertarian write-in candidates are required to obtain significantly more votes to qualify for the general election. 71. Accordingly, it is very difficult to qualify for the general election as a

Democrat, Republican, and Libertarian write-in candidate; however, unopposed Green write-in candidates are able to qualify for the general election if they simply vote for themselves. 72. This discrepancy makes it easy for other political parties or non-AGP

members to hijack the AGP. 73. Qualified electors can change their political party affiliation up to twenty-

nine days preceding a primary or general election. 74. The defendants named in their official capacities administered the partisan

primary elections on August 24, 2010 and will administer the general election on November 2, 2010. 75. Upon information and belief, the County Recorder Defendants are currently

preparing the ballot for the November 2, 2010 general election, which will include the names of the Sham Candidates. 76. Within a matter of days, the County Recorder Defendants will send the

ballots to the printer and then begin mailing ballots to military personnel, out-of-state voters, and early ballot voters. THE AGP IS A MINOR POLITICAL PARTY 77. In a democracy, the political ideologies of the major political parties,

representing the majority of the constituents, are likely to prevail in an election. 22

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However, the majority is expressly limited when its actions jeopardize or violate the constitutional rights of minor parties and their constituents. 78. Minor parties face a greater danger that their constitutional rights will be

violated simply because they operate against the ideology of the majority. Even one election in which the AGP is forced to associate with unwanted and possibly antithetical candidates is sufficient to irreparably damage the party. 79. The very fact that the AGP has not qualified for continued representation

on the ballot illustrates that the AGP is a minor political party with a small constituency, as does its registration of only approximately 4,000 members. THE STATE OF ARIZONA HAS FORCED THE AGP TO ASSOCIATE WITH INDIVIDUALS WHO DO NOT SHARE ITS POLITICAL IDEALS 80. Although states have broad power to regulate elections, they may not

exercise that power in a manner that violates the constitutional rights of their citizens and may not force political parties to associate with individuals who do not share their ideologies. 81. Arizona election laws severely burden the First Amendment rights of the

AGP and its constituents by forcing them to associate with candidates who have not been selected by the AGP and who do not represent the AGP’s values and platform. 82. Because state law permits any individual to represent the AGP by simply

filing as a write-in candidate and voting for himself or herself, Arizona has permitted the AGP to be infiltrated by sham candidates who do not share the same beliefs as the party platform and who are running under the AGP name to steal votes away from nonRepublican candidates. 83. By forcing the AGP to associate with unwanted nominees, Arizona has

deprived the AGP of its First Amendment freedom to choose its own nominees and to limit its association to those nominees.

23

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84.

The State has no compelling interest in severely burdening the right of its

citizens to freely associate in the selection of their own political party nominees in a manner that prevents the political party from being hijacked. 85. A.R.S. § 16-645(D) sweeps too broadly in trying to achieve the State’s

ends. This statute is not narrowly tailored to meet the State’s alleged interests because it has allowed ill-intentioned, non-endorsed candidates to infiltrate the AGP and become the AGP’s nominees on the general election ballot. THE STATE DENIES EQUAL PROTECTION TO MINOR PARTIES 86. All political parties, whether large or small, are associations of individuals

that seek to advance some form of political ideology. In this way, they are similarly situated under the United States Constitution. 87. Minor political parties that do not qualify for continued representation on

the Arizona ballot are subject to the plurality requirement in A.R.S. § 16-645(D), whereas major political parties are not. 88. A candidate for a political party qualified for continued representation on

the official ballot gains write-in candidate status pursuant to A.R.S. § 16-645(E), and that candidate must receive the required number of votes as calculated by the nomination petition requirements set forth in A.R.S. § 16-322. 89. Because Arizona allows certain write-in candidates to appear on the general

election ballot by obtaining only a plurality of the votes cast for that party and for that office in the primary, and because this rule does not apply to major political parties, Arizona is protecting major parties’ First Amendment right to associate while denying that same right to minor political parties. This state action invidiously discriminates against minor parties in violation of the Equal Protection Clause of the Fourteenth Amendment to the United States Constitution.

24

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FIRST CAUSE OF ACTION (Violation of 42 U.S.C. § 1983 – First Amendment) Plaintiffs re-allege and incorporate all of the allegations contained in the

preceding paragraphs of this verified complaint as though fully set forth herein. 91. A.R.S. § 16-645(D) is unconstitutional under the First Amendment on its

face and as applied to the AGP. 92. A.R.S. § 16-645(D) is facially unconstitutional because it compels political

parties that have not qualified for continued representation to put forward in the general election, and thereby associate with, candidates who receive only a plurality of the votes, as opposed to a number of votes equivalent to at least the same number of signatures required by A.R.S. § 16-322, which is what is required of Republican, Democrat, and Libertarian write-in candidates. Thus, A.R.S. § 16-645(D) compels minor political parties to associate with candidates that did not garner any modicum of support from the party. 93. A.R.S. § 16-645(D) is unconstitutional as applied to the AGP because it

compels the AGP, following a primary election, to publicly associate with candidates other than those with whom the AGP has freely associated, including candidates whose views are diametrically opposed to those of the AGP. When, as with these Sham Candidates, a write-in prevails in obtaining the AGP nomination despite holding views antithetical to those of the AGP, the State has impermissibly forced the AGP to publicly associate with those whom it would otherwise have chosen to exclude. 94. This statutory scheme enables an unwanted and possibly antithetical

candidate to be placed on the official general election ballot through a voting system that deprives the AGP of its ability to control its association and the identity of its nominees. This statutory scheme violates the AGP’s First Amendment right to free association.

25

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SECOND CAUSE OF ACTION (Violation of 42 U.S.C. § 1983 – Fourteenth Amendment, Equal Protection Clause) 95. Plaintiffs re-allege and incorporate all of the allegations contained in the

preceding paragraphs of this verified complaint as though fully set forth herein. 96. The Equal Protection Clause of the Fourteenth Amendment prohibits state

actors from discriminating against similarly situated individuals or groups unless the state can demonstrate that its interest can withstand the appropriate level of scrutiny. 97. The State discriminates among political parties by subjecting minor parties

to a statutory mechanism that forces them to associate with unwanted nominees while simultaneously shielding major parties from this same mechanism. In doing so, the State invidiously discriminates between two similarly situated, constitutionally protected organizations, and thus violates the Equal Protection Clause of the Fourteenth Amendment. THIRD CAUSE OF ACTION (Violation of 42 U.S.C. § 1983 – Fourteenth Amendment, Substantive Due Process) 98. Plaintiffs re-allege and incorporate all of the allegations contained in the

preceding paragraphs of this verified complaint as though fully set forth herein. 99. The Fourteenth Amendment to the United States Constitution, enforceable

pursuant to 42 U.S.C. § 1983, provides that no state shall deprive any person of life, liberty, or property without due process of law. The above-described conduct by Defendants infringes upon Plaintiffs’ fundamental rights and protected liberty interests, and in so doing violates Plaintiffs’ right not to be deprived of substantive due process. 100. The Fourteenth Amendment’s Due Process Clause has a substantive

component that protects against government interference with fundamental rights and protected liberty interests. Plaintiffs have a protected, fundamental right and liberty interest in being able to meaningfully exercise their right to vote. In fact, there are few rights more fundamental to a functioning democracy than the right to participate in the election of government officials. 26

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101.

Arizona law interferes with and deprives Plaintiffs of their fundamental

right to meaningfully vote because those individuals wishing to support a nominee of the AGP will be unable to distinguish between those candidates who are legitimate AGP nominees and those who have nominated themselves to the ballot in pursuit of ulterior motives. These individuals are forced under A.R.S. § 16-645(D) to cast a meaningless, possibly antithetical vote. FOURTH CAUSE OF ACTION (Violation of Ariz. Const. Art. 7, Section 12 – Purity of Elections) 102. Plaintiffs re-allege and incorporate all of the allegations contained in the

preceding paragraphs of this verified complaint as though fully set forth herein. 103. A.R.S. § 16-645(D) does not “secure the purity of elections and guard

against abuses of the elective franchise” and, therefore, it violates Article 7, Section 12 of the Arizona Constitution. 104. The State of Arizona, by subjecting minority political parties to the

plurality requirement contained in A.R.S. § 16-645(D) to select party nominees, has failed to preserve the purity of elections in violation of the Arizona Constitution. FIFTH CAUSE OF ACTION (Violation of A.R.S. §§ 16-1006, 16-1013) 105. Plaintiffs re-allege and incorporate all of the allegations contained in the

preceding paragraphs of this verified complaint as though fully set forth herein. 106. Defendants acted in violation of A.R.S. § 16-1006 because they

“knowingly by … corrupt means, either directly or indirectly … attempt[ed] to influence an elector in casting his vote or to deter him from casting his vote … attempt[ed] to awe, restrain, hinder or disturb an elector in the free exercise of the right of suffrage … [or] defraud[ed] an elector by deceiving and causing him to vote for a different person for an office or for a different measure than he intended or desired to vote for.” 107. Defendants acted in violation of A.R.S. § 16-1013 because they

“knowingly … [b]y … fraudulent device or contrivance [], [] impede[d], prevent[ed] or 27

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otherwise interfere[d] with the free exercise of the elective franchise of any voter, or to compel, induce or to prevail upon a voter either to cast or refrain from casting his vote at an election, or to cast or refrain from casting his vote for any particular person or measure at an election.” SIXTH CAUSE OF ACTION (Injunctive Relief) 108. Plaintiffs re-allege and incorporate all of the allegations contained in the

preceding paragraphs of this verified complaint as though fully set forth herein. 109. As alleged herein, A.R.S. § 16-645(D) is unconstitutional on its face and as

applied to the AGP. Plaintiffs thus have a strong likelihood of success on the merits. 110. Given the nature of Plaintiffs’ claim that A.R.S. § 16-645(D) is

unconstitutional as applied to them, Plaintiffs lack an adequate remedy at law. 111. There exists an imminent and ongoing threat to the AGP by the Defendants

to deprive Plaintiffs of their constitutional rights by permitting unwanted and possibly antithetical nominees to appear on the general election ballot such that Plaintiffs are forced to associate with these sham candidates in violation of their constitutional rights. 112. The AGP faces irreparable injury if the party’s candidates and nominees are

selected in a process in which the AGP is deprived of its right to define its association. Even if the political party has a chance to disavow any unwanted or antithetical candidates following the primary election, the mere association with these candidates could forever alter the message and positions taken by those associated with the AGP, and could permanently alter the public’s perception of the AGP. 113. Moreover, granting the requested injunctive relief will promote the public

interest by protecting the electoral process and safeguarding the fundamental right to vote. 114. Plaintiffs are entitled to preliminary and permanent injunctive relief

prohibiting the Secretary of State, County Boards of Supervisors, and County Recorders from including the Defendant Sham Candidates on the general election ballot. 28

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115.

In addition, Plaintiffs are entitled to preliminary and permanent injunctive

relief restraining Defendants from implementing A.R.S. § 16-645(D). PRAYER FOR RELIEF Plaintiffs respectfully request the Court enter judgment: 1. Declaring A.R.S. § 16-645(D) unconstitutional both on its face and as

applied to the Arizona Green Party; 2. Applying the same requirements relating to write-in candidates of parties

with continued representation, as set forth in A.R.S. § 16-645(E), to minority political parties, or at least to the Arizona Green Party; 3. Preliminarily and permanently restraining the governmental defendants

named in their official capacities and all those acting in active concert and participation with them from placing the names of the Defendant Sham Candidates on the official general election ballot; 4. Awarding Plaintiffs’ their reasonable attorneys’ fees and costs pursuant to

42 U.S.C. § 1988; and 5. Granting such further relief as this Court deems appropriate.

RESPECTFULLY SUBMITTED this 6th day of September, 2010. COPPERSMITH SCHERMER & BROCKELMAN PLC

By s/ Roopali H. Desai Keith Beauchamp James J. Belanger Roopali H. Desai Attorneys for Plaintiffs Arizona Green Party and Claudia Ellquist

29

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OJS 44 (Rev. 12/07)

Case 2:10-cv-01902-DGC Document 1-1

Filed CIVIL COVER SHEET 09/06/10 Page 1 of 1

The JS 44 civil cover sheet and the information contained herein neither replace nor supplement the filing and service of pleadings or other papers as required by law, except as provided by local rules of court. This form, approved by the Judicial Conference of the United States in September 1974, is required for the use of the Clerk of Court for the purpose of initiating the civil docket sheet. (SEE INSTRUCTIONS ON THE REVERSE OF THE FORM.)

I. (a) PLAINTIFFS Arizona Green Party, an Arizona political party; and Claudia Ellquist, an individual, (b) County of Residence of First Listed Plaintiff Maricopa
(EXCEPT IN U.S. PLAINTIFF CASES)

DEFENDANTS

Ken Bennett, in his official capacity as Secretary of State for the State of Arizona; et al. Maricopa County of Residence of First Listed Defendant
(IN U.S. PLAINTIFF CASES ONLY) NOTE: IN LAND CONDEMNATION CASES, USE THE LOCATION OF THE LAND INVOLVED.

(c) Attorney’s (Firm Name, Address, and Telephone Number)

Attorneys (If Known)

Roopali H. Desai, Coppersmith Schermer & Brockelman PLC 2800 N. Central Ave, Ste 1200, Phoenix, AZ 85004 (602-381-5478) II. BASIS OF JURISDICTION (Place an “X” in One Box Only) III. CITIZENSHIP OF PRINCIPAL PARTIES(Place an “X” in One Box for Plaintiff
’ 1
U.S. Government Plaintiff

’ 3 Federal Question (U.S. Government Not a Party) ’ 4 Diversity
(Indicate Citizenship of Parties in Item III)

(For Diversity Cases Only) PTF Citizen of This State ’ 1

DEF ’ 1

and One Box for Defendant) PTF DEF Incorporated or Principal Place ’ 4 ’ 4 of Business In This State Incorporated and Principal Place of Business In Another State Foreign Nation

’ 2

U.S. Government Defendant

Citizen of Another State

’ 2 ’ 3

’ ’

2

’ 5 ’ 6

’ 5 ’ 6

Citizen or Subject of a Foreign Country

3

IV. NATURE OF SUIT
CONTRACT

(Place an “X” in One Box Only) TORTS PERSONAL INJURY 310 Airplane 315 Airplane Product Liability 320 Assault, Libel & Slander 330 Federal Employers’ Liability 340 Marine 345 Marine Product Liability 350 Motor Vehicle 355 Motor Vehicle Product Liability 360 Other Personal Injury CIVIL RIGHTS 441 Voting 442 Employment 443 Housing/ Accommodations 444 Welfare 445 Amer. w/Disabilities Employment 446 Amer. w/Disabilities Other 440 Other Civil Rights PERSONAL INJURY ’ 362 Personal Injury Med. Malpractice ’ 365 Personal Injury Product Liability ’ 368 Asbestos Personal Injury Product Liability PERSONAL PROPERTY ’ 370 Other Fraud ’ 371 Truth in Lending ’ 380 Other Personal Property Damage ’ 385 Property Damage Product Liability PRISONER PETITIONS ’ 510 Motions to Vacate Sentence Habeas Corpus: ’ 530 General ’ 535 Death Penalty ’ 540 Mandamus & Other ’ 550 Civil Rights ’ 555 Prison Condition

FORFEITURE/PENALTY

BANKRUPTCY

OTHER STATUTES

’ ’ ’ ’ ’ ’ ’ ’ ’ ’ ’ ’ ’ ’ ’ ’ ’ ’

110 Insurance 120 Marine 130 Miller Act 140 Negotiable Instrument 150 Recovery of Overpayment & Enforcement of Judgment 151 Medicare Act 152 Recovery of Defaulted Student Loans (Excl. Veterans) 153 Recovery of Overpayment of Veteran’s Benefits 160 Stockholders’ Suits 190 Other Contract 195 Contract Product Liability 196 Franchise REAL PROPERTY 210 Land Condemnation 220 Foreclosure 230 Rent Lease & Ejectment 240 Torts to Land 245 Tort Product Liability 290 All Other Real Property

’ ’ ’ ’ ’ ’ ’ ’ ’

’ ’ ’ ’ ’ ’ ’

’ 610 Agriculture ’ 620 Other Food & Drug ’ 625 Drug Related Seizure of Property 21 USC 881 ’ 630 Liquor Laws ’ 640 R.R. & Truck ’ 650 Airline Regs. ’ 660 Occupational Safety/Health ’ 690 Other LABOR ’ 710 Fair Labor Standards Act ’ 720 Labor/Mgmt. Relations ’ 730 Labor/Mgmt.Reporting & Disclosure Act ’ 740 Railway Labor Act ’ 790 Other Labor Litigation ’ 791 Empl. Ret. Inc. Security Act
IMMIGRATION ’ 462 Naturalization Application ’ 463 Habeas Corpus Alien Detainee ’ 465 Other Immigration Actions

’ 422 Appeal 28 USC 158 ’ 423 Withdrawal 28 USC 157
PROPERTY RIGHTS ’ 820 Copyrights ’ 830 Patent ’ 840 Trademark

’ ’ ’ ’ ’ ’ ’ ’ ’ ’ ’ ’ ’ ’ ’ ’ ’ ’ ’

SOCIAL SECURITY 861 HIA (1395ff) 862 Black Lung (923) 863 DIWC/DIWW (405(g)) 864 SSID Title XVI 865 RSI (405(g)) FEDERAL TAX SUITS ’ 870 Taxes (U.S. Plaintiff or Defendant) ’ 871 IRS—Third Party 26 USC 7609

’ ’ ’ ’ ’

400 State Reapportionment 410 Antitrust 430 Banks and Banking 450 Commerce 460 Deportation 470 Racketeer Influenced and Corrupt Organizations 480 Consumer Credit 490 Cable/Sat TV 810 Selective Service 850 Securities/Commodities/ Exchange 875 Customer Challenge 12 USC 3410 890 Other Statutory Actions 891 Agricultural Acts 892 Economic Stabilization Act 893 Environmental Matters 894 Energy Allocation Act 895 Freedom of Information Act 900Appeal of Fee Determination Under Equal Access to Justice 950 Constitutionality of State Statutes

V. ORIGIN
’ 1 Original Proceeding

(Place an “X” in One Box Only)

Appeal to District Appellate Court

’ 2 Removed from
State Court

’ 3 Remanded from

’ 4 Reinstated or ’ 5 Transferred from ’ 6 Multidistrict another district Reopened Litigation (specify)

’ 7 Judge from Magistrate
Judgment

42 U.S.C. §§1983, 1988; (1st & 14th Amendments); Ariz. Const. Art. 7, §12; A.R.S. §§16-1006 & -1013 VI. CAUSE OF ACTION Brief description of cause: Constitutional challenge to State election statute CHECK YES only if demanded in complaint: DEMAND $ ’ CHECK IF THIS IS A CLASS ACTION VII. REQUESTED IN UNDER F.R.C.P. 23 ’ Yes ’ No JURY DEMAND: COMPLAINT: VIII. RELATED CASE(S) (See instructions): JUDGE DOCKET NUMBER IF ANY
DATE SIGNATURE OF ATTORNEY OF RECORD

Cite the U.S. Civil Statute under which you are filing (Do not cite jurisdictional statutes unless diversity):

09/06/2010
FOR OFFICE USE ONLY RECEIPT # AMOUNT

s/ Roopali H. Desai

APPLYING IFP

JUDGE

MAG. JUDGE

Print

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Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 1 of 121

Arizona Green Party, et al. v. Bennett, et al. Index of Exhibits to Verified Complaint

Ex. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23.

Document Ryan Blackman Voter Registration
Ryan Blackman Write-In Candidate Filing Papers Richard Grayson Write-In Candidate Filing Papers Christopher Campbell Voter Registration Christopher Campbell Write-In Candidate Filing Papers Anthony Goshorn Voter Registration Anthony Goshorn Write-In Candidate Filing Papers Matthew Shusta Write-In Candidate Filing Papers Clint Clement Voter Registration Clint Clement Write-In Candidate Filing Papers Andrew (“Drew”) Blischak Voter Registration Andrew (“Drew”) Blischak Write-In Candidate Filing Papers Michelle Lochmann Voter Registration Michelle Lochmann Write-In Candidate Filing Papers Thomas Meadows Voter Registration Thomas Meadows Write-In Candidate Filing Papers Theodore Gomez Voter Registration Theodore Gomez Write-In Candidate Filing Papers Benjamin Pearcy Voter Registration Benjamin Pearcy Write-In Candidate Filing Papers Facebook Message from Matt Salmon Transcript of Phone Conversation with Christopher Campbell Declaration of Shawn Nelson

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 2 of 121

Arizona Green Party, et al. v. Bennett, et al. Index of Exhibits to Verified Complaint
(continued)

Ex. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34.

Document
Mary Jo Pitzl, Arizona Democratic Party Alleges Fraud, The Arizona Republic, Aug. 31, 2010 Transcript of Phone Conversation with Gail Ginger Transcript of Phone Conversation with John Mills Declaration of Luisa Valdez Screenshot of May’s Facebook Page Showing a Picture of Goshorn and May Steve May Filing Papers Declaration of Jackie Thrasher Mary Jo Pitzl, Dems see red as Republicans run as Greens, The Arizona Republic, Oct. 11, 2008 Declaration of Jerry Joslyn 2010 Primary Election Official Write-In Results Summary Arizona Secretary of State Minimum Signature Requirements for Each Party

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 3 of 121

EXHIBIT 1

Maricopa County Elections Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 4 of 121

Page 1 of 2

Voter 10.1948
raw: 3155 E ROOSEVELT ST 217 SCOTTSDALE AZ 86257 Re$tdanllatMd

Name: RVAN.KINGSLEY BLACIMAN

Statue: A

Birth Y! TEXAS BIrthotiy Occupadon; OCCUPATION NOT DESIGNATED Preclnct 0167 SALT RIVER qrmarenl EV List: N RelstratIon Date 7113/2010 ModIfIcatIon Date: 7/13/2010 Polling Place Volunteer N Party GREEN

Case 2:10-cv-01902-DGC Document 1-2 Maricopa County Elections

Filed 09/06/10 Page 5 of 121

Page 1 of 2

VOTER

ON HISTORY
Prhnary 2004 Previous P&nary: 2006 PrevIous Qenercl: 2008 Current Prtmar’: 2008 Current Genere 2003

Nod

General: 2004

VTjGRANGE HISTORY

AIE
713112oG;1200:00 AM-70326319 7/2812010 12:00:00 AM-70326319

Date 7131/2010 12:00:00 AM 7/13/2010 12:00:00 AM

Type U N

Reason COR NONCRITICAL ORIG REG

Assoo ID

_

;

A

to

https://l 56.42.40. 50/electioninfo/VoterHistory. aspx? Voterld=3 540948

8/20/2010

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 6 of 121

0-

11310

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 7 of 121

OFFICE OF THE SECRETARY OF STATE STATE OF ARIZONA RECEIPT WRITE-IN CANDIDATE FILING OF REQUIRED FORMS

\LLL

L

SECRETARY OF STATE

(PRIMARY ELECTION)

201JUL 13 PM 252

NAME OF CANDIDATE ADDRESS

Blackman. Ryan 8155 East Roosevelt Street #217
Residence

Scottsdale
City

85257
Zip

MAILING ADDRESS

Same as Above
City Zip

(575) 6357-968
(

Phone Number EMAIL ADDRESS: OFFICE SOUGHT

Fax Number

United States Conaressman

5 District Number

LI El

FORMS TO BE FILED WITH PETITIONS: STATE CANDIDATE NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION, CAMPAIGN FINANCE LAWS STATEMENT FINANCIAL DISCLOSURE STATEMENT

II

I

El

FEDERAL CANDIDATE NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION STATEMENT ON RECALL (OPTIONAL)

OTE: Each candidate for a state office must file with the Secretary of State either a Statement of Organization of a political committee or a $500 Threshold Exemption Statement. Check one and include ID#: ID# from

D STATEMENT OF ORGANIZATION or U $500 THRESHOLD EXEMPTION STATEMENT

(check one)

This is to acknowledge that all forms required by law to be submitted to the Secretary of State for nomination by Arizona Primary Election to be held on August 24, 2010 have been received in this office on the 1 3 th ofjj, 2010.

Candidate or Representative

tOtJ)j.th

Q&yac

KENBENNEU Secretary of State by:

60


(Office Revision 05/20/2010)

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 8 of 121

STATE OF ARIZONA

JUL 13 PM

Write-in Federal Candidate
NOMINATION PAPER AFFIDAVIT OF QUALIFICATION (A.R.S. §§ 16-311,16-312)
FOR OFFICE I BE ONI ’

You are hereby notified that I, the undersigned ,A auqlified elect

ate for the office of (if applicable)

A5
of_

h

the

to beyoted on at thAR

GENERAL (circle one) election to be .held on the _______day

I will have been a citizen of the United States for

2_ 7years next preceding my election and will

meet the age requirement for the office I seek, and when elected, be an Inhabitant of the state from which I am chosen.

I do solemnly swear (or affirm) to the above qualifications and to having fulfilled the constitutional and statutory requirements for holding said office.

Actual residence address or description of place of residence Post office address -

(city or town)

(zip)

(city or town) Print or type your name on the following line as you wish it to be listed. on the Notice of Official Write-In Candidates, last name first:

(zip)

421de&a’I
LAST NAME

1

4411
FIRST NAME

CANDIDATE SIGNATURE Subscribed AND SWORN to (or affirmed) before me this _______day of

te ol Adzona N UNTY MiiI 16, 2012 (Seal)

EAL NION .L.JUNION =

Notary Public My Commission Expires

Office Revision 9/30/2002

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 9 of 121

EXHIBIT 3

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 10 of 121

OFFICE OF THE SECRETARY OF STATE STATE OF ARIZONA RECEIPT WRITE-IN CANDIDATE FILING OF REQUIRED FORMS

(PRIMARY ELECTION)

NAME OF CANDIDATE ADDRESS

Grayson, Richard

1093W. 14th Avenue
Residence

Apache Junction
City

85120
Zip

MAILING ADDRESS

Same as Above
City Phone Number Fax Number - :i;

EMAIL ADDRESS: OFFICE SOUGHT United States Conaressman
S

District Number

FORMS TO BE FILED WITH PETITIONS: STATE CANDIDATE NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION, CAMPAIGN FINANCE LAWS STATEMENT FINANCIAL DISCLOSURE STATEMENT

LI El

FEDERAL CANDIDATE NOMINATION PAPER, AFFIDAVIT OF II QUALIFICATION Pq STATEMENT ON RECALL (OPTIONAL)

,OTE: Each candidate for a state office must file with the Secretary of State either a Statement of Organization of a political committee or a $500 Threshold Exemption Statement. Check one and include ID#: ID# from

fl

STATEMENT OF ORGANIZATION or

El $500 THRESHOLD EXEMPTION STATEMENT

(check one)

This is to acknowledge that all forms required bylaw to be submitted to the Secretary of State for nomination by Arizona Primary Election to be held on August 24, 2010 have been received in this office on the 28 th day of JYiM, 2010.

Candidate or Representative

KEN BENNETT Secretary of State by:

4

1aJt

(Office Revision 05/2012010)

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 11 of 121

STATE OF ARIZONA
191Z

Write-in Federal Candidate NOMINATION PAPER AFFIDAVIT OF QUALIFICATION (A.R.S. §§ 16-311,16-312)

FOR OFFICE USE ONLY

You are hereby notified that I, the undersigne i, a qualified elector, am a candidate for the office of O fi77716J (1k-i-/(( m R(S/o4L /J1 -g’c ’for the (?(: eAJ
Party (if applicable) to be voted on at day of.
,

GENERAL (circle one) election to be held on the

-

12

0/2
a)
years next preceding my election and will

will have been a citizen of the United States for

meet the age requirement for the office I seek, and when elected, be an Inhabitant of the state from which I am chosen.

I do solemnly swear (or affirm) to the above qualifications and to having fulfilled the constitutional and statutory requirements for holding said office.
6,

Z0 / 3 iJ, / Actual residence address or description of place of residence
Post office address

-rLf

7,~~
(zip)

(city or town)

/__~?
(city or

q7J

67
(zip)

2

Print or type your name on the following line as you wish it to be listed on the Notice of Official Write-In Candidates, last name first:

/./c//7’
LAST NAME FIRST NAME

CANDIDATE SIGNATURE
Subscribed AND SWORN to (or affirmed) before me this ) /Y.of.__.1)I

(if’
My

2010

Notary Public

My Commission Expires: 0 5T_ 4 ([/

(

-..

2-0 /

/

(Seal) Office Revision 9/30/2002

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 12 of 121

11’’!

’r:\

/

SECRETARY OF STATE
State Capitol, West Wing Phoenix, Arizona 85007-2808 (602) 542-4285 Fax: (602) 542-6172

STATEMENT ON RECALL (OPTIONAL)
A.R.S., Title 19, § 221-222: Prior to a primary or any election, a candidate for the office of United States senator, or A. representative in congress, may tile with the secretary of state a statement addressed to the people as follows:

If elected to the office

7! 5’

S
(here name the office)

.-.

I shall deem myself responsible to the people and under obligation to them to resign immediately if not re-elected on a recall vote.

(4rej

OR

If elected to the office____________________________________________________________
there name the office)

I shall not deem myself under obligation to the people to resign if not re-elected by a recall vote.

(Signature)

B.

The secretary of state shall give the statement to the public press when made.

Revised 05/92

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 13 of 121

EXHIBIT 4

Case 2:10-cv-01902-DGC Document 1-2 Maricopa County Elections

Filed 09/06/10 Page 14 of 121

Page 1 of 2

-

i..V&M

Name: CH1TOPHER 8ARL CAMPBELL

Status: A

12303209

1d*t!atA&drss: 3365W SANDRA TER PHOENIX, AZ $5053

U4drs
Registration Date: 611912003

/U(rotit,y:
’tptin: STUDENT Prcinct: 0423- KINGS "rmanenLEV List: N

Modification Date: 7/1512010 Polling Place Volunteec N Party: GREEN

Supervisorial: 0U4 GTON #6 SpecIal: Q100 V23

https :// 156.42.40. 50/electioninfo/Voterinformation. aspx? Voterld=23 03209

8/6/2010

Case 2:10-cv-01902-DGC Document 1-2 Maricopa County Elections

Filed 09/06/10 Page 15 of 121

Page 1 of 2

\7QTER ELF.CLIUN H rsT

)RY

Date 1Q00:00 AM-60417835 712112010,(2:00:00 AM-60417835 "30/200812;00:00 AM-201012667 J51200:100:00 AM-200005604 AM-200005604 7/22/2010 12:00:00 AM 7/15/2010 12:00:00 AM 7127/2008 12:000AM 15/2003 12:0000 AM 6/9/2003 12:QO;00 AM

Type U M M U N

Reason COR NON - 0 Rt.TIQAL MOD PlY MOD RES Added DLN to StatelDs ORIG REG

AssolD

-. -

;.

P.

https://1 56.42.40. 50/electioninfo/VoterHistory. aspx? Voterld=23 03209

8/6/2010

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 16 of 121

EXHIBIT 5

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 17 of 121

ii1:p\

/431

STATE OF ARIZONA Write-in Candidate NOMINATION PAPER AFFIDAVIT OF QUALIFICATION CAMPAIGN FINANCE LAWS STATEMENT [A.R.S. §§ 16-311,16-312,16.;905(K)(5)]

SCREThRY OF STATE UJ1JL5 PM 2:07
FOR OFFICE USE.ONLY

I

-

You are hereby notified that I, the undersigned, a qualified elector, am a candidate for the office of

vJr
- -ire..evu

Ljc1

/0 t

for the

Party (if applicable) to be voted on at the

RYr GENERAL (circle one) election to be held on Iwill have been.a citizen of the United States for have been a citizen of Arizona for and my date of birth is the

year(s) next preceding my election and will

-.5 year(s) next preceding my election and that my age is day of

,25

/Yla/
for

, 19 _., and have resided in County for

/.J4arscc2\..

Z5

year(s) and in precinct

tiLa 5

.....3..._ year(s) before my election.

I do solemnly swear (or affirm) that at the time of filing, I am a resident of the county, district or precinct which 1 propose to represent, and as to all other qualifications, I will be qualified at the time of election to hold the office that I seek, having fulfilled the constitutional and statutory requirements for holding said office.

3305 L’\L
Actual residence address, or description of place of residence Post office address .
(S

AoehI
(city or town) (zip)

(city or town)

(zip

Print or type your name on the following line as you wish it to be listed

on the Notice of Official Write-In Candidates.

LAS1VNAME

FIRST NAME

,CANDIDA1ESIGNATURE Subscribed AND SWORN to (or affirmed) .before me this day of 20

) D.

My Commission Expires: (Seat) I have read all applicable laws relating to campaig ,financing and eporting.
J SEAL

I I 9.

Notary Public

- stc1 t, of Z.

ono

My Comm. Exp;res No

- 2, 2011

C

)PIO

ATE SIGNATURE
Office Revision 9/30/2002

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 18 of 121

OFFICE OF THE SECRETARY OF STATE STATE OF ARIZONA RECEIPT WRITE-IN CANDIDATE FILING OF REQUIRED FORMS

F CF

V ED

SECRETARY OF STP1E

(PRIMARY ELECTION)

ZflIU JUL 15 FM 2:

NAME OF CANDIDATE ADDRESS

Campbell, Christopher

3305 West Sandra Ter
Residence

Phoenix
City

85053
Zip

MAILING ADDRESS

Same as Above
City

(623) 332-0525
Phone Number EMAIL ADDRESS OFFICE SOUGHT chris.campbe11525@grnail.com State Senator 10
District Number Fax Number

FORMS TO BE FILED WITH PETITIONS: STATE CANDIDATE NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION, ’’ CAMPAIGN FINANCE LAWS STATEMENT FINANCIAL DISCLOSURE STATEMENT

.LII1 0

FEDERAL CANDIDATE NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION STATEMENT ON RECALL (OPTIONAL)

1UTE: Each candidate for a state office must file with the Secretary of State either a Statement of Organization of a political committee or a $500 Threshold Exemption Statement. Check one and include ID#: 201000690 ID# from

0 STATEMENT OF ORGANIZATION

or

IZI $500 THRESHOLD EXEMPTION STATEMENT
,

(check one)

This is to acknowledge that all forms required by law to be submitted to the Secretary of State for nomination by Arizona Primary Election to be held on August 24, 2010 have been received in this office on the jday of July 2010.

Candidate or Representative

i4

KEN BENNETT Secretary of
1(OIfice Revision 05/20/2010)

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 19 of 121

r r r flLi.J V

’.

SECRETARY OF STATE

Lu
-

2010 JUL
FINANCIAL DISCLOSURE STATEMENT
(For use by Public Officers and Candidates of the State of Arizona)

15 PN 2:07

Name of Public Officer or Candidate

d~ r, ~3 he
3
.5Me

dattz2i’e

1/
P4
12

Address

.Ter 7
5vi6L7’ r

o3
1

ublic Office Held or Sought Check one:

District

LI

I am a public officer filing this statement covering the 12 months of calendar year 20 I am a candidate for a public office, and am filing this Financial Discl,sure Statement covering the 12 20 (’? to the .h)/t/ months preceding the date of this statement, from the month of 20 16 month of
,

/

Lii

I have been appointed to fill a vacancy in a public office and am filing this Financial Disclosure Statement covering the 12 month period ending with the last full month prior to the date I took office.

VERIFICATION
I do solemnly swear that the Financial Disclosure Statement filed herewith is in all things true and correct, and fully shows all information I am required to report pursuant to A.R.S. § 38-542.

Signature o ,ptthlic Officer or Candidate

State of1c?C)rC)
County of

i1 I
.dayof 20

and Subscribed and sworn to (or affirmed) before me this

I.

.1 1
-

OFFIC IA

L SEAL

My Commission expires (Seal)
My Comm Expire

LEYVA
2, 2077

s 11jov.

Secretary of State

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 20 of 121

3. Professional, Occupational and Business Licenses
What to disclose: List all licenses issued to or held by you or any member of your household at any time during the period covered by this Statement.

TYPE OF LICENSE OR PERMIT

NAME IN WHICH LICENSE IS ISSUED

PUBLIC OFFICER OR HOUSEHOLD MEMBER HOLDING LICENSE, IF NOT ISSUED IF OWN NAME

JURISDICTION(S) OF LICENSE

LOCATION OF BUSINESS

Aaodin,

/iflC.0

1?A

1 /)M1

j.

efv M

Ca’j ?1y

4. Personal Creditors
What to disclose: The name and address of each creditor -to whom you, or a member of your household owed a personal debt over $1,000 during the period covered by this Statement. If the debt was incurred or discharged during this period, list the date and whether it was incurred or discharged. You need not disclose: Debts resulting from the ordinary conduct of a business (disclose those in Section C). Debts on residences or recreational property, on motor vehicles not used for commercial purposes, on debts secured by cash values on life insurance, or debts you owe to relatives, personal credit card transactions or istailment contracts.

PERSONAL DEBTS OVER $1,000 NAME AND ADDRESS OF CREDITOR (OR PERSON TO WHOM PAYMENTS ARE MADE)
-

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD OWING THE DEBT

DATE INCURRED AND/OR DISCHARGED

AItct

zI//

7/V’
,lncurredD Discharged

5tde*

ic5

Al’;

Ct.

P2

V 0 r?
lncurredj Discharged LIlncurred Discharged

Secretary of State

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 21 of 121

5. Personal Debtors What to disclose: The name of each debtor who owed you or a member of your household a debt over $1,000 at any time during the period covered by this Statement, and the approximate value of the debt (See last page of value categories). If the debt was incurred or discharged during the period covered by this Statement, report the date and whether the debt was incurred or discharged.

DEBTS OVER $1,000 OWED TO YOU PERSONALLY
PUBLIC OFFICER OR MEMBER OF HOUSEHOLD TO WHOM THE DEBT IS OWED AMOUNT BY VALUE CATEGORY

NAME OF DEBTOR

DATE INCURRED AND/OR DISCHARGED

_________________

D Incurred

El Discharged

Ljl incurred LlDischarged
IncurredDischarged

6. Gifts What to disclose: The name of the donor who gave you or a member of your household a single gift or an accumulation of gifts with a value over $500, if that gift does NOT fit into a category below. need not disclose: Gifts you or a household member received by will, intestate succession, inter vivos Mng) trusts, or testamentary trusts established by. a spouse or ancestor. Gifts received from any other member of the household or relatives to the second degree of consanguinity (parents, grandparents, siblings, children and grandchildren) or political contributions reported on campaign finance reports.
VU 11 PUBLIC OFFICER OR MEMBER OF HOUSEHOLD - RECIPIENT

NAME OF DONOR OF GIFTS OVER $500

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 22 of 121

SECTION B: REPORTABLE INTERESTS

7. Offices or Fiduciary Relationships in Businesses, Nonprofit Organizations or Trusts
What to disclose: The name and address of each business, organization, trust or nonprofit organization or association in which you or any member of your household held any office OR had a fiduciary relationship during the period covered by this Statement. Describe the office or relationship.

NAME OF ORGANIZATION AND ADDRESS

NAME OF PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

OFFICE OR FIDUCIARY RELATIONSHIP

9/

8. Ownership or Financial Interest in Trusts, or Investment Funds
What to disclose: The name and address of each business, trust, investment or retirement fund in which you or any member of your household had an ownership or beneficial interest of over $1 ,000. This includes stocks, partnerships, joint ventures, sole proprietorships, annuities, mutual funds and retirement accounts. List the perbentage of ownership or interest, and categorize the value of the equity. (See last page for value tegories.)

NAME AND ADDRESS OF BUSINESS OR TRUST

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

DESCRIPTION OF INTEREST

EQUITY BY VALUE CATEGORY

/

R’r,trv nf Sft

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 23 of 121

What to disclose: Bonds issued by a single agency worth more than $1,000 that you or a member of your household hold, or held during the period covered by this Statement. If the bonds were acquired or divested during the period, report the date that occurred.

BONDS OVER $1,000

ISSUING AGENCY

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

VALUE CATEGORY

DATE ACQUIRED AND/OR DIVESTED

Acquired EDivested

LjAcquiredLjDivested

LijAcquiredLiDivested

10. Real Property Ownership What to disclose: Arizona real property and improvements to which you or a member of your household hold, or held title during the period covered by this Statement. Describe the property’s location and approximate size. Using the value categories (see last page) report the value of your equity. If that property was acquired or divested during the period covered by this Statement, list the date and what occurred. You need not disclose:
Your primary residence or property you use for personal recreation.

LOCATION AND APPROXIMATE SIZE OF ARIZONA REALTY

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD OR BUSINESS

EQUITY BY VALUE CATEGORY

DATE ACQUIRED OR DIVESTED

LIJAcquired1Divested

]Acquired IlDivested

JAcquired DDivested

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 24 of 121

SECTION C: BUSINESS INTERESTS

II.

Business Names

What to disclose: The name of any business under which you or any member of your household did business during the period covered by this Statement. Include corporations, limited liability companies, partnerships and trade names. Using the definitions provided in statute, disclose if the business named is controlled or dependent. If the business is both controlled and dependent, mark both boxes.

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

BUSINESS NAME

BUSINESS ADDRESS

CONTROLLED AND/OR DEPENDENT BUSINESS

Vl/J

[]Controlled ]Dependent jiControlled Dependent

El Controlled
jiliDependent

LiControlled
Dependent IMPORTANT: IF A BUSINESS LISTED ABOVE DID NOT GROSS MORE THAN $10,000 OR PROVIDE MORE THAN 10% OF YOUR PERSONAL COMPENSATION DURING THE PERIOD COVERED BY THIS STATEMENT, YOU DO NOT NEED TO COMPLETE THE REST OF THIS STATEMENT.

12. Controlled Business Information
What to disclose: The name of each controlled business you listed above, and the goods or services provided } the business. If a single client or customer (person or business) accounts for more than $10,000 and 25% of the gross income, describe what it is your business provides to that customer or client. Then, in column 4, desribe what the client/customer’s business does (if your major client is a person, leave the last column blank). If you do not have a major client, leave the last two columns blank. You need not disclose: The name of any customer or client, or the activities of any customer or client who is an individual rather than a business.

NAME OF YOUR CONTROLLED BUSINESS

GOODS OR SERVICES PROVIDED BY YOUR BUSINESS

WHAT YOUR BUSINESS PROVIDES TO YOUR MAJOR CUSTOMER OR CLIENT

BUSINESS AcTlvrr’y’ OF MAJOR CUSTOMER OR CLIENT

0

rtrv rf Stht

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 25 of 121

13. Dependent Business . Information What to disclose: The name of each dependent business, the goods or services provided by the dependent business, the goods or services provided to the major customer or client and the business activity if the major customer or client is a business. If the dependent business is also a controlled business, disclose it only in response to #12, above. You need not disclose: The name or identity of the customer or client, or the amount of income from the customer or client. If the customer or client is an individual (rather than a business), you are not required to disclose that person’s activities.

NAME OF DEPENDENT BUSINESS

GOODS OR SERVICES PROVIDED BY THE BUSINESS

GOODS OR SERVICES PROVIDED TO THE MAJOR CUSTOMER OR CLIENT

BUSINESS ACTIVITY OF THE MAJOR CUSTOMER OR CLIENT, IF A BUSINESS

14. Real Property Owned by Business What to disclose: Arizona real property and improvements the titles to which were held by a controlled or dependent business listed above. If the business is one that deals in real property and improvements, list the aggregate value of all parcels held in the period covered by this Statement. Describe the property’s location and approximate size. Using the value categories (see last page) report the value of equity in your business. If e property was acquired or divested during the period covered by this Statement, list that and the date.

LOCATION AND APPROXIMATE SIZE OF ARIZONA REALTY

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD OR BUSINESS

EQUITY BY VALUE CATEGORY

DATE ACQUIRED OR DIVESTED

AcquiredDivested

LilAcquired []Divested

Acquired flDivested

]Acquired ]Divested
[:

Case 2:10-cv-01902-DGC Document 1-2

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15. Business’ Creditors
What to disclose: The name and address of each creditor to which your business owed more than $10,000, if that amount was also more than 30% of your total business indebtedness at any time during the period covered by this Statement. If the debt was incurred, or discharged during the period covered by this Statement, report that and the date. You need not disclose: Debts resulting from a business other than a controlled or dependent business.

BUSINESS DEBTS OVER $10,000 AND 30%
NAME AND ADDRESS OF CREDITOR (OR PERSON TO WHOM PAYMENTS ARE .MADE) NAME OF CONTROLLED OR DEPENDENT BUSINESS (FROM ITEM 3 OR 4) DATE INCURRED AND/OR DISCHARGED

11%
jIncurredJDischarged

IncurredflDischarged

lncurredDischarged

16. Business’ Debtors
What to disclose: The name of the debtor for each debt exceeding $10,000 owed to a controlled or

dependent business which was also more than 30% of the total indebtedness to the business which was owed at any time during the preceding calendar year. If the debt was incurred or discharged during the year; list that and the date. List value category. DEBTS OVER $10,000 AND 30% OWED TO YOUR BUSINESS
NAME OF CONTROLLED OR DEPENDENT BUSINESS TO WHOM THE DEBT IS OWED AMOUNT BY VALUE CATEGORY DATE INCURRED AND/OR DISCHARGED

NAME OF DEBTOR

flincurred D Discharged

Incurred

Discharged

Value Categories: (from ARS § 38-542(B)) Category I -$1,000 to $25,000 Category 2 - More than $25,000 to $100,000 Category 3 - More than $100,000

Secretary of State

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 27 of 121

111U111 1 1 1 1 1 111 1 1
0000070262

ED

flc,j L. STATE OF ARIZONA SEC RETAR Y O F STA T E $500 THRESHOLD EXEMPTION STATEMENfO JUL 15 PH 2:02
COMMITTEE ID NUMBER

Pursuant to A.R.S. §§ 16-902.01 and 16-903(A) NAME OF POLITICAL COMMITTEE
FRIENDS OF CHRIS CAMPBELL

201000690
DATE
07/1 512010

TYPE OF COMMITTEE
$500 THRESHOLD (CANDIDATE)

COMMITTEE ADDRESS
3305W SANDRA TER.

CITY PHOENIX CITY PHOENIX

STATE
AZ

ZIP
85053

COMMITTEE MAILING ADDRESS (if different from above)
3305W SANDRA TER

STATE
AZ

ZIP
85053

"OMMITTEE TELEPHONE #
d23) 332-0525

COMMITTEE FAX #

COMMITTEE EMAIL ADDRESS
CHRIS.CAMPBELL525@GMAIL.COM

NAME OF SPONSORING ORGANIZATION (if applicable)

TYPE OF ORGANIZATION

ADDRESS OF SPONSORING ORGANIZATION

RELATIONSHIP TO POLITICAL COMMITTEE

FOR A CANDIDATE’S $500 THRESHOLD COMMITTEE, PLEASE PROVIDE THE FOLLOWING INFORMATION: OFFICE SOUGHT
STATE SENATOR - DISTRICT NO. 10

ELECTION CYCLE
2010

The above named committee hereby asserts the following: The Committee has heretofore neither accepted any Contributions nor made any expenditures. The committee intends to receive or expend less than $500. The committee will file a Statement of Organization within five business days afterexpending or receiving monies over the $500 limit pursuant to A.R.S. 16-902.01 and 16-903(A).

1,

(’r;cpki

(Printed Naihe of Candidate/Committee Officer)

Fr/

b//

, certify that this Exemption Statement is true and complØt.

ole
Signature

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 28 of 121

F:1Th 1 1 N Wo
-1 0

Case 2:10-cv-01902-DGC Document 1-2 Maricopa County Elections

Filed 09/06/10 Page 29 of 121

Page 1 of 2

Naflie: ANTHONY EDWARD GOSHORN SR Vot0rlDJ3337879 ResldentlÆlMdress:694$ E EARLL DR 3, SCOTTSDALE, AZ 85251 Malltnpfress: SIM Year 1966 BfrthState OHIO Irt1t Coiit: Occupation SERVICE Precinct 0571 PAIUTE Registration Date: 113012009 Modification Date: 5/1712010 Polling Piece Volunteer N Party: GREEN

Status:R

rrnanent EV List: N

City Umlt $COTTSDALE JuUeaco. M000WELL MOUNTAIN Hlgt SchdOljCOTTSDALE EepIcntw)Lt.ntffed School’ SCOTTSDALE UNIFIED #48

Congressional 006 LatsIattve 011 Suparvlsortab 003 SpocIaP Q100 Vol

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I
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https :1/156.42.40. 50/electioninfo/Voterinformation.aspx? Voterid=3 337879

8/6/2010

Case 2:10-cv-01902-DGC Document 1-2 Maricopa County Elections

Filed 09/06/10 Page 30 of 121

Page 1 of

HISTORY

Pna2004:

.

PPdn2Q06
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xt !’r4oUs General 2004

PrevIous Generst 2000

Current GonraI 2008

VOTER CHANGE I1IS’FORY
Date Type U M R D U M U N Reason COR NON CRITICAL MOD RES PTY RESTORATION REGISTRATION VERIFICATIO COR NON CRITICAL MOD PTY COR NON CRITICAL ORIOREG . Assoc ID

0001O’’JjOO.0D AM-60079697 0/8/2010 1200 ODAM 60019697
12010 120000 AM 903337879

61812010 120000 AM 5/17/2010 120000 AM
5/2712009 12.00:00 AM

.41/2009 120000 AM 903337879 31W200912:00o0 AM..70301813
O24000AM 10301813 20t920000 AM-201 303520

5127/2009 12:00 00 AM 3119/2009 120000 AM 21712009 12:00:00 AM 2/3/2009 120000 AM 1/30/2009 12.00 OOAM

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. W1.

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https :1/1 56.42.40.50/electioninfo/VoterHistory.aspx?Voterld=3 337879

.

8/6/2010

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 31 of 121

I Mel 10i I NFA

Case 2:10-cv-01902-DGC Document 1-2
’1E

Filed 09/06/10 Page 32 of 121

STATE OF ARIZONA
i9lZ

SEC JUL 5

1E i3
FOR OFFICE USE ONLY

Write-in Candidate
NOMINATION PAPER 7l) AFFIDAVIT OF QUALIFICATION CAMPAIGN FINANCE LAWS STATEMENT [A.R.S. §§ 16-311,16-312,16-905(K)(5)]

You are hereby notified that I, the undersigned, a cpalified elector, am a candidate for the office of f( / L( for the

(r-clJ

.

Party (if applicable) to bevoted on at the JU6_(}

GENERAL (circle one) election lobe held on

jOiC2

I will have been a citizen of the United States for ______ year(s) next preceding my election and will have been a. citizen of Arizona for and my date of birth is the L Zl O year(s) next preceding my election and that my age is day of 19.3%_., and have resided in County for ttL

/

2 year(s) and in precinct

ar(s) before my election. I do solemnly swear (or affirm) that at the time of filing, I am a resident of the county, district or precinct whih I propose to represent, and as to all other qualifications, I will be qualified at the time of election to hold the office that I seek, having fulfilled the constitutional and statutory requirements for holding said office.

)

Actual residence address r description of place of residence Post office address

(city or town)

(zip)

/ 7/
(’city ori(own) (zip)

Print or type your name on the following line as you wish it to be listed on the Notice of Official Write-In Candidates.

.1
J /7
LAST NAME

_/_c/ /
FIRS- NAM

CANOIDATE SIGNATURE Subscribed AND SWORN to (or affirmed) befoine this
ALEXANDRA DE LA PAZ Notary Public - Arizona ricopa County

I_day of
Notary Public

20/o

My Commission Expires: I have read all applicable laws relating to

Sep _ 1__D 013

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 33 of 121

OFFICE OF THE SECRETARY OF STATE STATE OF ARIZONA RECEIPT WRITE-IN CANDIDATE FILING OF REQUIRED FORMS

SECRETARY OF STAlE

(PRIMARY ELECTION)

ZUlU JUL 15 PM I2 37

NAME OF CANDIDATE ADDRESS

Goshorn, Anthony "Grand Pa" 6949 East Earil Drive #3
Residence

Scottsdale
City

85251
Zip

MAILING ADDRESS

P. 0. Box 186 (480)212-6924
Phone Number Fax Number

Tempe
City

85280
Zip

EMAIL ADDRESS: OFFICE SOUGHT

votegrandpagmail.com State Senator

17
District Number

FORMS TO BE FILED WITH PETITIONS: STATE CANDIDATE NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION, ! VN CAMPAIGN FINANCE LAWS STATEMENT FINANCIAL DISCLOSURE STATEMENT

LI LI

FEDERAL CANDIDATE NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION STATEMENT ON RECALL (OPTIONAL)

OTE: Each candidate for a state office must file with the Secretary of State either a Statement of Organization of a political committee or a $500 Threshold Exemption Statement. Check one and include ID#: 201000670 ID# from

0 STATEMENT OF ORGANIZATION or M $500 THRESHOLD EXEMPTION STATEMENT

(check one)

This is to acknowledge that all forms required by law to be submitted to the Secretary of State for nomination by Arizona Primary Election to be held on August 24, 2010 have been received in this office on the jday of J uly, 2010.

Candidate or Representative

fl,1 ,&j)-

s Mf C’
,

KEN BENNETT Secretary of State by:
(Office Revision 05120(2010)

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 34 of 121

Ri-L1 ’vD

RY 0F STE

(ff

ThUJUL(S Mcitd3

FINANCIAL DISCLOSURE STATEMENT
(For use by Public Officers and Candidates of the State of Arizona)

Name of Public Officer or Candid ate

t?
District#

A

Address

Public Office Held or Sought Check one:

/7

I am a public officer filing this statement covering the 12 months of calendar year 20 I am a candidate for a public office, and am filing this Financial Disclosure Statement covejn the 12 , to the 20 months precej the date of this star,pent, from the month of month of 20 J 1-’7-.

1 c-’.

7

El

I have been appointed to fill a vacancy in a public office and am filing this Financial Disclosure Statement covering the 12 month period ending with the last full month prior to the date I took office. VERIFICATION

I do solemnly swear that the Financial Disclosure Statement filed herewith is in all thins-)rue and correct, and fully shows all information I am required to report pursuant to A.R.S. § 38-42. / ,

Officer or Candidate State of County of

Aril 0 {)c
ryAV

)
)2
day of

--r
JLLI’/ , 20 0
CNotary Public

Subscribed and sworn to (or affirmed) before me this

a ___3
My Commission expires
4t,

1

I

ALEXANDRA DE LA PAZ Maricopa County Comm. Expires Sep 10, 2013
- .- -

(Seal)

_17viy

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 35 of 121

SECTION A: PERSONAL DISCLOSURE 1. Names
What to disclose: Your and your spouse’s names and the names of minor children of whom you have legal custody.

YOUR NAME YOUR SPOUSE’S NAME

A 2 1h av z: -

CHILDREN’S NAMES

2. Sources of Personal Compensation
What to disclose: The name and address of each employer who paid you, your spouse, or any member of your household more than $1,000 in salary, wages, commissions, tips or other forms of compensation during the period covered by this report. Describe each employer’s business and the services for which you or a member of your household were Łompensated. Also, list anything of value that any other person, outside your household, received for your use or benefit of you or any member of your household. For example, if a person was paid by your employer to be your housekeeper, list that person’s wages and the name of the employer. You need not disclose: Any money you or any member of your household received that was gross income paid to a business you or your household member owned.
NAME AND ADDRESS OF EMPLOYER OR OTHER SOURCE OF COMPENSATION OVER $1,000

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

DESCRIPTION OF EMPLOYER’S BUSINESS AND SERVICES PROVIDED BY PUBLIC OFFICER OR MEMBER OFHOUSEHcLD
-

Secretary of State

2

Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 36 of 121

3. Professional, Occupational and Business Licenses
What to ,disclose: List all licenses issued to or held by you or any member of your household at any time during the period covered by this Statement.

TYPE OF LICENSE OR PERMIT

NAME IN WHICH LICENSE IS ISSUED

PUBLIC OFFICER OR HOUSEHOLD MEMBER HOLDING LICENSE, IF NOT ISSUED IF OWN NAME

JURISDICTION(S) OF LICENSE

LOCATION OF BUSINESS
mm-

4. Personal Creditors
What to disclose: The name and address of each creditor to whom you, or a member of your household

owed a personal debt over $1,000 during the period covered by this Statement. If the debt was incurred or discharged during this period, list the date and whether it was incurred or discharged.
You need not disclose: Debts resulting from the ordinary conduct of a business (disclose those in Section C).

Debts on residences or recreational property, on motor vehicles not used for commercial purposes, on debts secured by cash values on life insurance, or debts you owe to relatives, personal credit card transactions or installment contracts.

PERSONAL DEBTS OVER $1,000 NAME AND ADDRESS OF CREDITOR (OR PERSON TO WHOM PAYMENTS ARE MADE) PUBLIC OFFICER OR MEMBER OF HOUSEHOLD OWING THE DEBT --

,_

_-DA1E INCURRED AND/OR DISCHARGED

0 Incurred 0 Discharged

0 Incurred 0 Discharged

0 Incurred 0 Discharged

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 37 of 121

5. Personal Debtors What to disclose: The name of each debtor who owed you or a member of your household a debt over $1,000 at any time during the period covered by this Statement, and the approximate value of the debt (See last page of value categories). if the debt was incurred or discharged during the period covered by this Statement, report the date and whether the debt was incurred or discharged.
DEBTS OVER $1,000 OWED TO YOU PERSONALLY
PUBLIC OFFICER OR MEMBER OF HOUSEHOLD TO WHOM THE DEBT IS OWED AMOUNT BY VALUE CATDRr ATE INCURRED AND/OR DISCHARGED

NAME OF DEBTOR

0 incurred 0 Discharged

0 Incurred _0_Discharged

0 Incurred 0 Discharged

6. Gifts What to disclose: The name of the donor who gave you or a member of your household a single gift accumulation of gifts with a value over $500, if that gift does NOT fit into a category below.
or an

You need not disclose: Gifts you or a household member received by will, intestate succession, infer vivos (living) trusts, or testamentary trusts established by a spouse or ancestor. Gifts received from any other member of the household or relatives to the second degree of consanguinity (parents, grandparents, siblings, children and grandchildren) or political contributions reported on campaign finance reports.

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 38 of 121

SECTION B: REPORTABLE INTERESTS

7. Offices or Fiduciary Relationships in Businesses, Nonprofit Organizations or Trusts What to disclose: The name and address of each business, organization, trust or nonprofit organization or association in which you or any member of your household held any office OR had a fiduciary relationship during the period covered by this Statement. Describe the office or relationship.

NAME OF ORGANIZATION AND ADDRESS

NAME OF PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

OFFICE OR FIDUCIARY RELATIONSHIP

---

/

8. Ownership or Financial Interest in Trusts, or Investment Funds What to disclose: The name and address of each bsiness, trust, investment or retirement fund in which you or any member of your.household had an ownership or beneficial interest of over $1 ,000. This includes stocks, partnerships, joint ventures, sole proprietorships, annuities, mutual funds and retirement accounts. List the percentage of ownership or interest, and categorize the value of the equity. (See last page for value categories.)

H
NAME AND ADDRESS OF BUSINESS OR TRUST PUBLIC OFFICER OR MEMBER OF HOUSEHOLD
.

-

--’

DEJSeW INTEREST

VALUE CATEGORY

---

/

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 39 of 121

What to disclose: Bonds issued by a single agency worth more than $1000 that you or a member of your household hold, or held during the period covered by this Statement. If the bonds were acquired or divested during the period, report the date that occurred.

BONDS OvER $1,000

ISSUING AGENCY

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

VALUE CATEGORY

DATE ACQUIRED AND/OR

Djsrs-

0 Acquired 0 Divested

0 Acquired 0 Divested

0 Acquired _0_Divested

10. Real Property Ownership
What to disclose: Arizona real property and improvements to which you or a member of your household hold, or held title during the period covered by this Statement. Describe the property’s location and approximate size. Using the value categories (see last page) report the value of your equity. If that property was acquired or divested during the period covered by this Statement, list the date and what occurred.
You need not disclose: Your primary residence or property you use for personal recreation.

LOCATION AND APPROXIMATE SIZE OF ARIZONA REALTY

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD OR BUSINESS

EQUITY BY VALUE CATEGORY

DATE ACQUIRED OR DIVESTE

0

Acquired 0 Divested

0 Acquired 0 Divested

0 Acquired 0 Divested

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 40 of 121

SECTION C: BUSINESS INTERESTS 11. Business Names

What to disclose: The name of any business under which you or any member of your household did business during the period covered by this Statement. Include corporations, limited liability companies, partnerships and trade names. Using the definitions provided in statute, disclose if the business named is controlled or dependent. If the business is both controlled and dependent, mark both boxes.

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

LED AND/OR BUSINESS NAME BUSINESS ADDESB0 DEPENDENT BUSINESS

Controlled 0 Dependent 0 Controlled 0 Dependent 0 Controlled 0 Dependent 0 Controlled 0 Dependent IMPORTANT: IF A BUSINESS LISTED ABOVE DID NOT GROSS MORE THAN $10,000 OR PROVIDE MORE THAN 10% OF YOUR PERSONAL COMPENSATION DURING THE PERIOD COVERED BY THIS STATEMENT, YOU DO NOT NEED TO COMPLETE THE REST OF THIS STATEMENT.

12. Controlled Business Information
What to disclose: The name of each controlled business you listed above, and the goods or services provided by the business. If a single client or customer (person or business) accounts for more than $10,000 and 25% of the gross income, describe what it is your business provides to that customer or client. Then, in column 4, describe what the client/customer’s business does (if your major client is a person, leave the last column blank). If you do not have a.major client, leave the last two columns blank. You need not disclose: The name of any customer or client, or the activities of any customer or client who is an individual rather than a business.

NAME OF YOUR CONTROLLED BUSINESS

GOODS OR SERVICES PROVIDED BY YOUR BUSINESS

WHAT YOUR BUSINESS PROVIDES TO YOURMAe CyMERbR CLIENT

-

USNEtTlVffVMAJOR CUSTOMER OR CLIENT

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 41 of 121

13. Dependent Business Information What to disclose: The name of each dependent business, the goods or services provided by the dependent business, the goods or services provided to the major customer or client and the business activity if the major customer or client is a business. If the dependent business is also a controlled business, disclose it only in response to #12, above. You need not disclose: The name or identity of the customer or client, or the amount of income from the customer or client. If the customer or client is an individual (rather than a business), you are not required to disclose that person’s activities.
GOODS OR SERVICES PROVIDED TO THE MAJOR CUSTOMER OR CLIENT BUSINESS Aciivnx OF THE MAJOR CUSTOMER OR CLIENT, IF BUSINESS

NAME OF DEPENDENT BUSINESS

GOODS OR SERVICES PROVIDED BY THE BUSINESS

T1
14. Real Property Owned by Business What to disclose: Arizona real property and improvements the titles to which were held by a controlled or dependent business listed above. If the business is one that deals in real property and improvements, list the aggregate value of all parcels held in the period covered by this Statement. Describe the property’s location and approximate size. Using the value categories (see last page) report the value of equity in your business. If the property was acquired or .divested during the period covered by this Statement, list that and the date.
LOCATION AND APPROXIMATE SIZE OF ARIZONA REALTY
V

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD OR BUSINESS
V

EQUITY BY VALUE CATEGORY
V

DATE ACQUIRED OR DIVESTED
V

0 Acquired 0 Divested

0 Acquired 0 Divested

0 Acquired 0 Divested

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 42 of 121

IS. Business’ Creditors
What to disclose: The name and address of each creditor to which your business owed more than $10,000, if that amount was also more than 30% of your total business indebtedness at any time during the period covered by this Statement. If the debt was incurred or discharged during the period covered by this Statement, report that and the date. You need not disclose: Debts resulting from a business other than a controlled or dependent business.

BUSINESS DEBTS OVER $10000 AND 30% NAME AND ADDRESS OF CREDITOR (OR PERSON TO WHOM PAYMENTS ARE MADE) NAME OF CONTROLLED OR DEPENDENT BUSINESS (FROM ITEM 3 OR 4) DATE INCURRED AND/DRSCHARGED

0 Incurred 0 Discharged

0 Incurred 0 Discharged

0 Incurred 0 Discharged

/ 16.

Busness’ Debtors

What to disclose: The name of the debtor for each debt exceeding $10,000 owed to a controlled or dependent business which was also more than 30% of the total indebtedness to the business which was owed at any time during the preceding calendar year. If the debt was incurred or discharged during the year, list that and the date. List value category.
DEBTS OVER $10,000 AND 30% OWED TO YOUR BUSINESS NAME OF CONTROLLED OR DEPENDENT BUSINESS TO WHOM THE DEBT IS OWED AMOUNT BY VALUE CATEGORY DATE INCURRED AND/OR DISCHARGED

NAME OF DEBTOR

-

__------------0 Incurred 0 Discharged

0 Incurred 0 Discharged

Value Categories: (from ARS § 38-542(B)) Category I - $1,000 to $25,000 Category 2 - More than $25,000 to $100,000 Category 3 - More than $100,000

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 43 of 121

111111111111111
0000069889

r SECRETARY OF STATE
r * "-I

r r’ g" -

ZOlU JUL IS AM 11 35
Pursuant to A.R.S. NAME OF POLITICAL COMMITTEE
VOTE GRANDPA! 2010

16-902.01 and 16-903(A)

COMMITTEE ID NUMBER

201000670
DATE
0711212010

TYPE OF COMMITTEE
$500 THRESHOLD (CANDIDATE)

COMMITTEE ADDRESS
6949 E EARLL DR

CITY
SCOTTSDALE

STATE
AZ

ZIP
86251

COMMITTEE MAILING ADDRESS (if different from above) P0 BOX 186 COMMITTEE TELEPHONE #
(480) 212-6924

CITY
TEMPE

STATE
AZ

ZIP
85280

COMMITTEE FAX#

COMMITTEE EMAIL ADDRESS
VOTEGRANDPA@GMAIL.COM

NAME OF SPONSORING ORGANIZATION (if applicable)

TYPE OF ORGANIZATION

ADDRESS OF SPONSORING ORGANIZATION

RELATIONSHIP TO POLITICAL COMMITTEE

FOR A CANDIDATE’S $500 THRESHOLD COMMITTEE, PLEASE PROVIDE THE FOLLOWING INFORMATION: OFFICE SOUGHT
STATE SENATOR - DISTRICT NO. 17

ELECTION CYCLE
2010

The above named committee hereby asserts the following: The committee has heretofore neither accepted any contributions nor made any expenditures. The committee intends to receive or expend less than $500. The committee will file .a Statement of Organization within five business days after expending or receiving monies over the $500 limit pursuant to A.R.S. §§ 16-902.01 and 16-903(A).

4

ithat this Exemption Statement is true and complete.

?/ -/
Date

Office Revision 9/07

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 44 of 121

1 * 4 111-13 9-*bl
4
44 1

0 5

Case 2:10-cv-01902-DGC Document 1-2

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STATE OF ARIZONA Write-in Candidate NOMINATION PAPER AFFIDAVIT OF QUALIFICATION CAMPAIGN FINANCE LAWS STATEMENT (A.R.S. §§ 16-311,16-312,16-905(K)(5)] (

VLU

SCgE

TTE

3 02 ZUlU J L FOR OFFICE USE ONLY 5 M
for

You are hereby notified that I, the undersgned, a qualified elector, am a candidate for the office of

517

7

S’?A1 &7.

the

(C ee&)
WI

Party (if applicable) to be voted on at

GENERAL (circle one) election to be held on_ have been a citizen of the United States for ___ year(s) next preceding my election and will

have been a citizen of Arizona for and my date of birth is the

7
day. of

year(s) next precediyg my election and that my age is

YO

9’

precinct

f’ year(s) and in ___________________________________________ County for year(s) before my election. for 3
I do solemnly swear (or affirm) that at the time of filing, I am a resident of the county, district or

Ai

tJS7

_, 19

4_7, and have resided in

precinct which I propose to represent, and as to all other qualifications, I will be qualified at the time of election to hold the office that I seek, having fulfilled the constitutional and statutory requirements for holding said office.

9’2 S V3
Post office address

i1

fy _/’t

r / cOPa

Actual residence address or description of place of residence

. (city or town)

4z

5/. (zip)

(city or town)

(zip)

Print or type your name on the following line as you wish it to be listed on the Notice of Official Write-In Candidates.

LAST NAME

FIRST NAME

CANDIDATE SlG1’fATLiRE Subscribed AND SWORN to (or affirrnE

My Commission Expires: (Seal) I have read all applicable laws relating to campaign financing and rportin>.

RE CANDIDATE SI6NATU1
OFFICIAL SEAL Office Revision 9/30/2002

RIDGEA KIMBALL NOTARY PJStatoMzona

PINAL COUNTY My Comm. pes A iii 30 2011

Case 2:10-cv-01902-DGC Document 1-2
/
,1

Filed 09/06/10 Page 46 of 121

OFFICE OF THE SECRETARY OF STATE STATE OF ARIZONA

SECRETARY OF STI\IE RECEIPT WRITE-IN CANDIDATE FILING OF REQUIRED FO7 IS M 3: 08
(PRIMARY ELECTIOJUL

RECE/EO

NAME OF CANDIDATE ADDRESS

Shusta, Mafthew

42543 West Avella Drive
Residence

Maricopa
City

85138
Zip

MAILING ADDRESS

Same as Above
City Zip

(520) 631-6764
Phone Number Fax Number

EMAIL ADDRESS OFFICE SOUGHT

mshustal I 'yahoo.com

State Senator

23
District Number

FORMS TO BE FILED WITH PETITIONS:

STATE CANDIDATE
NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION, CAMPAIGN FINANCE LAWS STATEMENT FINANCIAL DISCLOSURE STATEMENT

FEDERAL CANDIDATE

LI LI

NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION STATEMENT ON RECALL (OPTIONAL)

.IbTE: Each candidate for a state office must file with the Secretary of State either a Statement of Organization of a political committee or a $500 Threshold Exemption Statement. Check one and include ID#: 201000675 lD# from

D .STATEMENT OF ORGANIZATION or 0 $500 THRESHOLD EXEMPTION STATEMENT

(check one)

This is to acknowledge that all forms required by law to be submitted to the Secretary of State for nomination by Arizona Primary Election to be held on August 24, 2010 have been received in this office on the 15 day of July, 2010. --

Candidate or Representative

KEN BENNETT Secretary of State by:

IJtLj4

Vf ’iazt&. Revision 05/20/2010) (Office

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 47 of 121

SES4

ScRET!\R OF TME z: :O JUL IS Ni3: O

RECEJ"-P

FINANCIAL DISCLOSURE STATEMENT
(For use by Public Officers and Candidates of the State of Arizona)

.Name of Public Officer or Candidate

A7’4i) Lc,,1LiZ7

Address

/03

U/

Av
District #

Public Office Held or Sought Check one:

D
/

I am a public officer filing this statement covering the 12 months of calendar year 20 I am a candidate for a public office, and am filing this Financial Disclosure Statement covering the 12 months preceding the date of this statement, from the month of ’ZIL-t-, 200?, to the month of _3Tt0, A& 4 I have been appointed to fill a vacancy in a public office and am filing this Financial Disclosure Statement covering the 12 month period ending with the last full month prior to the date I took office.

D

VERIFICATION
I do solemnly swear that the Financial Disclosure Statement filed herewith is in all things true and correct, and fully shows all information I am required to report pursuant

Signature of Public Officer or Candidate State of
Vi

)

County of___________

Subscribed and sworn to (or affirmed) before me this

day of

Lt _,

204.

_BR)DGEAK:MALL 0TARY N State tMzonaj My Commission expires _
M

V

mni.

r69 Arll 30. 2011

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 48 of 121

SECTION A: PERSONAL DISCLOSURE 1. Names
What to disclose: Your and your spouse’s names and the names of minor children of whom you have legal custody.

YOUR NAME YOUR SPOUSE’S NAME

CHILDREN’S NAMES

/

2.

Sources of Personal Compensation

What to disclose: The name and address of each employer who paid you, your spouse, or any member of your household more than $1 ,000 in salary, wages, commissions, tips or other forms of compensation during the period covered by this report. Describe each employer’s business and the services for which you or a member of your household were compensated. Also, list anything of value that any other person, outside your household, received for your use or benefit of you or any member of your household. For example, if a person was paid by your employer to be your housekeeper, list that person’s wages and the name of the employer. You need not disclose: Any money you or any member of your household received that was gross income paid to a business you or your household member owned.
NAME AND ADDRESS OF EMPLOYER OR OTHER SOURCE OF COMPENSATION OVER $1,000

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

DESCRIPTION OF EMPLOYER’S BUSINESS AND SERVICES PROVIDED BY PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

Ca fp/

//Jorlo(

V

s

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 49 of 121

3. Professional, Occupational and Business Licenses

What to disclose: List all licenses issued to or held by you or any member of your household at any time
during the period covered by this Statement.

TYPE OF LICENSE OR PERMIT

NAME IN WHICH LICENSE IS ISSUED

PUBLIC OFFICER OR HOUSEHOLD MEMBER HOLDING LICENSE, IF NOT ISSUED IF OWN NAME

JURISDICTION(S) OF LICENSE

LOCATION OF BUSINESS

/A

4. Personal Creditors

What to disclose: The name and address of each creditor to whom you, or a member of your household owed a personal debt over $1,000 during the period covered by this Statement. If the debt was incurred or discharged during this period, list the date and whether it was incurred or discharged.
You need not disclose: Debts resulting from the ordinary conduct of a business (disclose those in Section C). Debts on residences or recreational property, on motor vehicles not used for commercial purposes, on debts secured by cash values on life insurance, or debts you owe to relatives, personal credit card transactions or installment contracts.
PERSONAL DEBTSOVER $1,000
NAME AND ADDRESS OF CREDITOR (OR PERSON TO WHOM PMYMENTS ARE MADE) PUBLIC OFFICER OR MEMBER OF HOUSEHOLD OWING THE DEBT DATE INCURRED AND/OR DISCHARGED

W
7~
-

i

D Incurred 0 Discharged
0 Incurred
Discharged

[]Incurred

0 Discharged

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 50 of 121

5. Personal Debtors

What to disclose: The name of each debtor who owed you or a member of your household a debt over $1 ,000 at any time during the period covered by this Statement, and the approximate value of the debt (See last page of value categories). If the debt was incurred or discharged during the period covered by this Statement, report the date and whether the debt was incurred or discharged.
DEBTS OVER $1,000 OWED TO YOU PERSONALLY
PUBLIC OFFICER OR MEMBER OF HOUSEHOLD TO WHOM THE DEBT IS OWED AMOUNT BY VALUE CATEGORY

NAME OF DEBTOR

DATE INCURRED AND/OR DISCHARGED

D Incurred lDischarged

0 Incurred LjDischarged
EIncurredEJDischarged
6. Gifts What to disclose: The name of the donor who gave you or a member of your household a single gift or an

accumulation of gifts with a value over $500, if that gift does NOT fit into a category below.

inter vivos (living) trusts, or testamentary trusts established by a spouse or ancestor. Gifts received from any other member of the household or relatives to the second degree of consanguinity (parents, grandparents, siblings, children and grandchildren) or political contributions reported on campaign finance reports.
You need not disclose: Gifts you or a household member received by will, intestate succession,
NAME OF DONOR OF GIFTS OVER $500 PUBLIC OFFICER OR MEMBER OF HOUSEHOLD RECIPIENT

-

Secretary of State Office Revision September 2009

4

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 51 of 121

SECTION B: REPORTABLE INTERESTS

7. Offices or Fiduciary Relationships in Businesses, Nonprofit Organizations or Trusts
What to disclose: The name and address of each business, organization, trust or nonprofit organization or association in which you or any member of your household held any office OR had a fiduciary relationship during the period covered by this Statement. Describe the office or relationship.

NAME OF ORGANIZATION AND,ADDRESS

NAME OF PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

OFFICE OR FIDUCIARY RELATIONSHIP

il/A

8. Ownership or Financial Interest in Trusts, or Investment Funds
What to disclose: The name and address of each business, trust, investment or retirement fund in which you or any member of your household had an ownership or beneficial interest of over $1 ,000. This includes stocks, partnerships, joint ventures, sole proprietorships, annuities, mutual funds and retirement accounts. List the percentage of ownership or interest, and categorize the value of the equity. (See last page for value categories.)

NAME AND ADDRESS OF BUSINESS OR TRUST

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

DESCRIPTION OF INTEREST

EQUITY BY VALUE CATEGORY

ierid/ie/

/4a774j

SZi

qo/

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 52 of 121

9 Bonds What to disclose: Bonds issued by a single agency worth more than $1,000 that you or a member of your household hold, or held during the period covered by this Statement. If the bonds were acquired or divested during the period, report the date that occurred.

BONDS OVER $1,000

ISSUING AGENCY

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

VALUE CATEGORY

DATE ACQUIRED AND/OR DIVESTED

DAcquired DDivested

DAcquired DDivested

EjAcquired flDivested

10. Real Property Ownership What to disclose: Arizona real property and improvements to which you or a member of your household hold, or held title during the period covered by this Statement. Describe the property’s location and approximate size. Using the value categories (see last page) report the value of your equity. If that property was acquired or divested during the period covered by this Statement, list the date and what occurred. You need not disclose: Your primary residence or property you use for personal recreation.

LOCATION AND APPROXIMATE SIZE OF ARIZONA REALTY

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD OR BUSINESS

EQUITY BY VALUE CATEGORY

DATE ACQUIRED OR DIVESTED

AYA

[

]Acquired

[:]

Divested

JAcquired ElDivested

acquired ElDivested

Secretary of State Office Revision September

2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 53 of 121

SECTION C: BUSINESS INTERESTS. 11. Business Names

What to disclose: The name of any business under which you or any member of your household did business during the period covered by this Statement. Include corporations, limited liability companies, partnerships and trade names. Using the definitions provided in statute, disclose if the business named is controlled or dependent. If the business is both controlled and dependent, mark both boxes.
CONTROLLED AND/OR DEPENDENT BUSINESS UControHed Dependent

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

BUSINESS NAME

BUSINESS ADDRESS

/ /

Controlled JjDependent Controlled [ ]Dependent
:

flControlled Dependent

IMPORTANT: IF A BUSINESS LISTED ABOVE DID NOT GROSS MORE THAN $10,000 OR PROVIDE MORE THAN 10% OF YOUR PERSONAL COMPENSATION DURING THE PERIOD COVERED BY THIS STATEMENT, YOU DO NOT NEED TO COMPLETE THE REST OF THIS STATEMENT.

12. Controlled Business Information
What to disclose: The name of each controlled business you listed above, and the goods or services provided

by the business. If a single client or customer (person or business) accounts for more than $10,000 and 25% of the gross income, describe what it is your business provides to that customer or client. Then, in column 4, describe what the client/customer’s business does (if your major client is a person, leave the last column blank). If you do not have a major client, leave the last two columns blank. You need not disclose: The name of any .customer or client, or the activities of any customer or client who is an individual rather than a business.
WHAT YOUR BUSINESS PROVIDES TO YOUR MAJOR CUSTOMER OR CLIENT BUSINESS ACTIVITY OF MAJOR CUSTOMER OR CLIENT

NAME OF YOUR CONTROLLEDBUSINESS

GOODS OR SERVICES PROVIDED BY YOUR BUSINESS

A/A______________

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 54 of 121

13. Dependent Business Information
What to disclose: The name of each dependent business, the goods or services provided by the dependent business, the goods or services provided to the major customer or client and the business activity if the major customer or client is a business. If the dependent business is also a controlled business, disclose it only in response to #12, above. You need not disclose: The name or identity of the customer or client, or the amount of income from the customer or client. If the customer or client is an individual (rather than a business), you are not required to disclose that person’s activities.
GOODS OR SERVICES PROVIDED TO THE MAJOR CUSTOMER OR CLIENT BUSINESS ACTIVITY OF THE MAJOR CUSTOMER OR CLIENT, IF A BUSINESS

NAME OF DEPENDENT BUSINESS

GOODS OR SERVICES PROVIDED BY THE BUSINESS

14. Real Property Owned by Business
What to disclose: Arizona real property and improvements the titles to which were held by a controlled or dependent business listed above. If the business is one that deals in real property and improvements, list the aggregate value of all parcels held in the period covered by this Statement. Describe the property’s location and approximate size. Using the value categories (see last page) report the value of equity in your business. if the property was acquired or divested during the period covered by this Statement, list that and the date.

LOCATION AND APPROXIMATE SIZE OF ARIZONA REALTY

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD OR BUSINESS

EQUITY BY VALUE CATEGORY

DATE ACQUIRED OR DIVESTED

Acquired EDivested

]Acquired flDivested

LJCqu1red LiDivested

DAcquiredDivested

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 55 of 121

15. Business’ Creditors
What to disclose: The name and address of each creditor to which your business owed more than $10,000, if that amount was also more than 30% of your total business indebtedness at any time during the period covered by this Statement. If the debt was incurred or discharged during the period covered by this Statement, report that and the date. You need not disclose: Debts resulting from a business other than a controlled or dependent business.

BUSINESS DEBTS OVER NAME AND ADDRESS OF CREDITOR (OR PERSON TO WHOM PAYMENTS ARE MADE)

$10,000 AND 30%
DATE INCURRED AND/OR. DISCHARGED

NAME OF CONTROLLED OR DEPENDENT BUSINESS (FROM ITEM 3 OR 4)

,

Ii

/1J

Incurred

Discharged

jlncurredflDischarged

[]Incurred[ -] Discharged

16. Business’ Debtors
What to disclose: The name of the debtor for each debt exceeding $10,000 owed to a controlled or

dependent business which was also more than 30% of the total indebtedness to the business which was owed at anytime during the preceding calendar year. If the debt was incurred or discharged during the year, list that and the date. List value category.
DEBTS OVER

$10,000 AND 30% OWED TO YOUR BUSINESS
AMOUNT BY VALUE CATEGORY DATE INCURRED AND/OR DISCHARGED

NAME OF DEBTOR

NAME OF CONTROLLED OR DEPENDENT BUSINESS TO WHOM THE DEBT IS OWED

D incurred fl Discharged
lncurredJDischarged

Value Categories: (from AIRS § 38-542(B)) Category I -$1,000 to $25,000 Category 2 More than $25,000 to $100,000 Category 3 - More than $100,000

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 56 of 121

1 1 1 1 1 1 1 1 1 1 1 1 1 1 Il
0000069964

____

STATE OF ARIZONA SEREThRY OF STAT $500 THRESHOLD EXEMPTION STATEMEj1 JUL 15 ii 3: 02
COMMITTEE ID NUMBER

Pursuant to A.R.S. §§ 16-902.01 and 16-903(A) NAME OF POLITICAL COMMITTEE
MATT FOR SENATE

201000675
DATE
07/13/2010

TYPE OF COMMITTEE $500 THRESHOLD (CANDIDATE) COMMITTEE ADDRESS
42543 WAVELLA DRIVE

CITY
MARICOPA

STATE
AZ

ZIP
86138

COMMITTEE MAILING ADDRESS (if different from above)
42543 WAVELLA DR

CITY
MARICOPA

STATE
AZ

ZIP
85138

COMMITTEE TELEPHONE #
(620) 631-6764

COMMITTEE FAX #

COMMITTEE EMAIL ADDRESS
MSHUSTAI I @YAHOO.COM

NAME OF SPONSORING ORGANIZATION (if applicable)

TYPE OF ORGANIZATION

ADDRESS OF SPONSORING ORGANIZATION

RELATIONSHIP TO POLITICAL COMMITTEE

FOR A CANDIDATE’S $500 THRESHOLD COMMITTEE, PLEASE PROVIDE THE FOLLOWING INFORMATION: OFFICE SOUGHT
STATE SENATOR - DISTRICT NO. 23

ELECTION CYCLE
2010

The above named committee hereby asserts the following: The committee has heretofore neither accepted any contributions nor made any expenditures. The committee intends to receive or expend less than $500. The committee will file a Statement of Organization within five business days after expending or receiving monies over the $500 limit pursuant to A.R.S. §§ 16-902.01 and 16-903(A).

I,

(Printed Name of Candidate/Committe Oer)

J

, certify that this Exemption Statement is true and complete.

7-/ISignature Date

/o

4

Office Revision 9/07 -

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 57 of 121

*

m

U

Case 2:10-cv-01902-DGC Document 1-2 Maricopa County Elections

Filed 09/06/10 Page 58 of 121

Page 1 of 2

Case 2:10-cv-01902-DGC Document 1-2 Maricopa County Elections

Filed 09/06/10 Page 59 of 121

Page 1 of

rrIoN NW , -PRY
wroua Pflmary 2004 N
Next Previous General: 2004 N Previous Pilmavy 2006 N Previous General: 2006 N Current Primary: 2008 N

Current General: 2008 N

VOTER CHANGE HISTORY

A.

7/1012JM012.0000 AM-70326318

*0

69

Date 7/1312010 12 0000 AM 1/8/2010120000

Type M

Reason

Assoc ID

MOD PTY

7/8/20101200 GUAM 200957423
"2f2010 12.0000 AM 200057423 124/100S.,12;00;00 AM-902880629 AM 200967423

AM

U
U R M 0 U N

COR NON CRITICAL
RESTORED TO ACTIVE
RESTORATION

712/2010 12.0000 AM 11812008 112:00:00 AM 5/1912003 12:0000 AM 1/8/2008120000 AM 101812006 12:00:00 AM 10/6/2006 120000 AM

MOD RE8 PT?
REGISTRATION VERIFICATIO COR NON CRITICAL ORIG REG.

i/oaitoo-oo AM-902880629
10/8P2008 120000 AM 200526267 10/7/2008120000 AM 200526257

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 60 of 121

fliNfl1Tri

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 61 of 121

STATE OFARIZONA

.. OF STATE
NOMINATION PAPER AFFIDAVIT OF QUALIFICATION CAMPAIGN FINANCE LAWS STATEMENT ’(A.R.S. §§ 16-311,16-312,16-905(K)(5)]

2010 JUL 4
FOR OFFICE USE ONLY

You are hereby notified that I, the undersigned, a qualified elector, am a candidate for the office of

S1-,k
the the
CQQj\
WI

c’J- I
A

for Party (if applicable) to be voted on at

CI MARY GENERAL (circle one) election to be held on 2 ’1 ,4c.
have been a citizen of the United States for

-Oho
28’ f ,

Q9

year(s) next preceding my election and will , 19 County for and have resided in year(s) and in

have been a citizen of Arizona for and my date of birth is the / ( precinct

’9’
day of

year(s) next preceding my election and that my age is _ for

&./f

/,yr

year(s) before my election.

I do solemnly swear (or affirm) that at the time of filing, I am a resident of the county, district or precinct which I propose to represent, and as to all other qualifications, I will be qualified at the time of election to hold the office that I seek, having fulfilled the constitutional and statutory requirements for holding said office.

R d cs £
Post office address

1

S’ c//cJc /a
(city or town)
’S

Actual residence address or description of place of residence

525’7
(zip)

(city or town) Print or type your name on the following line as you wish it to be listed on the Notice of Official Write-In Candidates.

(zip)

CL’EMfvy
LAST NAME

C-LrA!r
FIRST NAME

CANDIDATE SIGNATURE Subscribed AND SWORN to (or affirmed) before me this
_______ 20 (’

_

I

OFFICIAL SEAL

Y NOTARY PUBLIC State of Mizona I My Commission Expires: MARIGOPA COUNTY @My Comm. Exp l(fSA M 16, 2 .012 ave read all applicable laws relating to campaign financing and reporting.

TRAVIS L. JUNION

I

ago

Notary Public

(p&’
CANDIDATE SIGNATURE
Office Revision 9/30/2002

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 62 of 121

OFFICE OF THE SECRETARY OF STATE STATE OF ARIZONA RECEIPT WRITE-IN CANDIDATE FILING OF REQUIRED FORMS

SECRETARY OF STATE

tEtVED

(PRIMARY ELECTION)

20JULI3 PM 2: 18

NAME OF CANDIDATE ADDRESS

Clement, Clint
8155 East Roosevelt Street #217
Residence

Scottsdale
City

85257
Zip

MAILING ADDRESS

Same as Above
City

(575) 650-0522
Phone Number Fax Number

EMAIL ADDRESS: OFFICE SOUGHT

maiI.com State Representative

17
District Number

FORMS TO BE FILED WITH PETITIONS: STATE CANDIDATE NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION, CAMPAIGN FINANCE LAWS STATEMENT FINANCIAL DISCLOSURE STATEMENT

Z

D LI

FEDERAL CANDIDATE NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION STATEMENT ON RECALL (OPTIONAL)

.4JTE: Each candidate for a state office must file with the Secretary of State either a Statement of Organization of a political committee or a $500 Threshold Exemption Statement. Check one and include ID#: 201000671 ID# from J STATEMENT OF ORGANIZATION or

0 $500 THRESHOLD EXEMPTION STATEMENT

(check one)

This is to acknowledge that all forms required by law to be submitted to the Secretary of State for nomination by Arizona Primary Election to be held on August 24, 2010 have been received in this office on the 13 th day of July, 2010.

Candidate or Representative

C.ctv.uh

&thym

KEN BENNETT Secretary of State by:

’7

(Office Revision 05/20/2010)

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 63 of 121

Li

SE1

E

JUL 13 ..M 1: 8

FINANCIAL DISCLOSURE STATEMENT
(For use by Public Officers and Candidates of the State of Arizona)

Name of Public Officer or Candidate

cL-i\rr
9c~

L\q1

Address

F- tZoose-ve-1+
District #

Public Office’ Held or Sought Check one:

L7

I am a public officer filing this statement covering the 12 months of calendar year 20 I am a candidate for a public office, and am filing this Financial Disclosure Statement covering the 1.2 months preceding the date of this statement, from the month of 20D, to the month of T.l. 20 0

0

I have been appointed to fill a vacancy in a public office and am filing this Financial Disclosure Statement covering the 12 month period ending with the last full month prior to the date I took office.

VERIFICATION
I do solemnly swear that the Financial Disclosure Statement filed herewith is in all things true and correct, and fully shows all information I am required to report pursuant to A.R.S. § 38542.

Signature of Public Officer or Candidate State of County of

/ 61a /-I

4

)

/fl a C,

Subscribed and sworn to (or affirmed) before me this

(

7

day of

)

1

,

20

Not My Commission expires
OFFICIAL S

blic

TRAVIS L. JSYN NOTARY PUBLIC State of Anzona
MARICOPA COUNTY My Comm. Expires April 16, 2012

Secretary of State

Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 64 of 121

SECTION A: PERSONAL DISCLOSURE

1.

Names

What to disclose: Your and your spouse’s names and the names of minor children of whom you have legal

custody.

YOUR NAME YOUR SPOUSE’S NAME

lIA

_p 2

æ1

CHILDREN’S NAMES

2 Sources of Personal Compensation

What to disclose: The name and address of each employer who paid you, your spouse, or any member of your household more than $1,000 in salary, wages, commissions, tips or other forms of compensation during the period covered by this report. Describe each employer’s business and the services for which you or a member of your household were compensated.
Also, list anything of value that any other person, outside your household, received for your use or benefit of you or any member of your household. For example, if a person was paid by your employer to be your housekeeper, list that person’s wages and the name of the employer.

You need not disclose: Any money you or any member of your household received that was gross income paid to a business you or your household member owned.
NAME AND ADDRESS OF EMPLOYER OR OTHER SOURCE OF COMPENSATION OVER $1,000

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

DESCRIPTION OF EMPLOYER’S BUSINESS AND SERVICES PROVIDED BY PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

Ii

C

&A ri

I

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 65 of 121

3. Professional, Occupational and Business Licenses
What to disclose: List all licenses issued to or held by you or any member of your household at any time

during the period covered by this Statement.

TYPE OF LICENSE OR PERMIT

NAME IN WHICH LICENSE IS ISSUED

PUBLIC OFFICER OR HOUSEHOLD MEMBER HOLDING LICENSE, IF NOT ISSUED IF OWN NAME

JURISDICTION(S) OF LICENSE

LOCATION OF BUSINESS

4. Personal Creditors
What to disclose: The name and address of each creditor to whom you, or a member of your household owed a personal debt over $1,000 during the period covered by this Statement. If the debt was incurred or discharged during this period, list the date and whether it was incurred or discharged. You need not disclose: Debts resulting from the ordinary conduct of a business (disclose those in Section C).

Debts on residences or recreational property, on motor vehicles not used for commercial purposes, on debts secured by cash values on life insurance, or debts you owe to relatives, personal credit card transactions or installment contracts.

PERSONAL DEBTS OVER $1,000
NAME AND ADDRESS OF CREDITOR (OR PERSON TO WHOM PAYMENTS ARE MADE) PUBLIC OFFICER OR MEMBER OF HOUSEHOLD OWING THE DEBT DATE INCURRED.AND/OR DISCHARGED

fAJo

,

D Incurred D Discharged
0 Incurred 0 Discharged
[Dlncurred DDischarged

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 66 of 121

5. Personal Debtors What to disclose: The name of each debtor who owed you or a member of your household a debt over $1 ,000 at any time during the period covered by this Statement, and the approximate value of the debt (See last page of value categories). If the debt was incurred or discharged during the period covered by this Statement, report the date and whether the debt was incurred or discharged.

DEBTS OVER $1,000 OWED TO YOU PERSONALLY
PUBLIC OFFICER OR MEMBER OF HOUSEHOLD TO WHOM THE DEBT IS OWED

NAME OF DEBTOR

AMOUNT BY VALUE CATEGORY

DATE INCURRED AND/OR DISCHARGED

D Incurred E Discharged

0 Incurred DDischarged
EjlncurredEiDischarged 6. Gifts What to disclose: The name of the donor who gave you or a member of your household a single gift or an accumulation of gifts with a value over $500, if that gift does NOT fit into a category below. You need not disclose: Gifts you or a household member received by will, intestate succession, inter vivos (living) trusts, or testamentary trusts established by a spouse or ancestor. Gifts received from any other member of the household or relatives to the second degree of consanguinity (parents, grandparents, siblings, children and grandchildren) or political contributions reported on campaign finance reports.

NAME OF DONOR OF GIFTS OVER $500

I

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD - RECIPIENT

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 67 of 121

SECTION B: REPORTABLE INTERESTS

7. Offices or Fiduciary Relationships in Businesses, Nonprofit Organizations or Trusts
What to disclose: The name and address of each business, organization, trust or nonprofit organization or association in which, you or any member of your household held any office OR had a fiduciary relationship during the period covered by this Statement. Describe the office or relationship.

NAME OF ORGANIZATION AND ADDRESS

,

NAME OF PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

OFFICE OR FIDUCIARY RELATIONSHIP

a. Ownership or Financial

Interest in Trusts, or Investment Funds

What to disclose: The name and address of-each business, trust, investment or retirement fund in which you or any member of your household had an ownership or beneficial interest of over $1,000. This includes stocks, partnerships, joint ventures, sole proprietorships, annuities, mutual funds and retirement accounts. List the percentage of ownership or interest, and Categorize the value of the equity. (See last page for value categories.)

NAME AND ADDRESS OF BUSINESS OR TRUST

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

DESCRIPTION OF INTEREST

EQUITY BY VALUE CATEGORY

GvA

C(
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//

FI

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 68 of 121

9. Bonds What to disclose: Bonds issued by a single agency worth more than $1 ,000 that you or a member of your household hold, or held during the period covered by this Statement. If the bonds were acquired or divested during the period, report the date that occurred.

BONDS OVER $1,000

ISSUING AGENCY

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

VALUE CATEGORY

DATE ACQUIRED AND/OR DIVESTED

DAcquired ODivested

EjAcquired DDivested

flAcquired LiDivested

10. Real Property Ownership What to disclose: Arizona real property and improvements to which you or a member of your household hold, or held title during the period covered by this Statement. Describe the property’s location and approximate size. Using the value categories (see last page) report the value of your equity. If that property was acquired or divested during the period Covered by this Statement, list the date and what occurred.

You need not disclose: Your primary residence or property you use for personal recreation.
LOCATION AND APPROXIMATE SIZE OF ARIZONA REALTY PUBLIC OFFICER OR MEMBER OF HOUSEHOLD OR BUSINESS EQUITY BY VALUE CATEGORY DATE ACQUIRED OR DIVESTED

[]Acquired ODivested

acquired Ojivested

jAcquired OJivested

Secretary of State Office Revision September 2009

6

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 69 of 121

SECTION C: BUSINESS INTERESTS 11. Business Names

What to disclose: The name of any business under which you or any member of your household did business

during the period covered by this Statement. Include corporations, limited liability companies, partnerships and trade names. Using the definitions provided in statute, disclose if the business named is controlled or dependent. If the business is both controlled and dependent, mark both boxes.

I

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

BUSINESS NAME

BUSINESS ADDRESS

CONTROLLED AND/OR DEPENDENT BUSINESS

f

.cj

/ /

i1A

RCon trolled

flDependent Controlled ODependent DControlled Dependent

U

O

flControlled Dependent IMPORTANT: IF A BUSINESS LISTED ABOVE DID NOT GROSS MORE THAN $10,000 OR PROVIDE MORE THAN 10% OF YOUR PERSONAL COMPENSATION DURING THE PERIOD COVERED BY THIS STATEMENT, YOU DO NOT NEED TO COMPLETE THE REST OF THIS STATEMENT.
12. Controlled Business Information What to disclose: The name of each controlled business you listed above, and the goods or services provided

by the business. If a single client or customer (person or business) accounts for more than $10,000 and 25% of the gross income, describe what it is your business provides to that customer or client. Then, in column 4, describe what the client/customer’s business does (if your major client is a person, leave the last column blank). If you do not have a major client, leave the last two columns blank.
You need not disclose: The name of any customer or client, or the activities of any customer or client who is

an individual rather than a business.

NAME OF YOUR CONTROLLED BUSINESS

GOODS OR SERVICES PROVIDED BY YOUR BUSINESS

WHAT YOUR BUSINESS PROVIDES TO YOUR MAJOR CUSTOMER OR CLIENT

BUSINESS ACTIVITY OF MAJOR CUSTOMER OR CLIENT

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 70 of 121

13. Dependent Business Information
What to disclose: The name of each dependent business, the goods or services provided by the dependent

business, the goods or services provided to the major customer or client and the business activity if the major customer or client is a business. If the dependent business is also a controlled business, disclose it only in response to #12, above.

You need not disclose: The name or identity of the customer or client, or the amount of income from the
customer or client. If the customer or client is an individual (rather than a business), you are not required to disclose that person’s activities.

NAME OF DEPENDENT BUSINESS

GOODS OR SERVICES PROVIDED BY THE BUSINESS

GOODS OR SERVICES PROVIDED TO THE MAJOR CUSTOMER OR CLIENT

BUSINESS ACTIVITY OF THE MAJOR CUSTOMER OR CLIENT, IF A BUSINESS

14. Real Property Owned by Business
What to disclose: Arizona real property and improvements the titles to which were held by a controlled or

dependent business listed above. If the business is one that deals in real property and improvements, list the aggregate value of all parcels held in the period covered by this Statement. Describe the property’s location and approximate size. Using the value categories (see last page) report the value of equity in your business. If the property was acquired or divested during the period covered by this Statement, list that and the date.

LOCATION AND APPROXIMATE SIZE OF ARIZONA REALTY

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD OR BUSINESS

EQUITY BY VALUE CATEGORY

DATE ACQUIRED OR DIVESTED

Acquired []Divested

Acquired DDivested

acquired JJivested

Acquired []Divested

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 71 of 121

15. Business’ Creditors
What to disclose: The name and address of each creditor to which your business owed more than $10,000, if that amount was also more than 30% of your total business indebtedness at any time during the period covered by this Statement. If the debt was incurred or discharged during the period covered by this Statement, report that and the date. You need not disclose: Debts resulting from a business other than a controlled or dependent business.

BUSINESS DEBTS OVER $10,000 AND 30%
NAME AND ADDRESS OF CREDITOR (OR PERSON TO WHOM PAYMENTS ARE MADE) NAME OF CONTROLLED OR DEPENDENT BUSINESS (FROM ITEM 3 OR 4) DATE INCURRED AND/OR DISCHARGED

[-]Incurred

Discharged

[-]Incurred FjDischarged

[-]Incurred RDischarged

16. Business’ Debtors
What to disclose: The name of the debtor for each debt exceeding $10,000 owed to a controlled or dependent business which was also more than 30% of the total indebtedness to the business which was owed at any time during the preceding calendar year. If the debt was incurred or discharged during the year, list that and the date. List value category.

DEBTS OVER $10,000 AND 30% OWED TO YOUR BUSINESS
NAME OF CONTROLLED OR DEPENDENT BUSINESS TO WHOM THE DEBT IS OWED AMOUNT BY VALUE CATEGORY DATE INCURRED AND/OR DISCHARGED

NAME OF DEBTOR

IncurredD Discharged

Dlncurred

Discharged

Value Categories: (from ARS § 38-542(B)) Category I -$1,000 to $25,000 Category 2 - More than $25,000 to $100,000 Category 3.- More than $100,000

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 72 of 121

11N11111111111111111111
0000069901

STATE OF ARIZONA $500 THRESHOLD EXEMPTION STATEMENT
Pursuant to A.R.S. §§ 16-902.01 and 16-903(A)

U REi;i TE SECERY OF 2010 JUL 13 ’M 1:
148

COMMITTEE ID NUMBER

201000671
DATE
07/12/2010

NAME OF POLITICAL COMMITTEE VOTE CJ - STATE HOUSE DISTRICT 17 TYPE OF COMMITTEE
$500 THRESHOLD (CANDIDATE)

COMMITTEE ADDRESS
8155 E. ROOSEVELT STREET

CITY

STATE
AZ

ZIP
85257

Z.l 7

SCOUSDALE

COMMITTEE MAILING ADDRESS (if different from above)
8155 E ROOSEVELT ST

CITY
SCOTfSDALE

STATE
AZ

ZIP
85257

40 2-1 -7
COMMITTEE FAX #

COMMITTEE TELEPHONE 9
(575) 650-0522

COMMITTEE EMAIL ADDRESS
CLCLEMEN@GMAIL.COM

I

NAME OF SPONSORING ORGANIZATION (if applicable)

TYPE OF ORGANIZATION

ADDRESS OF SPONSORING ORGANIZATION

RELATIONSHIP TO POLITICAL COMMITTEE

FOR A CANDIDATE’S $500 THRESHOLD COMMITTEE, PLEASE PROVIDE THE FOLLOWING INFORMATION: OFFICE SOUGHT
STATE REPRESENTATIVE

ELECTION CYCLE

- DISTRICT 17

2010

The above named Committee hereby asserts the following: The committee has heretofore neither accepted any contributions nor made any expenditures. The committee intends to receive or expend less than $500. The committee will file a Statement of Organization within five business days after expending or receiving monies over the $500 limit pursuant to A.R.S. §§ 16-902.01 and 16-903(A).

I,

I/A (Printed Name of Candidate/Committee Officer)

C

C/Qf-/E

, certify that this Exemption Statement is true and complete.

Signature

Date

Office Revision 9/07

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 73 of 121

EXHIBIT I I

Case 2:10-cv-01902-DGC Document 1-2 .-Maric6pa County Elections

Filed 09/06/10 Page 74 of 121

Page 1 of

Case 2:10-cv-01902-DGC Document 1-2 Maricopa County Elections

Filed 09/06/10 Page 75 of 121

Page 1 of 2

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 76 of 121

EXHIBIT 12

Case 2:10-cv-01902-DGC Document 1-2
TAB 8

Filed 09/06/10 Page 77 of 121

SE\
STATE OF ARIZONA
Write-in Candidate NOMINATION PAPER E).flfl U

TE

UL IS

I0 27

AFFIDAVIT OF QUALIFICATION CAMPAIGN FINANCE LAWS STATEMENT [A.R.S. §§ 16-311,16-312,16-905(K)(5)]

FOR OFFICE USE ONLY

You are hereby notified that I, the undersigned, a qualified elector, am a candidate for the office of pt e p

ki Q

jV
2.. LI /?
yM
&

for the Party (if applicable) to be voted on at the

C? r
RfvtAY1 or GENERAL (circle one) election to be held on I will have been a citizen of the United States for have been a citizen of Arizona for and my date of birth is the 0 L/

g 1’

Z_1 t i-i

year(s) next preceding my election and will

year(s) next preceding my election and that my age is day of

24

,t

Dcernkr
for

,

19 __

,

and have resided in

r.

C. 0

County for

LI

year(s) and in precinct

II

k-vt t 05 e

?)

year(s) before my election.

I do solemnly swear (or affirm) that at the time of filing, I am a resident of the county, district or precinct which I propose to represent, and as to all other qualifications, I will be qualified at the time of election to hold the office that I seek, having fulfilled the constitutional and statutory requirements for holding said office.

Q1 27 N. P
Post office address

IRA 4 71

6 ke. n A (Cc
(city or town) (city or town)

5 22
(zip)

Actual residence address or description of place of residence

(zip)

Print or type your name on the following line as you wish it to be listed

on the Notice of Official Write-In Candidates.

~ak
LAST NAME.
-

Dce LAj
FIRST N AN TE SIGNATURE

Subscribed AND SWORN to (or affirmed) before me this

day of

20/ 0

STEPHEN PORPORA MARICOPA COUNTY
MYmlon re.

March 10,

My Commission Expires: __ 3

/0’

I have read all applicable laws relating to campaign financing and rep ing.

CANDIDATE SIGNATURE
Office Revision 9/30/2002

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 78 of 121

OFFICE OF THE SECRETARY OF STATE STATE OF ARIZONA RECEIPT WRITE-IN CANDIDATE FILING OF REQUIRED FORMS

(PRIMARY ELECTION)

NAME OF CANDIDATE ADDRESS

Blischak, Drew 2727 North Price Road #71
Residence

Chandler
City

85224
Zip

MAILING ADDRESS

Same as Above
Lip

(480) 269-3739
Phone Number EMAIL ADDRESS: OFFICE SOUGHT bIischakqmaiI.com State Representative 20 District Number Fax Number

FORMS TO BE FILED WITH PETITIONS: STATE CANDIDATE NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION, ; CAMPAIGN FINANCE LAWS STATEMENT FINANCIAL DISCLOSURE STATEMENT

L]

FEDERAL CANDIDATE NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION STATEMENT ON RECALL (OPTIONAL)

NOTE: Each candidate for a state office must file with the Secretary of State either a Statement of Organization of a political Jommittee or a $500 Threshold Exemption Statement. Check one and include ID#: 201000686 ID# from

LIJ STATEMENT OF ORGANIZATION or N $500 THRESHOLD EXEMPTION STATEMENT (check one)
,

This is to acknowledge. that all forms required by law to be submitted to the Secretary of State for nomination by Arizona Primary Election to be held on August 24, 2010 have been received in this office on the I day of July 2010.

Candidate or Representative

2OLVAU.

£QJtJL

KEN BENNETT Secretary of State by:

4

Office Revision 05/20/2010)

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 79 of 121

’ -

D

SETIRdFATE

2010 JUL 15 AM 10: 27
FINANCIAL. DISCLOSURE STATEMENT
(For use by Public Officers and Candidates of the State of Arizona)

Name of Public Officer or Candidate
Address

-Pn

ew

2727

h 5c,~6k G N. Pcv R * 71
District #_____

Pub li c Office Held or Sought Check one:

El

lam a public officer filing this statement covering the 12 months of calendar year 20 I am a candidate for a public office, and am filing this Financial Disclosure Statement covering the 12 5u17 I 206I to the months preceding the date of this statement from the month of tI-I month of lot 9 20 10

El

I have been appointed to fill a vacancy in a public office and am filing this FinnclaI Disclosure Statement covering the 12 month period ending with the last full month prior to the date I took office.

VERIFICATION
I do solemnly swear that the Financial Disclosure Statement filed herewith is in all things true and correct, and fully shows all information I am required to report pursuant to A.R.S. § 38-542.

Signatre of Pub ic Officer or Candidate State of _ County of

r )I

STEPHEN PORPORA
NOTARY PUBUC ARIZONA
-

L

My Commission Expirea March 10, 2014

Subscribed and sworn to (or affirmed) before me this

I

ay of

20

/0

My

3. Commission expires (Seal)
1

\

Notary Public

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 80 of 121

SECTION A: PERSONAL DISCLOSURE 1. Names
What to disclose: Your and your spouse ’s names and the names of minor children of whom you have legal custody.

YOUR NAME

Drew
E

Bt-k

: :M

2.

Sources of Personal Compensation

What to disclose The name and address of each employer who paid you your spouse or any member of your household more than $1,000 in salary, wages, commissions, tips Or other forms of compensation during the period covered by this report. Describe each employer’s. business and the services for which you or a member of your household were ompensated. Also, list anything of value that any other person, outside your household, received for your use or benefit of you or any member of your household. For example, if a person was paid by your employer to be your housekeeper, list that person’s wages and the name of the employer. You need not disclose: Any money you or any member of your household received that ws gross income paid to a business you or your household member owned.
NAME AND ADDRESS OF EMPLOYER OR OTHER SOURCE OF COMPENSATION OVER $1,000
-

OFFICER OR MEMBER OF HOUSEHOLD

PUBLIC

DESCRIPTION OF EMPLOYER’S BUSINESS AND SERVICES PROVIDED BY PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

Sit itk

1 lOG’ P U41 C6

Pc’e4e

a1feA..
?

OR D
f’ht’cn

vSirr)ec

c’v-ce

Secretary of State Office Revision September 2009

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Filed 09/06/10 Page 81 of 121

3. Professional, Occupational and Business Licenses What to disclose: List all licenses issued to or held by you or any member of your household at any time during the period covered by this Statement.
PUBLIC OFFICER OR HOUSEHOLD MEMBER HOLDING LCENSEI IF NOT ISSUED IF OWN NAME

TYPE OF LICENSE OR PERMIT

NAME IN WHICH LICENSE IS ISSUED

JURISDICTION(S) OF LICENJE

LOCATION OF BUSINESS

_____

__

4. Personal Creditors What to disclose: The name and address of each creditor to whom you, or a member of your household owed a personal debt over $1,000 during the period covered by this Statement. If the debt was incurred or discharged during this period, list the date and whether it was incurred or discharged. You need not disclose: Debts resulting from the ordinary conduct of a business (disclose those in Section C). Debts on residences or recreational property, on motor vehicles not used for commercial purposes, on debts secured by cash values on life insurance, or debts you owe to relatives, personal credit card transactions or installment contracts.
PERSONAL DEBTS OVER $1,000 NAME AND ADDRESS OF CREDITOR (OR PERSON TO WHOM PAYMENTS ARE MADE) PUBLIC OFFICER OR MEMBER OF HOUSEHOLD OWING THE DEBT DATE INCURRED AND/OR DISCHARGED

iv
0 Incurred 0 Discharged .0 Incurred 0 Discharged

7
0 Incurred 0 Discharged

Secretary of State Office Revision September2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 82 of 121

5. Personal Debtors
What to disclose: The name of each. debtor who owed you or a member of your household a debt over $1,000 at any time during the period covered by this Statement, and the approximate value of the debt (See last page of value categories). If the debt was incurred or discharged during the period covered by this . Statement, report the date and whether the debt was incurred or discharged. DEBTS
-NAME OF DEBTOR OVER $1,000 OWED TO YOU PERSONALLY

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD TO WHOM THE DEBT IS OWED

AMOUNT BY VALUE g.EGORY

DATE INCURRED AND/OR DISCHARGED

0

Incurred _0_Discharged

_

0 Incurred 0 Discharged

0 Incurred 0 Discharged

6. Gifts What to disclose: Thename of the’ donor who gave you or a member of your household a single gift or an accumulation of gifts with a value over $500, if that gift does NOT fit into a category below. You need not disclose: Gifts you or a household member received by will, intestate succession, inter vivos (living) trusts, or testamentary trusts established by a spouse or ancestor. Gifts received from any other member of the household or relatives to the second degree of consanguinity (parents, grandparents, siblings, children and grandchildren) or political contributions reported on campaign finance reports.
NAME OF DONOR OF GIFTS OVER $500

I’

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD - RECIPIENT

Secretary of State Office Revision September 2009

4

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Filed 09/06/10 Page 83 of 121

SECTION B: REPORTABLE INTERESTS 7. Offices or Fiduciary Relationships in Businesses, Nonprofit Organizations or Trusts
What to disclose: The name and address of each business, organization, trust or nonprofit organization or association in which you or any member of your household held any office OR had a fiduciary relationship during the period covered by this Statement. Describe the office or relationship.

NAME OF ORGANIZATION AND ADDRESS

NAME OF PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

OFFICE OR FIDUCIARY RELATIONSHIP

Pre51i

S. Ownership or Financial Interest in Trusts, or investment Funds
What to - disclose: The name and address of each .bªsiness, trust, investment or retirement fund in which you or any member of your household had an ownership or beneficial interest of over $1,000. This includes stocks, partnerships, joint ventures, sole proprietorships, annuities, mutual funds and retirement accounts. List the percentage of ownership or interest, and categorize the value of the equity. (See last page for value categories.)

NAME AND ADDRESS OF BUSINESS OR TRUST
-

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD’

DESCRIPTION OF INTEREST

EQUITY BY VALUE CAT E GORY

-

Pc’et.1j
_____________________

0wrec
-

T133

.Li’Oo

I Ifc

f

t.gq

____________

IiiIEEELIIt_
Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 84 of 121

What to disclose: Bonds issued by a single agency worth more than $1 ,000 that you or a member of your household hold, or held during the period covered by this Statement. If the bonds were acquired or divested during the period, report the date that occurred.

PUBLIC OFFICER OR BONDS OVER $1, 000 ISSUING AGENCY MEMBER OF HOUSEHOLD VALUE CATEGORY DATE ACQUIRED AND/OR DIVESTED

0

Acquired 0 Divested

________ __________

____

0 Acquired 0 Divested

0 Acquired 0 Divested

10. Real Property Ownership
What to disclose: Arizona real property and improvements to which you or a member of your household hold, or held title during the period covered by this Statement. Describe the property’s location and approximate size. Using the value categories (see last page) report the value of your equity. . If that property was acquired or divested during the period covered by this Statement, list the date and what occurred. You need not disclose: Your primary residence or property you use for personal recreation.

LOCATION AND APPROXIMATE SIZE OF ARIZONA REALTY

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD OR BUSINESS
.

EQUITY BY VALUE CATEGORY

DATE ACQUIRED OR DIVESTED

ia7NPc’kP1F71
d&cZ529.

Pret-..i B14Ak
S

Acquired 0 Dieted

f\IA fV 5,

0 Acquired El Divested

0 Acquired 0 Divested

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 85 of 121

SECTION C: BUSINESS INTERESTS It Business Names

What to disclose: The name of any business under which you or any member of your household did business during the period covered by this Statement. Include corporations, limited liability companies, partnerships and trade names. Using the definitions provided in statute, disclose if the business named is controlled or dependent. If the business is both controlled and dependent, mark both boxes.
CONTROLLED AND/OR DEPENDENT BUSINESS

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

BUSINESS NAME

BUSINESS ADDRESS

cm

1:

WoE

Wr

zoo

’6ontrolled 0 Dependent 0 Controlled 0 Dependent 0 Controlled 0 Dependent

IMPORTANT: IF A BUSINESS LISTED ABOVE DID NOT GROSS MORE THAN $10,000 OR PROVIDE MORE THAN 10% OF YOUR PERSONAL COMPENSATION DURING THE PERIOD COVERED BY THIS STATEMENT,, YOU DO NOT NEED TO COMPLETE THE REST OF THIS STATEMENT.

12. .CntroHed Business Information What to disclose: The name of each controlled business you listed above, and the goods or services provided by the business. If a single client or customer (person or business) accounts for more than $10,000 and 25% of the gross income, describe what it is ybur business provides to that customer or client. Then, in column 4, describe what the client/customer’s business does (if your major client is person, leave the last column blank). If you do not have a major client, leave the last two columns blank. You need not disclose: The name of any customer or client, or the activities of any customer or client who is an individual rather than a business.
WHAT YOUR BUSINESS PROVIDES TO YOUR MAJOR CUSTOMER OR CLIENT BUSINESS ACTIVITY OF MAJOR CUSTOMER OR CLIENT

NAME OF YOUR CONTROLLED BUSINESS

GOODS OR SERVICES PROVIDED BY YOUR BUSINESS

Pe4e

tr

Flo-or

Secretary of State Office Revision September 2009

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Filed 09/06/10 Page 86 of 121

13. Dependent Business Information What to disclose: The name of each dependent business, the goods or services provided by the dependent business, the goods or services provided to the major customer or client and the business activity if the major customer or client is a business. If the dependent business is also a controlled business, disclose it only in response to #12, above. You need not disclose: The name or identity of the, customer or client, or the amount of income from the customer or client. If the customer or client is an individual (rather than a business), you are not required 10 disclose that person’s activities.
GooDs OR SERVICES PROVIDED TO THE MAJOR CUSTOMER OR CLIENT BUSINESS AcTlvrry’ OF THE MAJOR CUSTOMER OR CLIENT, IF A BUSINgSS

NAME OF DEPENDENT BUSINESS

GOODS. OR.SERVICES PROVIDED BY THE BUSINESS

14. Real Property Owned by Business What to disclose: Arizona real property and improvements the titles to which were held by a cntrotled or dependent business listed above. If the business is one that deals in real property and improvements, list the aggregate value of all parcels held in the period covered by this Statement. Describe the property’s location and approximate size. Using the value categories (see last page) report the value of equity in your business. If the property was acquired or divested during the period covered by this Statement, list that and the date.
LOCATION AND APPROXIMATE SIZE OF ARIZONA RE A LTY PUBLIC OFFICER OR MEMBER OF HOUSEHOLD OR BUSINESS EQUITY BY VALUE CATEGORY DATE ACQUIRED OR DIVESTED

0 Acquired 0 Divested

O Acquired 0 Divested

I

0 Acquired D Divested

7 o Acquired 0 Divested

Secretary of State Office Revision September 2009

8

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15. Business’ Creditors What to disclose: The name and address of each creditor to which your business owed more than $10,000, if that amount was also more than 30% of your total business indebtedness at any time during the period covered by this Statement. If the debt was incurred or discharged during the period covered by this Statement, report that and the date. You need not disclose: Debts resulting from a business other than a controlled or dependent business
BUSINESS DEBTS OVER $10,000 AND 30%
NAME AND ADDRESS OF CREDITOR (OR PERSON TO WHOM PAYMENTS ARE MADE) NAME OF CONTROLLED OR DEPENDENT BUSINESS (FROM ITEM 3 OR 4) DATE INCURRED AND/OR DISCHARGED

MCI ma
0 Incurred 0 Discharged

O Incurred 0 Discharged

O Incurred 0 Discharged

16. Business’ Debtors What to disclose: The name of the debtor for each debt exceeding $10,000 owed to a controlled or dependent business which was also more than 30% of the total indebtedness to the business which was owed at any time during the preceding calendar year. If the debt was incurred or discharged during the year, list that and the date. List value category.
DEBTS OVER $10,000 AND 30% OWED TO YOUR BUSINESS
NAME OF CONTROLLED OR DEPENDENT BUSINESS TO WHOM THE DEBT IS OWED AMOUNT BY VALUE CATEGORY DATE INCURRED AND/OR DISCHARGED

NAME OF DEBTOR

IV
0 Incurred 0 Discharged

0 Incurred 0 Discharged

Value Categories: (from AIRS § 38-542(B)) Category I - $1,000 to $25,000 Category 2 More than $25,000 to $100,000 Category 3 - More than $100,000

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 88 of 121

111N11111111111111111E
0000070197

STATE OF ARIZONA $500 THRESHOLD EXEMPTION STATEMENT
Pursuant to A.R.S. 16-902.01 and 16-903(A)

SECRE

OF STME

ZOJULt5 M1O:Zl
COMMITTEE ID NUMBER

201000686
DATE
07/14/2010

NAME OF POLITICAL COMMITTEE
ELECT DREW BLISCHAK

TYPE OF COMMITTEE
$500 THRESHOLD (CANDIDATE)

COMMITTEE ADDRESS
2727 N. PRICE #71

CITY
CHANDLER

STATE
AZ

ZIP
85224

COMMITTEE MAILING ADDRESS (if different from above)
2727 N PRICE RD UNIT 71

CITY
CHANDLER

STATE
AZ

ZIP
85224

COMMITTEE TELEPHONE #
(480) 2693739

COMMITTEE FAX #

COMMITTEE EMAIL ADDRESS
BLISCHAK@GMAIL.COM

NAME OF SPONSORING ORGANIZATION (if applicable)

TYPE OF ORGANIZATION

ADDRESS OF SPONSORING ORGANIZATION

nA

RELATONSHIP TO POLITICAL COMMITTEE

NA VA

FOR A CANDIDATE’S $500 THRESHOLD COMMITTEE, PLEASE PROVIDE THE FOLLOWING INFORMATION: OFFICE SOUGHT
STATE REPRESENTATIVE

ELECTION CYCLE

- DISTRICT 20

2010

The above named committee hereby asserts the following: The committee has heretofore neither accepted any contributions nor made any expenditures. The committee intends to receive or expend less than $500. The committee will file a Statement of Organization within five business days after expending or receiving monies over the $500 limit pursuant to A.R.S. §§ 16-902.01 and 16-903(A).

Nev B I
)

(Printed Name of Candidate/Committee Officer)

5c,ha, k

, certify that this Exemption Statement is true and complete.

0

Office Revision 9/07

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 89 of 121

EXHIBIT 13

Case 2:10-cv-01902-DGC Document 1-2 Maricopa County Elections

Filed 09/06/10 Page 90 of 121 Page 1 of 2

W’oRMAPzoN
Name: MICHELLE COLETTE LOCHMANN

Voter ID 3239263 RetdllaI Address: 1650 E THUNDERBIRD RD 1076, PHOENIX, AZ 65022 MaUngAIdress. BLrtI Ycar974 Birth Blh O9thpAWPRQF:OTHER Pxnct 0246 EL CAMINO COLORADO

Registration Data: 9/28/2008 ModifIcatIon

M6: 7111=0110

Polling Place Volunteer N Party: GREEN

Permanent EV List Y

Case 2:10-cv-01902-DGC Document 1-2 Maricopa County Elections

Filed 09/06/10 Page 91 of 121
Page 1 of 2

aoN BIs’roRy
: currentGeneral: 208 V
-

ke4jPsIs General: 2004

PravIou3 General: 2000 :

VGWEWBANGE HISTORY
Date 7/19/2
20000 AM-70042839 7/1512010 12:00:00 AM

Type M U M U N

Reason

Assoc ID

MOD PTY COR NON CRITICAL MOD PTV PTY
COR NON CRITICAL

7m/20iOi2O0:0O AM-202000363 ’7/201Q 12:0 0:00 AM-202090363 S~o 0:00
AM-201116099

716/2010 12:00:00 AM 6/1412010 12:00:00 AM iWiI2000 12:00:00 AM
0/26/2008 12:00:00AM

ORIGREG

11

.,

https:// 156.42.40. 50/elcctionintb/VotcrI-Iistory.aspx?Voterld=3239263

8/6/2010

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 92 of 121

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STATE OF ARIZONA Write-in Candidate NOMINATION PAPER AFFIDAVIT OF QUALIFICATION CAMPAIGN FINANCE LAWS STATEMENT [A.R.S. §§ 16-311,16-312,16-905(K)(5)]

SECRE IA

OF S TT E

g JUL 5 PM t: L3
FOR OFFICE USE ONLY

You are hereby notified that I, the undersigned, a qualified elector, am a candidate for the office of for the Party (if applicable) to be voted on at theiR or GENERAL (circle one) election to be held on I will have been a citizen of the United States for ’35 year(s) next preceding my election and will have been a citizen of Arizona for and my date of birth is the

a

year(s) next preceding my election and that my age is County for for

3 5

/ 14 vcl_ o.,
precinct

I

day of

, 19, and have resided in

2

year(s) and in

V(

. year(s) before my election.

I do solemnly swear (or affirm) that at the time of filing, I am a resident of the county, district or precinct which I propose to represent, and as to all other qualifications, I will be qualified at the time of election to hold the office that I seek, having fulfilled the constitutional and statutory requirements for holding said office.

74 4JZrJ TJ/’ 7&eiy
Actual residence address or description of place of residence (city or town)

(zip)
(zip)

7
Post office address (city or town) Print or type your name on the following line as you wish it to be listed on the Notice of Official Write-In Candidates.

CANDIDATE SIGNATURE Subscribed AND SWORN to (or affirmed) before me this
f BRIAN McGRATH NOTAR

/)

day of

’-’- _k

20

TA Urizona

Notary Public

My Commission Expires: (Seal) I have read all applicable laws relating to campaign financing,.and reporting.

I Comm. Expires Nov. 21, 2010

k
CANDIDATE SIGNATURE
Office Revision 9/3012002

Case 2:10-cv-01902-DGC Document 1-2

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OFFICE OF THE SECRETARY OF STATE STATE OF ARIZONA RECEIPT WRITE-IN CANDIDATE FILING OF REQUIRED FORMS

SECREThRY OF STATE

RECEVLD

2010 JUL 15 pj t: 43

(PRIMARY ELECTION)

NAME OF CANDIDATE ADDRESS

Lochmann, Michelle 1550 East Thunderbird Road #1076
Residence

Phoenix
City

85022
Zip

MAILING ADDRESS

13236 North 7th Street Suite 4 #263 (602) 441-4063
Phone Number Fax Number

Phoenix
City

85022
Zip

EMAIL ADDRESS: OFFICE SOUGHT

micheIIeIochmannyahoo.com

Secretary of State
District Number

FORMS TO BE FILED WITH PETITIONS: STATE CANDIDATE NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION, CAMPAIGN FINANCE LAWS STATEMENT FINANCIAL DISCLOSURE STATEMENT

El

FEDERAL CANDIDATE NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION STATEMENT ON RECALL (OPTIONAL)

5TE: Each candidate for a state office must file with the Secretary of State either a Statement of Organization of a political committee or a $500 Threshold Exemption Statement. Check one and include I 201000697 ID# from 0 STATEMENT OF ORGANIZATION or

0 $500 THRESHOLD EXEMPTION STATEMENT (check one)

This is to acknowledge that all forms required by law to be submitted to the Secretary of State for nomination by Arizona Primary Election to be held on August 24, 2010 have been received in this office on the 15th day ofyIv, 2010.

Candidate or Representative

KEN BEN N ETT Secretary of State by:
(Office Revisbn 05/20/2010)

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 95 of 121

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P

:ci

FINANCIAL DISCLOSURE STATEMENT
(For use by Public Officers and Candidates of the State of Arizona)

Name of Public Officer or Candidate

/1/1 (r’ h’

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ko c X wi itna
/o7i
oeiY
District #

Address

ublic Office Held or Sought Check one:

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I am a public officer filing this statement covering the 12 months of calendar year 20 I am a candidate for a public office, and am filing this Financial Disclosure Statement covering the 12 200 g , to the months preceding the date of this statement, from the month of i j _.20 0 month of

El

1 have been appointed to fill a vacancy in a public office and am filing this Financial Disclosure Statement covering the 12 month period ending with the last full month prior to the date I took office.

VERIFICATION
I do solemnly swear that the Financial Disclosure Statement filed herewith is in all things true and correct, and fully shows all information I am required to report pursuantto A. .S. § 38-542.

Signature of Public Officer Candidate State ofJ’i County of , itc
)
)

Ail,

Subscribed and sworn to (or affirmed) before me this / OFFICIAL SEAL BRIAN .MGGRATFJ NOTARY PUBUC Slate ojzona MAR166PA COUNTY Myomm.ExpirosNov.21,2o1 j

day of

,20

/7

/( /7_i ( C t_7 My Commission expires
(Seal) Secretary of State Office Revision September 2009

0

, Notary Public

I

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 96 of 121

SECTION A: PERSONAL DISCLOSURE
1. Names

What to disclose: Your and your spouse’s names and the names of minor children of whom you have legal custody.

YOUR NAME YOUR SPOUSE ’S NAME

CHILDREN ’S NAMES

OL

1OS

X\
2. Sources of Personal Compensation What to disclose: The name and address of each employer who paid you, your spouse, or any member of your household more than $1 ,000 in salary, wages, commissions, tips or other forms of compensation during the period covered by this report. Describe each employer ’s business and the services for which you or a member of your household were compensated. Also, list anything of value that any other person, outside your household, received for your use or benefit of you or any member of your household. For example, if a person was paid by your employer to be your housekeeper, list that person’s wages and the name of the employer. You need not disclose: Any money you or any member of your household received that was gross income paid to a business you or your household member owned.
NAME AND ADDRESS OF EMPLOYER OR OTHER SOURCE OF COMPENSATION OVER $1,000

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

DESCRIPTION OF EMPLOYER’S BUSINESS AND SERVICES PROVIDED BY PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

b)

cLE$L3fl kO

ro Lq

Qc(rjYce

Secretary of State Office Revision September 2009

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I Professional, Occupational and Business Licenses
What to disclose: List all licenses issued to or held by you or any member of your household at any time during the period covered by this Statement.

TYPE OF LICENSE OR PERMIT

NAME IN WHICH LICENSE IS ISSUED

PUBLIC OFFICER OR HOUSEHOLD MEMBER HOLDING LICENSE, IF NOT ISSUED IF OWN NAME

JURISDICTION(S) OF LICENSE

LOCATION OF BUSINESS

_____

4. Personal Creditors
What to disclose: The name and address of each creditor to whom you, or a member of your household owed a personal debt over $1,000 during the period covered by this Statement. If the debt was incurred or discharged during this period, list the date and whether it was incurred or discharged. You need not disclose: Debts resulting from the ordinary conduct of a business (disclose those in Section C). Debts on residences or recreational property, on motor vehicles not used for commercial purposes, on debts secured by cash values on. life insurance, or debts you owe to relatives, personal credit card transactions or installment contracts.

PERSONAL DEBTS OVER $1,000
NAME AND ADDRESS OF CREDITOR (OR PERSON TOW HOM PAYMENTS ARE MADE) PUBLIC OFFICER OR MEMBER OF HOUSEHOLD OWING THE DEBT DATE INCURRED AND/OR DISCHARGED

C-ftUQO
4Qth1\0O RT) X.S

J\QYUWQ
Incurred El Discharged

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Incurred 0 Discharged

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gfncurredE]Disch arged
>

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4

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 98 of 121

5. Personal Debtors
What to disclose: The name of each debtor who owed you or a member of your household a debt over
$1,000 at any time during the period covered by this Statement, and the approximate value of the debt (See last page of value categories). If the debt was incurred or discharged during the period covered by this Statement, report the date and whether the debt was incurred or discharged.

DEBTS OVER $1,000 OWED TO YOU PERSONALLY PUBLIC OFFICER OR MEMBER OF HOUSEHOLD TO WHOM THE DEBT IS OWED

NAME OF DEBTOR

AMOUNT BY VALUE CATEGORY

DATE INCURRED AND/OR DISCHARGED

El Incurred El Discharged

J incurred

JDischarged

fl IncurredDischarged
6. Gifts
What to disclose: The name of the donor who gave you or a member of your household a single gift or an
accumulation of gifts with a value over $500, if that gift does NOT fit into a category below.

You need not disclose:

Gifts you or a household member received by will, intestate succession, inter vivos (living) trusts, or testamentary trusts established by a spouse or ancestor. Gifts received from any other member of the household or relatives to the second degree of consanguinity (parents, grandparents, siblings, children and grandchildren) or political contributions reported on campaign finance reports.

NAME OF DONOR

OF GIFTS

OVER $500

I PUBLIC OFFICER OR MEMBER

OF

HOUSEHOLD - RECIPIENT

Secretary of State Office Revision September 2009

4

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SECTION B: REPORTABLE INTERESTS

7. Offices or Fiduciary Relationships in Businesses, Nonprofit Organizations or Trusts
What to disclose: The name and address of each business, organization, trust or nonprofit organization or association in which you or any member of your household held any office OR had a fiduciary relationship during the period covered by this Statement. Describe the office or relationship.

NAME OF ORGANIZATION AND ADDRESS

NAME OF PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

OFFICE OR FIDUCIARY RELATIONSHIP

8. Ownership or Financial Interest in Trusts, or Investment Funds
What to disclose: The name and address of each business, trust, investment or retirement fund in which you

or any member of your household had an ownership or beneficial interest of over $1,000. This includes stocks, partnerships, joint ventures, sole proprietorships, annuities, mutual funds and retirement accounts. List the percentage of ownership or interest, and categorize the value of the equity. (See last page for value categories.)

NAME AND ADDRESS OF BUSINESS OR TRUST

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD
.

DESCRIPTION OF INTEREST

EQUITY BY VALUE CATEGORY

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

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9. Bonds

NA

What to disclose: Bonds issued by a single agency worth more than $1,000 that you or a member of your household hold, or held during the period covered by this Statement. If the bonds were acquired or divested during the period, report the date that occurred.

BONDS OVER $1,000

ISSUING AGENCY

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

VALUE CATEGORY

DATE ACQUIRED AND/OR DIVESTED

DAcquired DDivested

[]Acquired ElDivested

DAcquired fDivested

10.. Real Property Ownership What to disclose: Arizona real property and improvements to which you or a member of your household hold, or held title during the period covered by this Statement. Describe the property’s location and approximate size. Using the value categories (see last page) report the value of your equity. If that property was acquired or divested during the period covered by this Statement, list the date and what occurred. You need not disclose: Your primary residence or property you use for personal recreation.

LOCATION AND APPROXIMATE SIZE OF ARIZONA REALTY

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD OR BUSINESS

EQUITY BY VALUE

CATEGORY

DATE ACQUIRED OR DIVESTED

DAcquired DDivested

]Acquired JDivested

Acquired DDivested

Secretary of State Office Revision September 2009

6

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SECTION C: BUSINESS INTERESTS II. Business Names

What to disclose: The name of any business under which you or any member of your household did business during the period covered by this Statement. Include corporations, limited liability companies, partnerships and trade names. Using the definitiOns provided in statute, disclose if the business named is controlled or dependent. If the business is both controlled and dependent, mark both boxes.
PUBLIC OFFICER OR MEMBER OF HOUSEHOLD CONTROLLED AND/OR DEPENDENT BUSINESS

BUSINESS NAME

BUSINESS ADDRESS

Qorp -4Q
CAA Lkox h

1323
A

)7SkY?+
- -

jcorz LJ-

ControlIed Dependent

& L9N- 6V 0

[]Controlled DDependent DControlled Dependent flControlled Dependent

IMPORTANT: IF A BUSINESS LISTED ABOVE DID NOT GROSS MORE THAN $10,000 OR PROVIDE MORE THAN 10% OF YOUR PERSONAL COMPENSATION DURING THE PERIOD COVERED BY THIS STATEMENT, YOU DO NOT NEED TO COMPLETE THE REST OF THIS STATEMENT.

12. Controlled Business Information

What to disclose: The name of each controlled business you listed above, and the goods or services provided by the business. If a single client or customer (person or business) accounts for more than $10,000 and 25% of the gross income, describe what it is your business provides to that customer or client. Then, in column 4, describe what the client/customer’s business does (if your major client is a person, leave the last column blank). If you do not have a major client, leave the last two columns blank. You need not disclose: The name of any customer or client, or the activities of any customer or client who is an individual rather than a business.
GOODS OR SERVICES PROVIDED BY YOUR BUSINESS WHAT YOUR BUSINESS PROVIDES TO YOUR MAJOR CUSTOMER OR CLIENT BUSINESS. ACTIVITY OF MAJOR CUSTOMER OR CLIENT

NAME OF YOUR CONTROLLED BUSINESS

Secretary of State Office Revision September 2009

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13. Dependent Business Information
What to disclose: The name of each dependent business, the goods or services provided by the dependent business, the goods or services provided to the major customer or client and the business activity if the major customer or client is a business. If the dependent business is also a controlled business, disclose it only in response to #12, above. You need not disclose: The name or identity of the customer or client, or the amount of income from the customer or client. If the customer or client is an individual (rather than a business), you are not required to disclose that person’s activities.

NAME OF DEPENDENT BUSINESS

GOODS OR SERVICES PROVIDED BY THE BusiNEss

GOODS OR SERVICES PROVIDED TO THE MAJOR CUSTOMER OR CLIENT

BusiNEss AcTivrrr’ OF THE MAJOR CUSTOMER OR CLIENT, IF A BUSINESS

14. Real Property Owned by Business
What to disclose: Arizona real property and improvements the titles to which were held by a controlled or dependent business listed above. If the business is one that deals in real property and improvements, list the aggregate value of all parcels held in the period covered by this Statement. Describe the property’s location and approximate size. Using the value categories (see last page) report the value of equity in your business. If the property was acquired or divested during the period covered by this Statement, list that and the date.

LOCATION AND APPROXIMATE SIZE OF ARIZONA REALTY

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD OR BUSINESS

EQUITY BY VALUE CATEGORY

DATE ACQUIRED OR DIVESTED

LjAcquired IliDivested

Acquired ODivested

jocquired ODivested

Acquired IJDivested

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

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15. Business’ Creditors \ \

.

What to disclose: The name and address of each creditor to which your business owed more than $10,000, if that amount was also more than 30% of your total business indebtedness at any time during the period covered by this Statement. If the debt was incurred or discharged during the period covered by this Statement, report that and the date. You need not disclose: Debts resulting from a business other than a controlled or dependent business.
BUSINESS DEBTS OVER $10,000 AND 30%
NAME AND ADDRESS OF CREDITOR (OR PERSON TO WHOM PAYMENTS ARE MADE) NAME OF CONTROLLED OR DEPENDENT BUSINESS (FROM ITEM 3 OR 4) DATE INCURRED AND/OR DISCHARGED

Dlncurred

Discharged

Dlncurred MDischarged

DlncurredDischarged

16. Business’ Debtors
What to disclose: The name of the debtor for each debt exceeding $10,000 owed to a controlled or dependent business which was also more than 30% of the total indebtedness to the business which was owed at any time during the preceding calendar year. lithe debt-was incurred or discharged during the year, list that and the date. List value category.
DEBTS OVER $10,000 AND 30% OWED TO YOUR BUSINESS
NAME OF CONTROLLED OR DEPENDENT BUSINESS TO WHOM THE DEBT IS OWED AMOUNT BY VALUE CATEGORY DATE INCURRED AND/OR DISCHARGED

NAME OF DEBTOR

0 Incurred D.Dlscharged 0 Incurred R Discharged
Value Categories: (from AIRS § 38-542(B)) Category I - $1,000 to $25,000 Category 2 More than $25,000 to $100,000 Category 3 - More than $100,000

Secretary of State Office Revision September 2009

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I I11i11IJli1 Ull Il !
0000070338

Initial Registration 0 Amended Statement r1 Out M State Committee

STATE OF ARIZONA SECRET?RY Ip - S1iTE POLITICAL COMMITTEE 4:38 STATEMENT OF ORGANJ93 15
Titles 16 & 19, Arizona Revised Statutes Definitions, statutory references and important information on page 2. COMMITTEE ID NUMBER

o

Standing Political Committee

201000697
DATE
07/16/2010

NAME OF POLITICAL COMMITTEE (For ballot measure committee, name shall include official petition serial number)
LOCHMANN FOR SECRETARY OF STATE

TYPE OF COMMITTEE
CANDIDATE (NON-PARTICIPATING)

BALLOT MEASURE

0 SUPPORT

0 OPPOSE

COMMITTEE ADDRESS
1550 E THUNDERBIRD RD APT 1076

CITY
PHOENIX

STATE
AZ

ZIP
85022

COMMITTEE MAILING ADDRESS (if different from above)
13236 N 7TH ST SUITE 4 #263

CITY
PHOENIX

STATE
AZ

ZIP
85022

COMMITTEE TELEPHONE #
(602) 441-4063

COMMITTEE FAX #
.

COMMITTEE EMAIL ADDRESS
MICHELLELOCHMANN@YAHOO.COM

NAME OF SPONSORING ORGANIZATION (if applicable)

TYPE OF ORGANIZATION

ADDRESS OF SPONSORING ORGANIZATION

RELATIONSHIP TO POLITICAL COMMITTEE

EACH POUTICAL COMMITTEE SHALL HAVE A CHAIRMAN AND TREASURER. THE POSITION OF CHAIRMAN AND TREASURER OF A SINGLE POLITICAL COMMITTEE MAY NOT BE HELD BY THE SAME INDIVIDUAL, EXCEPT THAT A CANDIDATE MAY BE CHAIRMAN AND TREASURER OF HIS OR HER OWN CAMPAIGN COMMITTEE. A.R.S. § 16-902(A). NAME OF COMMITTEE CHAIRMAN
MICHELLE LOCI-IMANN

CHAIRMAN’S TELEPHONE #
(602)441-4063

CHAIRMAN’S FAX #

CHAIRMAN’S ADDRESS
13236 N 7TH ST SUITE 4#263

CITY
PHOENIX

STATE
I AZ

ZIP
85022

CHAIRMAN’S OCCUPATION
INSURANCE BROKER

CHAIRMAN’S EMPLOYER
CORPORATE BENEFIT CONSULTING

CHAIRMAN’S EMAIL ADDRESS
MICHELLELOCHMANNcYAHOO.COM

NAME OF COMMITTEE TREASURER
MIKE GARLIKOV

TREASURER’S TELEPHONE It
.
(602) 441-4063

TREASURER’S FAX It
__________________

TREASURER’S ADDRESS
17606 N 17TH PL

CITY
PHOENIX

STATE
AZ

ZIP
85022

TREASURER’S OCCUPATION
MARKETING

TREASURER’S EMPLOYER
SELF

TREASURER’S EMAIL ADDRESS
. MICHELLELOCHMANN@YAHOO.COM

BEFORE A COMMITTEE ACCEPTS A CONTRIBUTION OR MAKES AN EXPENDITURE IT SHALL DESIGNATE AT LEAST ONE ACCOUNT AT A QUALIFIED FINANCIAL INSTITUTION. A.R.S. § 16-902(C). LIST THE NAMES OF ALL FINANCIAL INSTITUTIONS WITH WHICH THE COMMITTEE MAINTAINS ACCOUNTS OR SAFETY DEPOSIT BOXES. (Do not list account numbers.) 1.
BANK OF AMERICA

2.

3.

FOR A CANDIDATE’S CAMPAIGN COMMITTEE OR AN EXPLORATORY COMMITTEE, PROVIDE THE FOLLOWING INFORMATION: (For Exploratory Committees party affiliation and office sought are optional.) NAME OF CANDIDATE OR DESIGNATING INDIVIDUAL ("DI")
MICHELLE LOCHMANN

ELECTION CYCLE
2010

CANDIDATE OR D/I’S TELEPHONE #
(602)441-4063

CANDIDATE OR DII’S FAX it

COUNTY OF RESIDENCE
MARICOPA

CANDIDATE OR 0/I’S ADDRESS
13236 N 7TH ST SUITE 4 #263

CITY
PHOENIX

STATE
AZ

ZIP
85022

CANDIDATE OR D/I’S EMAIL ADDRESS
PJHCHELLELOCHMANNYAHOO.COM

PARTY AFFILIATION
GREEN

OFFICE SOUGHT
SECRETARY OF STATE

PAGE 1 of 2

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[Committee ID: Date: Form ID:

201000697
0711512010

0000070338

S
Chairman’s D/I’s or Candidate’s

STATE OF ARIZONA POLITICAL COMMITTEE STATEMENT OF ORGANIZATION

YOUR APPLICATION IS NOT COMPLETE WITHOUT THE REQUIRED SIGNATURES BELOW: BOX I All committees require the signature of both the chairman and treasurer. Standing Committees, see BOX 3 below.

CHAIRMAN’S AND TREASURER’S STATEMENT: We, the undersigned, have examined the information contained in this statement of organization and, to the best of our knowledge and belief, it is true, correct and complete Date: Date:

7-1 $"--/ c9 7 -1 9 -1

Treasurer’s signature:

BOX 2

Complete and sign this additional box only if the committee is candidate’s campaign committee or exploratory committee.

DESIGNATING INDIVIDUAL OR CANDIDATE’S STATEMENT: I authorize the above-named political committee as my political committee to receive contributions and make exoenditures on my behalf.

Date:

7 15/ 0

BOX 3

Complete and notarize this box only if the committee has been in existence for more than one year and is filing for Standing Committee status.

STANDING POLITICAL COMMITTEE’S STATEMENT (if applicable) (A.R.S. §16-902.1): I/we hereby declare the status of this political committee as a standinq oolltical committee. Date: Date: Chairman’s

BRIAN . Mc 33RA
MARICOPACO NTY
. NOTAjy PUBLIC ’ M,IP.MOPA q1@4f Arizona ’I
)ss. 0fAri7Qn
ii

7 /$ 7’V

Treasurer’s )

State of Arizona Conty of

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flycbUfly of It<

p_)

SU$CRIBED AND rORN.XQ before me this My Commission Expi otalY Public

L&JRIBED AND SWORN TO before me this j Ji _;c7 , ll
Commission Expires/i_/ ’1l6tary Public

/

DEFINITION OF POLITICAL COMMIUEE: A.R.S. § 16-901(19) "Political committee" means a candidate or any association or combination of persons that is organized, conducted or combine d for the purpose of influencing the result of any election or to determine whether an individual will become a candidate for election in this state or in any county, city, town, district or precinct in this state, that engages in political activity in beh aif of or against a candidate for election or retention or in support of or opposition to an initiative, referendum or recall or any other measure or proposition and that applies for a serial number and circulates petitions and, in the case of a candidate for public office except those exempt pursuant to section 16-903, that receives contributions or makes expenditures in connection therewith, notwithstanding that the association or combination of persons may be a part of a larger association, combination of persons or sponsoring organization not primarily organized, conducted or combined for the purpose of influencing the result of any election in this state or in any county, city, t own or precinct in this state. NOTE FOR INDIVIDUALS INVOLVED IN POLITICAL ACTIVITIES: An individual, acting alone, is not a political committee under Arizona law and need not file a statement of organization. If any additional person or persons join the effort (as defined above in A.R.S. § 16-901(19)) begun by an individual, the association of persons has become a "political committee’ under Arizona law, and must file a statement of organization before accepting contributions, making expenditures, distributing literature or circulating petitions. A.R.S. § 16-902.01(A). NOTE FOR THOSE INVOLVED IN INITIATIVE, REFERENDUM AND RECALL EFFORTS: Before circulating initiative, referendum or recall petitions, a political committee must file its statement of organization with the appropriate filing office. Signatures obtained on petitions prior to the filing of the statement of organization are void and shall not be counted in determining the legal sufficiency of the petition. A.R.S. §§ 19-114(3) and I 9-21)2(C). Even though an individual, acting alone, may begin the initiative, referendum or recall effort, as soon as other persons join the effort, the association of persons must register a a political committee. The statement of organization must be filed regardless of whether the committee intends to accept contributions or make expenditures.

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Office Revision 9/07

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Filed 09/06/10 Page 106 of 121

EXHIBIT 15

Case 2:10-cv-01902-DGC Document 1-2 Maricopa County Elections

Filed 09/06/10 Page 107 of 121

Page 1 of 2

Case 2:10-cv-01902-DGC Document 1-2 Maricopa County Elections

Filed 09/06/10 Page 108 of 121

Page 1 of

VOTER ELECrION HISTORY
Next Pevtbus Primary: 2004 , Next Pj’evfrtue General 2004
Preous Pdma,y 2008 PrevIous General 2008 Current Prtmary 2008 Current General 2008

VCANGE.HISTORY

S

At’#’SS

E

Data 712812010 12:00:00 AM 7/16/201012:00:00AM

Type U N

Reason COR NON CRITICAL ORIGREG

Assoc ID

712W2010 12:00:00 AM-202112975
7/201201012:00:00AM-202112975

https:// 156.42.40. 50/electioninfo/VoterHistory.aspx? VoterId3 536046

8/6/2010

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 109 of 121

EXHIBIT 16

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 110 of 121

STATE OF ARIZONA
-.

Write-in Candidate
NOMINATION PAPER AFFIDAVIT OF QUALIFICATION CAMPAIGN FINANCE LAWS STATEMENT 16 311,16 312,16 905(K)(5)]
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JUL 15 PH

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FOROFFICEUSEONLY

You are hereby notified that I, the undersigned, a qualified elector, am a candidate for the office of

f’_
the PRIMARY5? GENERAL (circle one) election to be held
--

for Party (if applicable) to be voted on at

--+wHJ-Iave been a citizen of the United States for /1! day of

6 year(s) next preceding my election and will
, ,

have been a citizen of Arizona for and my date of birth is .the _ ’A/\ 01-1 -O 24 C precinct

year(s) next preceding my election and that my age is

1k O*’J’1’VflcL
for

I 9PZ-1’ and have resided in
year(s) and in

County for

_3

year(s) before my election.

I do solemnly swear (or affirm) that at the time of filing, 1 am a resident of the county, district or precinct which I propose to represent, and as to all other qualifications, I will be qualified at the time of election to hold the office that I seek, having fulfilled the constitutional and statutory requirements for holding said office.

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Actual residence address or description of place of residence (city or town)

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(zip)

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office (city or town) Print or type your name on the following line as you wish it to be listed on the Notice of Official Write-In Candidates. (zip)

LAST NAME

FIRST NAME

CANDIDATE SIGNATURE Subscribed AND SWO Notary Public Arizona
-

ed)

JONATHAN RAML Maricopa County

My Commission Expires February 28, 2014

Notary Public My Commission Expires:

e

(Seal) I have read all applicable laws relating to campaign financing and reporting.

\H
Office Revision 9/30/2002

CANDIDATE SIGNATURE

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 111 of 121

OFFICE OF THE SECRETARY OF STATE STATE OF ARIZONA RECEIPT WRITE-IN CANDIDATE FILING OF REQUIRED FORMS

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SECRE1AR’( OF S TME

(PRIMARY ELECTION)

2019 JUL 15 FM

5

NAME OF

CANDIDATE
ADDRESS

Meadows. Thomas 3200 East Hazelwood
Residence

Phoenix
City

85018
Zip

MAILING ADDRESS

P. 0. Box 186 (480) 529-2041
Phone Number

Tempe
City Fax Number

85280
Zip

EMAIL ADDRESS: OFFICE SOUGHT

.ryoga imlost@yahoo.com State Treasurer District Number

_

FORMS TO BE FILED WITH PETITIONS: STATE CANDIDATE NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION, VN CAMPAIGN FINANCE LAWS STATEMENT FINANCIAL DISCLOSURE STATEMENT

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FEDERAL CANDIDATE NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION STATEMENT ON RECALL (OPTIONAL)

OTE: Each candidate for a state office must file with the Secretary of State either a Statement of Organization of a political committee or a $500 Threshold Exemption Statement Check one and include ID#: 201000694 ID# from

0 STATEMENT OF ORGANIZATION or fl $500 THRESHOLD EXEMPTION STATEMENT

(check one)

This is to acknowledge that all forms required by law to be submitted to the Secretary of State for nomination by Arizona Primary Election to be held on August 24, 2010 have been received in this office on the 15th day ofjj, 2010.

Candidate or Representative

KEN BENNETT Secretary of State by: Ak&

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(Office Revision 05/2012010)

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 112 of 121

¶ 4

SECRE1Ry OF STATE 20 JUL 15 PM : 5
FINANCIAL DISCLOSURE STATEMENT
(For use by Public Officers and Candidates of the State of Arizona)

RECEVNJ

Name of Public Officer or Candidate/

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(7?i t_J

Address

ublic Office Held or Sought Check one:

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Sau
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District #______

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1 am a public officer filing this statement covering the 12 months of calendar year 20 I am a candidate for a public office, and am filing this Financial Discqre Statement covejqg the 12 months precciing the date of this statement, from the month of 2%Q7 , to the L_ 4 1 )Q Q month of t. 20)(’l_.

F-1

I have been appointed to fill a vacancy in a public office and am filing this Financial Disclosure Statement covering the 12 month period ending with the last full month prior to the date I took office.

VERIFICATION
I do solemnly swear that the Financial Disclosure Statement filed herewith is in all things true and correct, nd fully shows all information I am required to report pursuant to A.R.S. § 38-542.

Signature of Public Officer or Candidate State of County of

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CU

N
\day of 0 , 20 tC

Subscribed and sworn to (or affirmed) before me this
t.

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JONATHAN RAML ____ Notary Public . Art zOna Maricopa County My Commission Expires 014rc 21 February 26, 2014

AQ Notary Public

My Commission expires (Seal)
Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 113 of 121

SECTION A: PERSONAL DISCLOSURE 1. Names

What to disclose: Your and your spouse’s names and the names of minor children of whom you have legal custody.

YOUR NAME YOUR SPOUSE’S NAME

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yY? ei1

i

CHILDREN’S NAMES

2.

Sources of Personal Compensation

What to disclose: The name and address of each employer who paid you, your spouse, or any member of your household more than $1 ,000 in salary, wages, commissions, tips or other forms of compensation during the period covered by this report. Describe each employer’s business and the services for which you or a member of your household were compensated. Also, list anything of value that any other person, outside your household, received for your use or benefit of you or any member of your household. For example, if a person was paid by your employer to be your housekeeper, list that person’s wages and the name of the employer. u need not disclose: Any money you or any member of your household received that was gross income paid to a business you or your household member owned.
NAME AND ADDRESS OF EMPLOYER OR OTHER SOURCE OF COMPENSATION OVER $1,000

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

DESCRIPTION OF EMPLOYER’S BUSINESS AND SERVICES PROVIDED BY PUBLIC OFFICER-OR MEMBER OF HOUSEHOLD

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 114 of 121

3.

Professional, Occupational and Business Licenses

What to disclose: List all licenses issued to or held by you or any member of your household at any time during the period covered by this Statement.

TYPE OF LICENSE OR PERMIT

NAME IN WHICH LICENSE IS ISSUED

PUBLIC OFFICER OR HOUSEHOLD MEMBER HOLDING LICENSE, IF NOT ISSUED IF OWN NAME

JURISDICTION(S) OF LICENSE

LOCATION OF BUSINESS

4.

Personal Creditors

What to disclose: The name and address of each creditor to whom you, or a member of your household owed a personal debt over $1 ,000 during the period covered by this Statement. If the debt was incurred or discharged during this period, list the date and whether it was incurred or discharged. You need not disclose: Debts resulting from the ordinary conduct of a business (disclose those in Section C). Debts on residences or recreational property, on motor vehicles not used for commercial purposes, on debts secured by cash values on life insurance, or debts you owe to relatives, personal credit card transactions or installment contracts.
PERSONAL DEBTS OVER $1000 NAME AND ADDRESS OF CREDITOR (OR PERSON TO WHOM PAYMENTS ARE MADE) PUBLIC OFFICER OR MEMBER OF HOUSEHOLD OWING THE DEBT DATE INCURRED AND/OR DISCHARGED

-

gi-

f’(
J Incurred D Discharged

D Incurred D Discharged
lncurred Discharged

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 115 of 121

5.

Personal Debtors

What to disclose: The name of each debtor who owed you or a member of your household a debt over $1,000 at any time during the period covered by this Statement, and the approximate value of the debt (See last page of value categories). If the debt was incurred or discharged during the period covered by this Statement, report the date and whether the debt was incurred or discharged.

DEBTS OVER $1,000 OWED TO YOU PERSONALLY PUBLIC OFFICER OR MEMBER OF HOUSEHOLD TO WHOM THE DEBT IS OWED

NAME OF DEBTOR

AMOUNT BY VALUE CATEGORY

DATE INCURRED AND/OR DISCHARGED

0 Incurred 0 Discharged

0 Incurred [jjDischarged

IncurredDischarged

6. Gifts What to disclose: The name of the donor who gave you or a member of your household a single gift or an accumulation of gifts with a value over $500, if that gift does NOT fit into a category below. YOu need not disclose: Gifts you or a household member received by will, intestate succession, inter vivos (living) trusts, or testamentary trusts established by a spouse or ancestor. tGifts received from any other mber of the household or relatives to the second degree of consanguinity (parents, grandparents, siblings, children and grandchildren) or political contributions reported on campaign finance reports.

NAME OF DONOR OF GIFTS OVER $500

- - _I

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD - RECIPIENT

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 116 of 121

SECTION B: REPORTABLE INTERESTS Offices or Fiduciary Relationships in Businesses, Nonprofit Organizations or Trusts

7.

What to disclose: The name and address of each business, organization, trust or nonprofit organization or association in which you or any member of your household held any office OR had a fiduciary relationship during the period covered by this Statement. Describe the office or relationship.

8.

Ownership or Financial Interest in Trusts, or Investment Funds

What to disclose: The name and address of each business, trust, investment or retirement fund in which you or any member of your household had an ownership or beneficial interest of over $1,000. This includes stocks, partnerships, joint ventures, sole proprietorships, annuities, mutual funds and retirement accounts. List the percentage of ownership or interest, and categorize the value of the equity. (See last page for value categories.)
EQUITY BY VALUE ATEGORY

NAME AND ADDRESS OF BUSINESS OR TRUST

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

DESCRIPTION OF INTEREST

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 117 of 121

What to disclose: Bonds issued by a single agency worth more than $1 ,000 that you or a member of your household hold, or held during the period covered by this Statement. If the bonds were acquired or divested during the period, report the date that occurred.

BONDS OVER

$1 ,000

ISSUING AGENCY

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

VAI! TEGORY

DATE ACQUIRED AND/OR DIVESTED

DAcquired

0 Divested

AcquiredDDivested

DAcquired ODivested

10. Real Property Ownership What to disclose: Arizona real property and improvements to which you or a member of your household hold, or held title during the period covered by this Statement. Describe the property’s location and approximate size. Using the value categories (see last page) report the value of your equity. If that property was acquired or divested during the period covered by this Statement, list the date and what occurred. You need not disclose: Your primary residence or property you use for personal recreation.

LOCATION AND APPROXIMATE SIZE OF ARIZONA REALTY

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD OR BUSINESS

EQUITY BY VALUE CATEGORY

DATE ACQUIRED OR

D43eETE

DAcquired

Divested

DAcquired DDivested

flAcquired DDivested

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 118 of 121

SECTION C: BUSINESS INTERESTS 11. Business Names

What to disclose: The name of any business under which you or any member of your household did business

during the period covered by this Statement. Include corporations, limited liability companies, partnerships and trade names. Using the definitions provided in statute, disclose if the business named is controlled or dependent. If the business is both controlled and dependent, mark both boxes.

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD

BUSINESS NAME

BUSINESS ADDRESS

CONTROLLED DEPENT’INESS

olIed Dependent Controlled Dependent
Controlled

Dependent UControlled Dependent IMPORTANT: IF A BUSINESS LISTED ABOVE DID NOT GROSS MORE THAN $10,000 OR PROVIDE MORE THAN 10% OF YOUR PERSONAL COMPENSATION DURING THE PERIOD COVERED BY THIS STATEMENT, YOU DO NOT NEED TO COMPLETE THE REST OF THIS STATEMENT.

12. Controlled Business Information
What to disclose: The name of each controlled business you listed above, and the goods or services provided

by the business. If a single client or customer (person or business) accounts for more than $10,000 and 25% the gross income, describe what it is your business provides to that customer or client. Then, in column 4, uescribe what the client/customer’s business does (if your major client is a person, leave the last column blank). If you do not have a major client, leave the last two columns blank.
You need not disclose: The name of any customer or client, or the activities of any customer or client who is

an individual rather than a business.
WHAT YOUR BUSINESS PROVIDES TO YOUR MAJOR CUSTOMER OR CLIENT BUSINESS ACTIVITY OF MAJOR CUSTOMER OR CLIENT

NAME OF YOUR CONTROLLED BUSINESS

GOODS OR SERVICES PROVIDED BY YOUR BUSINESS

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 119 of 121

13. Dependent Business Information
What to disclose: The name of each dependent business, the goods or services provided by the dependent business, the goods or services provided to the major customer or client and the business activity if the major customer or client is a business. If the dependent business is also a controlled business, disclose it only in response to #12, above. from the You .need not disclose: The name or identity of the customer or client, or the amount of Inco not required to customer or client. If the customer or client is an individual (rather than a business), yo disclose that person’s activities.

NAME OF DEPENDENT BUSINESS

GOODS OR SERVICES PROVIDED BY THE BUSINESS.

SERVICES GOOD 8’TbED TO THE MAJOR CUSTOMER OR CLIENT

BUSINESS ACTIVITY OF THE MAJOR CUSTOMER OR CLIENT, IF A BUSINESS

4. Real Property Owned by Business
What to disclose: Arizona real property and improvements the titles to which were held by a controlled or dependent business listed above. If the business is one that deals in real property and improvements, list the aggregate value of all parcels held in the period covered by this Statement. Describe the property’s location and approximate size. Using the value categories (see last page) report the value of equity in your business,_-lf the property was acquired or divested during the period covered by this Statement, list that and the dat

LOCATION AND APPROXIMATE SE OF ARIZONA REALTY

PUBLIC OFFICER OR MEMBER OF HOUSEHOLD OR BUSINESS

EQUITY BY VALUE CATEGORY .-

ATE ACQUIRED OR DIVESTED

AcquiredDDivested

Acquired UDivested

_____________

cquired flDivested

AcquiredDivested

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 120 of 121

15. Business’ Creditors
What to disclose: The name and address of each creditor to which your business owed more than $10,000, if that amount was also more than 30% of your total business indebtedness at any time during the period covered by this Statement. If the debt was incurred or discharged during the period covered by this Statement, report that and the date.

You need not disclose: Debts resulting from a business other than a controlled or dependent business.
BUSINESS DEBTS OVER $10,000 AND
NAME AND ADDRESS OF CREDITOR (OR PERSON TO WHOM PAYMENTS ARE MADE) 3 ATE INCURRED AND/OR AE

NAME OF CONTROLLED OR DEPENDENT ESS FROM lTEM3OR
(

[-]Incurred

D Discharged

fllncurredDischarged

fllncurredDischarged

4Business’ Debtors 6.
What to disclose: The name of the debtor for each debt exceeding $10,000 owed to a controlled or

dependent business which was also more than 30% of the total indebtedness to the business which was owed at any time during the preceding calendar year. If the debt was incurred or discharged during the year, list that and the date. List value category. DEBTS OVER $10,000 AND
30%

OWED TO YOUR BUSI
MOUNT BY VALUE CATEGORY DATE INCURRED AND/OR DISCHARGED

NAME OF DEBTOR

NAME OF CONTROLLED OR DEPENDENT BUSINESS TO WITHE DEBT IS OWe’

J Incurred Discharged

Dtncurred MDischarged

Category I - $1,000 to $25,000 Category 2 More than $25,000 to $100,000 Category 3 - More than $100,000

Secretary of State Office Revision September 2009

Case 2:10-cv-01902-DGC Document 1-2

Filed 09/06/10 Page 121 of 121

1 1 1 1 1 1III1 1 1I II I
0000070301
191 O

STATE OF ARIZONA. $500 THRESHOLD EXEMPTION STATEMENT

SECRETARY OF STATE

2010 JUL 15 PIM 14 32
COMMITTEE ID NUMBER

Pursuant to A.R:S. § 16-902.01 and 16-903(A) NAME OF POLITICAL COMMITTEE
VOTE THOMAS MEADOWS 2010

201000694
DATE
07115/2010

TYPE OF COMMITTEE
$500 THRESHOLD (CANDIDATE)

COMMITTEE ADDRESS
420

CITY
TEMPE

STATE
AZ

ZIP
85281

S MILL AVE

COMMITTEE MAILING ADDRESS (if different from above) P0 BOX 186 COMMITTEE TELEPHONE #
80) 529-2041

CITY
TEMPE

STATE
AZ

ZIP
85280

COMMITTEE FAX #

COMMITTEE EMAIL ADDRESS
RYOGA_IMLOSTcYAHOO.COM

NAME OF SPONSORING ORGANIZATION (if applicable)

TYPE OF ORGANIZATION

ADDRESS OF SPONSORING ORGANIZATION

RELATIONSHIP TO POLITICAL COMMITTEE

FOR A CANDIDATE’S $500 THRESHOLD COMMITTEE, PLEASE PROVIDE THE FOLLOWING INFORMATION: OFFICE SOUGHT
STATE TREASURER

ELECTION CYCLE
2010

The above named committee hereby asserts the following: The-committee has heretofore neither accepted any contributions nor made any expenditures. The committee intends to receive or expend less than $500. The committee will file a Statement of Organization within five business days after expending or receiving monies over the $500 limit pursuant to A.R.S. §§ 16-902.01 and 16-903(A).

I,

44

.

(Printed Name of Gandidate7Committee Officer) /

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OW

certify that this Exemption Statement is true and complete.

VV

Office Revision 9/07

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