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Case 2:10-cv-01902-DGC Document 1 Filed 09/06/10 Page 1 of 31

1 Keith Beauchamp (012434)


James J. Belanger (011393)
2 Roopali H. Desai (024295)
COPPERSMITH SCHERMER & BROCKELMAN PLC
3 2800 North Central Avenue, Suite 1200
Phoenix, Arizona 85004
4 (602) 381-5490 (Direct)
5 kbeauchamp@csblaw.com
jbelanger@csblaw.com
6 rdesai@csblaw.com

7 Attorneys for Plaintiffs


Arizona Green Party and Claudia Ellquist
8
9 UNITED STATES DISTRICT COURT

10 DISTRICT OF ARIZONA
11 Arizona Green Party, an Arizona political party; ) No.
and Claudia Ellquist, an individual, )
12 )
13 Plaintiffs, ) VERIFIED COMPLAINT
)
14 v. ) (42 U.S.C. § 1983 and § 1988
15 ) (First Amendment and
Ken Bennett, in his official capacity as ) Fourteenth Amendment);
16 Secretary of State for the State of Arizona; ) Ariz. Const. Art. 7, Sec. 12;
LeNora Johnson, in her official capacity as ) A.R.S. §§ 16-1006, 16-1013,
17 Recorder for Apache County; Jim Claw, R. John ) and Injunctive Relief)
18 Lee and Tom White Jr., in their official capacity )
as members of the Board of Supervisors for )
19 Apache County; Christine Rhodes, in her )
official capacity as Recorder for Cochise )
20
County; Patrick Call, Ann English and Richard )
21 Searle, in their official capacity as members of )
the Board of Supervisors for Cochise County; )
22 Candace Owens, in her official capacity as )
23 Recorder for Coconino County; Elizabeth )
Archuleta, Lena Fowler, Mandy Metzger, Matt )
24 Ryan and Carl Taylor, in their official capacity )
as members of the Board of Supervisors for )
25
Coconino County; Sadie Dalton, in her official )
26 capacity as Recorder for Gila County; Shirley )
Dawson, Tommie Martin and Michael Pastor, in )
27 their official capacity as members of the Board )
28 of Supervisors for Gila County; Wendy John, in )
Case 2:10-cv-01902-DGC Document 1 Filed 09/06/10 Page 2 of 31

1 her official capacity as Recorder for Graham )


County; Mark Herrington, Drew John and )
2 James Palmer, in their official capacity as )
3 members of the Board of Supervisors for )
Graham County; Berta Manuz, in her official )
4 capacity as Recorder for Greenlee County; )
David Gomez, Richard Lunt, and Hector )
5
Ruedas, in their official capacity as members of )
6 the Board of Supervisors for Greenlee County; )
Shelly Baker, in her official capacity as )
7 Recorder for La Paz County; John Drum, Holly )
8 Irwin, and Sandy Pierce, in their official )
capacity as members of the Board of )
9 Supervisors for La Paz County; Helen Purcell, )
in her official capacity as Recorder for )
10
Maricopa County; Fulton Brock, Andrew )
11 Kunasek, Don Stapley, Mary Rose Wilcox and )
Max Wilson, in their official capacity as )
12 members of the Board of Supervisors for )
13 Maricopa County; Carol Meier, in her official )
capacity as Recorder for Mohave County; )
14 Buster Johnson, Tom Sockwell and Gary )
Watson, in their official capacity as members of )
15
the Board of Supervisors for Mohave County; )
16 Laurette Justman, in her official capacity as )
Recorder for Navajo County; Jerry Brownlow, )
17 J.R. Despain, Jonathan Nez, David Tenney and )
18 Jesse Thompson, in their official capacity as )
members of the Board of Supervisors for )
19 Navajo County; F. Ann Rodriguez, in her )
official capacity as Recorder for Pima County; )
20
Sharon Bronson, Raymond Carroll, Ann Day, )
21 Richard Elias and Ramon Valadez, in their )
official capacity as members of the Board of )
22 Supervisors for Pima County; Laura Dean- )
23 Lytle, in her official capacity as Recorder for )
Pinal County; Bryan Martyn, Pete Rios and )
24 David Snider, in their official capacity as )
members of the Board of Supervisors for Pinal )
25
County; Suzanne Sainz, in her official capacity )
26 as Recorder for Santa Cruz County; John )
Maynard Jr., Rudy Molera and Manuel Ruiz, in )
27 their official capacity as members of the Board )
28 of Supervisors for Santa Cruz County; Ana )

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1 Wayman-Trujillo, in her official capacity as )


Recorder for Yavapai County; Chip Davis, )
2 Carol Springer and Thomas Thurman, in their )
3 official capacity as official capacity as members )
of the Board of Supervisors for Yavapai )
4 County; Robyn Stallworth-Pouquette, in her )
official capacity as Recorder for Yuma County; )
5
and Greg Ferguson, Russell McCloud, Kathryn )
6 Prochaska, Marco Reyes and Lenore Stuart, in )
their official capacity as members of the Board )
7 of Supervisors for Yuma County; Ryan )
8 Blackman, an individual; Richard Grayson, an )
individual; Christopher Campbell, an individual; )
9 Anthony Goshorn, an individual; Matthew )
Shusta, an individual; Clint Clement, an )
10
individual; Andrew Blischak, an individual; )
11 Michelle Lochmann, an individual; Thomas )
Meadows, an individual; Theodore Gomez, an )
12 individual; Benjamin Pearcy, an individual; )
13 )
Defendants. )
14 )
15 The Arizona Green Party, an Arizona political party, and Claudia Ellquist allege
16 for their Verified Complaint as follows:
17 NATURE OF THE ACTION
18 1. The First and Fourteenth Amendments to the United States Constitution
19 guarantee the right of individuals to associate in a political party, the right of that party
20 and its adherents to select their own nominees for partisan political office, and the right of
21 that party and its adherents to limit nominees to those individuals who share the interests
22 and ideologies of the party.
23 2. In ensuring the freedom of political parties to control and restrict their
24 associations, the First Amendment protects these parties from being “hijacked” by those
25 adverse to those parties.
26 3. Arizona statutes governing political party affiliation and registration,
27 coupled with its laws governing write-in candidates for parties not qualified for continued
28 representation on the official ballot, violate the association rights of the Arizona Green

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1 Party and its members by forcing the party to be publicly associated with candidates who
2 have not been nominated by the party, who will alter the political message and agenda of
3 the party, who will mislead the voting public with respect to what the party and its
4 adherents believe, and who will cause party members to mistakenly vote for sham
5 candidates.
6 4. Arizona’s statutory scheme also fosters deceptive schemes, such as the
7 scheme alleged upon information and belief herein, such that major political parties can
8 manipulate minor political parties and thereby fraudulently affect the outcome of primary
9 and general elections and corrupt the entire electoral process.
10 JURISDICTION AND VENUE
11 5. Plaintiffs’ rights of political association and political expression are
12 guaranteed against abridgement by the State and those acting under color of its laws by
13 the First and Fourteenth Amendments to the United States Constitution and by 42 U.S.C.
14 § 1983. This Court has jurisdiction over these federal questions under 28 U.S.C. § 1331.
15 6. This Court has pendent jurisdiction over Plaintiffs’ state law claims
16 pursuant to 28 U.S.C. § 1367.
17 7. Venue is proper in this Court pursuant to 28 U.S.C. § 1391(b)(1) because
18 (i) all of the Defendants reside in, and may be found and served in, the District of
19 Arizona; and (ii) all of the events or omissions giving rise to these claims arose in the
20 District of Arizona.
21 THE PARTIES
22 The Plaintiffs
23 8. The Arizona Green Party (“AGP”) is a recognized political party in the
24 State of Arizona lacking continued representation on the official ballot.
25 9. Claudia Ellquist is a Co-Chair of the AGP. She resides and is a registered
26 voter in Pima County, Arizona.
27 10. The AGP and Ms. Ellquist are referred to here, collectively, as “Plaintiffs.”
28

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1 The Secretary of State


2 11. Ken Bennett is the Secretary of State for the State of Arizona and is named
3 in his official capacity as a defendant in this action as the officer with whom write-in
4 nomination papers are filed pursuant to A.R.S. §§ 16-311 and 312(C).
5 The County Boards of Supervisors
6 12. The members of the Board of Supervisors of Maricopa County are named
7 as defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the
8 Board of Supervisors of Maricopa County is responsible for notifying the appropriate
9 election board inspector of all candidates who have properly filed write-in nomination
10 papers and, pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with
11 canvassing the election and issuing certificates of nomination to successful candidates.
12 The Maricopa County Supervisors are Fulton Brock, Don Stapley, Andrew Kunasek,
13 Max Wilson, and Mary Rose Wilcox.
14 13. The members of the Board of Supervisors of Apache County are named as
15 defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board
16 of Supervisors of Apache County is responsible for notifying the appropriate election
17 board inspector of all candidates who have properly filed write-in nomination papers and,
18 pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the
19 election and issuing certificates of nomination to successful candidates. The Apache
20 County Supervisors are Jim Claw, R. John Lee, and Tom White Jr.
21 14. The members of the Board of Supervisors of Cochise County are named as
22 defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board
23 of Supervisors of Cochise County is responsible for notifying the appropriate election
24 board inspector of all candidates who have properly filed write-in nomination papers and,
25 pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the
26 election and issuing certificates of nomination to successful candidates. The Cochise
27 County Supervisors are Patrick Call, Ann English, and Richard Searle.
28

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1 15. The members of the Board of Supervisors of Coconino are named as


2 defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board
3 of Supervisors of Coconino County is responsible for notifying the appropriate election
4 board inspector of all candidates who have properly filed write-in nomination papers and,
5 pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the
6 election and issuing certificates of nomination to successful candidates. The Coconino
7 County Supervisors are Elizabeth Archuleta, Lena Fowler, Mandy Metzger, Matt Ryan,
8 and Carl Taylor.
9 16. The members of the Board of Supervisors of Gila County are named as
10 defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board
11 of Supervisors of Gila County is responsible for notifying the appropriate election board
12 inspector of all candidates who have properly filed write-in nomination papers and,
13 pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the
14 election and issuing certificates of nomination to successful candidates. The Gila County
15 Supervisors are Shirley Dawson, Tommie Martin, and Michael Pastor.
16 17. The members of the Board of Supervisors of Graham County are named as
17 defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board
18 of Supervisors of Graham County is responsible for notifying the appropriate election
19 board inspector of all candidates who have properly filed write-in nomination papers and,
20 pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the
21 election and issuing certificates of nomination to successful candidates. The Graham
22 County Supervisors are Mark Herrington, Drew John, and James Palmer.
23 18. The members of the Board of Supervisors of Greenlee County are named as
24 defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board
25 of Supervisors of Greenlee County is responsible for notifying the appropriate election
26 board inspector of all candidates who have properly filed write-in nomination papers and,
27 pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the
28

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1 election and issuing certificates of nomination to successful candidates. The Greenlee


2 County Supervisors are David Gomez, Richard Lunt, and Hector Ruedas.
3 19. The members of the Board of Supervisors of La Paz County are named as
4 defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board
5 of Supervisors of La Paz County is responsible for notifying the appropriate election
6 board inspector of all candidates who have properly filed write-in nomination papers and,
7 pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the
8 election and issuing certificates of nomination to successful candidates. The La Paz
9 County Supervisors are John Drum, Holly Irwin, and Sandy Pierce.
10 20. The members of the Board of Supervisors of Mohave County are named as
11 defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board
12 of Supervisors of Mohave County is responsible for notifying the appropriate election
13 board inspector of all candidates who have properly filed write-in nomination papers and,
14 pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the
15 election and issuing certificates of nomination to successful candidates. The Mohave
16 County Supervisors are Buster Johnson, Tom Sockwell, and Gary Watson.
17 21. The members of the Board of Supervisors of Navajo County are named as
18 defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board
19 of Supervisors of Navajo County is responsible for notifying the appropriate election
20 board inspector of all candidates who have properly filed write-in nomination papers and,
21 pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the
22 election and issuing certificates of nomination to successful candidates. The Navajo
23 County Supervisors are Jerry Brownlow, J.R. Despain, Jonathan Nez, David Tenney, and
24 Jesse Thompson.
25 22. The members of the Board of Supervisors of Pima County are named as
26 defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board
27 of Supervisors of Pima County is responsible for notifying the appropriate election board
28 inspector of all candidates who have properly filed write-in nomination papers and,

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1 pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the
2 election and issuing certificates of nomination to successful candidates. The Pima
3 County Supervisors are Sharon Bronson, Raymond Carroll, Ann Day, Richard Elias, and
4 Ramon Valadez.
5 23. The members of the Board of Supervisors of Pinal County are named as
6 defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board
7 of Supervisors of Pinal County is responsible for notifying the appropriate election board
8 inspector of all candidates who have properly filed write-in nomination papers and,
9 pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the
10 election and issuing certificates of nomination to successful candidates. The Pinal
11 County Supervisors are Bryan Martyn, Pete Rios, and David Snider.
12 24. The members of the Board of Supervisors of Santa Cruz County are named
13 as defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the
14 Board of Supervisors of Santa Cruz County is responsible for notifying the appropriate
15 election board inspector of all candidates who have properly filed write-in nomination
16 papers and, pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with
17 canvassing the election and issuing certificates of nomination to successful candidates.
18 The Santa Cruz County Supervisors are John Maynard Jr., Rudy Molera, and Manuel
19 Ruiz.
20 25. The members of the Board of Supervisors of Yavapai County are named as
21 defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board
22 of Supervisors of Yavapai County is responsible for notifying the appropriate election
23 board inspector of all candidates who have properly filed write-in nomination papers and,
24 pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the
25 election and issuing certificates of nomination to successful candidates. The Yavapai
26 County Supervisors are A.G. (“Chip” ) Davis, Carol Springer, and Thomas Thurman.
27 26. The members of the Board of Supervisors of Yuma County are named as
28 defendants in their official capacities because, pursuant to A.R.S. § 16-312(D), the Board

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1 of Supervisors of Yuma County is responsible for notifying the appropriate election


2 board inspector of all candidates who have properly filed write-in nomination papers and,
3 pursuant to A.R.S. §§ 16-622(A) and 645(A), the Board is charged with canvassing the
4 election and issuing certificates of nomination to successful candidates. The Yuma
5 County Supervisors are Greg Ferguson, Russell McCloud, Kathryn Prochaska, Marco
6 Reyes, and Lenore Stuart.
7 The County Recorders
8 27. LeNora Johnson is the Recorder for Apache County and is named in her
9 official capacity as a defendant in this action as the officer in charge of printing ballots
10 for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to
11 enjoin the Recorder from printing the names of certain sham candidates on the general
12 election ballot.
13 28. Christine Rhodes is the Recorder for Cochise County and is named in her
14 official capacity as a defendant in this action as the officer in charge of printing ballots
15 for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to
16 enjoin the Recorder from printing the names of certain sham candidates on the general
17 election ballot.
18 29. Candace Owens is the Recorder for Coconino County and is named in her
19 official capacity as a defendant in this action as the officer in charge of printing ballots
20 for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to
21 enjoin the Recorder from printing the names of certain sham candidates on the general
22 election ballot.
23 30. Sadie Dalton is the Recorder for Gila County and is named in her official
24 capacity as a defendant in this action as the officer in charge of printing ballots for the
25 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to enjoin
26 the Recorder from printing the names of certain sham candidates on the general election
27 ballot.
28

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1 31. Wendy John is the Recorder for Graham County and is named in her
2 official capacity as a defendant in this action as the officer in charge of printing ballots
3 for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to
4 enjoin the Recorder from printing the names of certain sham candidates on the general
5 election ballot.
6 32. Berta Manuz is the Recorder for Greenlee County and is named in her
7 official capacity as a defendant in this action as the officer in charge of printing ballots
8 for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to
9 enjoin the Recorder from printing the names of certain sham candidates on the general
10 election ballot.
11 33. Shelly Baker is the Recorder for La Paz County and is named in her official
12 capacity as a defendant in this action as the officer in charge of printing ballots for the
13 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to enjoin
14 the Recorder from printing the names of certain sham candidates on the general election
15 ballot.
16 34. Helen Purcell is the Recorder for Maricopa County and is named in her
17 official capacity as a defendant in this action as the officer in charge of printing ballots
18 for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to
19 enjoin the Recorder from printing the names of certain sham candidates on the general
20 election ballot.
21 35. Carol Meier is the Recorder for Mohave County and is named in her
22 official capacity as a defendant in this action as the officer in charge of printing ballots
23 for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to
24 enjoin the Recorder from printing the names of certain sham candidates on the general
25 election ballot.
26 36. Laurette Justman is the Recorder for Navajo County and is named in her
27 official capacity as a defendant in this action as the officer in charge of printing ballots
28 for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to

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1 enjoin the Recorder from printing the names of certain sham candidates on the general
2 election ballot.
3 37. F. Ann Rodriguez is the Recorder for Pima County and is named in her
4 official capacity as a defendant in this action as the officer in charge of printing ballots
5 for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to
6 enjoin the Recorder from printing the names of certain sham candidates on the general
7 election ballot.
8 38. Laura Dean-Lytle is the Recorder for Pinal County and is named in her
9 official capacity as a defendant in this action as the officer in charge of printing ballots
10 for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to
11 enjoin the Recorder from printing the names of certain sham candidates on the general
12 election ballot.
13 39. Suzanne Sainz is the Recorder for Santa Cruz County and is named in her
14 official capacity as a defendant in this action as the officer in charge of printing ballots
15 for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs seek to
16 enjoin the Recorder from printing the names of certain sham candidates on the general
17 election ballot.
18 40. Ana Wayman-Trujillo is the Recorder for Yavapai County and is named in
19 her official capacity as a defendant in this action as the officer in charge of printing
20 ballots for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503. Plaintiffs
21 seek to enjoin the Recorder from printing the names of certain sham candidates on the
22 general election ballot.
23 41. Robyn Stallworth-Pouquette is the Recorder for Yuma County and is
24 named in her official capacity as a defendant in this action as the officer in charge of
25 printing ballots for the 2010 General Election pursuant to A.R.S. §§ 16-501 – 16-503.
26 Plaintiffs seek to enjoin the Recorder from printing the names of certain sham candidates
27 on the general election ballot.
28

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1 The Sham Candidates


2 42. Defendant Ryan Blackman is a write-in candidate purporting to be
3 affiliated with the AGP. Blackman is a write-in candidate for the U.S. House of
4 Representatives in District 5. Blackman registered to vote for the first time on July 13,
5 2010. He registered as a Green. His voter registration is attached hereto as Ex. 1.
6 Blackman filed as a write-in candidate on that same day, on July 13, 2010. His filing
7 papers are attached hereto as Ex. 2.
8 43. Defendant Richard Grayson is a write-in candidate purporting to be
9 affiliated with the AGP. Grayson is a write-in candidate for the U.S. House of
10 Representatives in District 6. Upon information and belief, he switched his political
11 party from Republican to Green sometime in late 2009. Grayson filed as a write-in
12 candidate on May 28, 2010. His filing papers are attached hereto as Ex. 3.
13 44. Defendant Christopher Campbell is a write-in candidate purporting to be
14 affiliated with the AGP. Campbell is a write-in candidate for State Senator in District 10.
15 He switched his political party from Republican to Green on July 15, 2010. His voter
16 registration is attached hereto as Ex. 4. Campbell filed as a write-in candidate that same
17 day, July 15, 2010. His filing papers are attached hereto as Ex. 5.
18 45. Defendant Anthony Goshorn is a write-in candidate purporting to be
19 affiliated with the AGP. Goshorn is a write-in candidate for State Senator in District 17.
20 He switched his political party from Libertarian to Green on May 17, 2010 when he
21 attempted to gather sufficient signatures to qualify for the ballot as an AGP candidate for
22 State Representative in District 17. His voter registration is attached hereto as Ex. 6.
23 Having failed to qualify, Goshorn filed as a write-in candidate for State Senator on July
24 15, 2010. His filing papers are attached hereto as Ex. 7.
25 46. Defendant Matthew Shusta is a write-in candidate purporting to be
26 affiliated with the AGP. Shusta is a write-in candidate for State Senator in District 23.
27 Upon information and belief, he changed his political party from Democrat to Green on
28

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1 or about July 1, 2010. Shusta filed as a write-in candidate on July 15, 2010. His filing
2 papers are attached hereto as Ex. 8.
3 47. Defendant Clint Clement is a write-in candidate purporting to be affiliated
4 with the AGP. Clement is a write-in candidate for State Representative in District 17.
5 He changed his political party from Republican to Green on July 13, 2010. His voter
6 registration is attached hereto as Ex. 9. Clement filed as a write-in candidate that same
7 day, July 13, 2010. His filing papers are attached hereto as Ex. 10.
8 48. Defendant Andrew (“Drew”) Blischak is a write-in candidate purporting to
9 be affiliated with the AGP. Blischak is a write-in candidate for State Representative in
10 District 20. He changed his political party from Republican to Green on July 13, 2010.
11 His voter registration is attached hereto as Ex. 11. Blischak filed as a write-in candidate
12 that same day, July 13, 2010. His filing papers are attached hereto as Ex. 12.
13 49. Defendant Michelle Lochmann is a write-in candidate purporting to be
14 affiliated with the AGP. Lochmann is a write-in candidate for Secretary of State. She
15 changed her political party from Republican to Green on July 15, 2010. Her voter
16 registration is attached hereto as Ex. 13. Lochmann filed as a write-in candidate that
17 same day, July 15, 2010. Her filing papers are attached hereto as Ex. 14.
18 50. Defendant Thomas Meadows is a write-in candidate purporting to be
19 affiliated with the AGP. Meadows is a write-in candidate for State Treasurer. He
20 registered to vote for the first time on July 15, 2010. He registered as a Green. His voter
21 registration is attached hereto as Ex. 15. Meadows filed as a write-in candidate the same
22 day, July 15, 2010. His filing papers are attached hereto as Ex. 16.
23 51. Defendant Theodore Gomez is a write-in candidate purporting to be
24 affiliated with the AGP. Gomez is a write-in candidate for Corporation Commissioner.
25 He registered to vote for the first time on July 14, 2010. He registered as a Green. His
26 voter registration is attached hereto as Ex. 17. Gomez filed as a write-in candidate the
27 very next day, July 15, 2010. His filing papers are attached hereto as Ex. 18.
28

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


2 affiliated with the AGP. Pearcy is a write-in candidate for Corporation Commissioner.
3 He changed his political party from Republican to Green on July 14, 2010. His voter
4 registration is attached hereto as Ex. 19. Pearcy filed as a write-in candidate the very
5 next day, July 15, 2010. His filing papers are attached hereto as Ex. 20.
6 GENERAL ALLEGATIONS
7 53. Upon information and belief, members of the Arizona Republican Party
8 have conspired to place fraudulent AGP candidates on the official general election ballot
9 by encouraging members of their party, and others, to switch party affiliation and run as
10 write-in candidates in the August 24, 2010 primary election. [See e.g. Facebook message
11 from Matt Salmon attached hereto as Ex. 21.]
12 54. Ryan Blackman, Richard Grayson, Christopher Campbell, Anthony
13 Goshorn, Matthew Shusta, Clint Clement, Drew Blischak, Michelle Lochmann, Thomas
14 Meadows, Theodore Gomez, and Benjamin Pearcy (collectively, the “Sham Candidates”)
15 are all running as write-in AGP candidates without the endorsement of the AGP. Two
16 other individuals, Gail Ginger and Tim Hensley filed paperwork to run as Green write-in
17 candidates, and ran in the primary election, but did not qualify to advance to the general
18 election as the AGP nominee for the office that they sought.
19 55. Of the eleven Sham Candidates, none were members of the AGP for more
20 than a few days before becoming AGP candidates.
21 56. Pursuant to A.R.S. § 16-312(A), the last day to file as a write-in candidate
22 for the August 24, 2010 primary election was July 15, 2010.
23 57. Upon information and belief, the Sham Candidates do not share in the
24 AGP’s values and ideologies and are seeking office to confuse the electorate and siphon
25 votes, in violation of the Plaintiffs’ constitutional rights:
26 a. Campbell admits that he was approached by the Republican Party to
27 run as a sham AGP candidate in District 10 with the specific intent to take votes away
28 from the Democratic nominee. [See Transcript of phone conversation with Campbell

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1 attached hereto as Ex. 22; Declaration of Shawn Nelson attached hereto as Ex. 23; see
2 also Mary Jo Pitzl, Arizona Democratic Party Alleges Fraud, The Arizona Republic,
3 Aug. 31, 2010, attached hereto as Ex. 24.]
4 b. Campbell has numerous ties to the Republican Party. Campbell
5 lives with the daughter of the Republican former speaker of the house, Jim Weiers, and is
6 an acquaintance of Senator Linda Gray, the Republican incumbent in District 10. As
7 noted above, Campbell was a registered Republican until the day he filed as a Green
8 write-in candidate, which was on July 15, 2010, the last day to file as a write-in
9 candidate.
10 c. Campbell admits he supports Senate Bill (“SB”) 1070, a position in
11 direct conflict with the official position of the AGP, which strongly opposes SB 1070 and
12 would not endorse a candidate who supported SB 1070, regardless of that candidate’s
13 positions on other issues. [See Ex. 22.]
14 d. Gail Ginger was approached by members of the Republican Party to
15 become a member of the AGP and to file as a write-in candidate in order to deceive
16 voters into voting for her rather than the Democratic Party’s nominee. The purpose of
17 this scheme was to ensure the re-election of Republican Senator Gray. However, by
18 mistake, Ginger filed as a write-in candidate for State Senator in the same district as
19 Campbell and, therefore, dropped out of the race. In a phone conversation, Ginger
20 implicated Republicans as individuals with knowledge of the sham candidate scheme.
21 [See Transcript of phone conversation with Ginger attached hereto as Ex. 25; see also
22 Transcript of phone conversation with John Mills attached hereto as Ex. 26; see also
23 Exs. 23-24.]
24 e. Lochmann admitted that she was recruited by Derrick Lee, owner of
25 Campaign Finance Company, LLC and Lee Petition Management, who is linked to the
26 campaigns of various Republican candidates, to obtain Clean Elections money. [See
27 Declaration of Luisa Valdez attached hereto as Ex. 27.]
28

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1 f. Matt Salmon, President of the Log Cabin Republicans sent a


2 Facebook message seeking to recruit AGP members to run in certain election races. In
3 his message, Salmon stated that a Green candidate “would only need one write-in vote
4 (themselves).” [See Ex. 21; see also Ex. 27.]
5 g. Goshorn was approached by members of the Republican Party to
6 become a member of the AGP and to first attempt to gain access to the official general
7 election ballot by gathering signatures to appear on the ballot for State Representative in
8 Legislative District 17. After failing to gather a sufficient number of signatures, Goshorn
9 filed to run as a write-in candidate.
10 h. Steve May, a former two-term Republican State legislator, is the
11 driving force behind Goshorn’s nomination as an AGP nominee. [See Ex. 24; see also
12 attached screenshot of May’s Facebook page showing a picture of Goshorn and May
13 when Goshorn filed as a candidate attached hereto as Ex. 28.] May is a Republican
14 candidate for the same office that Goshorn is running for in Legislative District 17. His
15 filing papers are attached hereto as Ex. 29.
16 i. The nomination papers of Goshorn, Meadows, Gomez, and Pearcy
17 are written in the same handwriting, which matches that of May, a Republican candidate
18 for Legislative District 17. [See Exs. 7, 16, 18, 20 and 29.]
19 j. Goshorn, Pearcy, Meadows and Gomez all use the same post office
20 box address for their campaign mailing addresses.
21 k. Pearcy, Meadows, and Gomez all list a Starbucks coffee
22 establishment located at 420 S. Mill Avenue in downtown Tempe, Arizona as their
23 campaign filing addresses.
24 l. Goshorn, May, Pearcy, and Gomez filed their write-in nomination
25 papers at the exact same minute: 11:43 on July 15, 2010, the last day to file as a write-in
26 candidate.
27 m. Goshorn, May, Pearcy, and Gomez used the same notary for their
28 nomination papers.

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1 n. Goshorn and perhaps several other Sham Candidates were recruited


2 by May to get on the ballot as Green candidates. [See Ex. 24; see also Ex. 28.]
3 o. Members of the Republican Party have provided financial and in-
4 kind support to at least some, perhaps all, the Sham Candidates named in this Verified
5 Complaint.
6 p. The Sham Candidates switched their party affiliation to the AGP
7 despite the fact that the Sham Candidates do not subscribe to the AGP’s principles and
8 ideologies. Further, they did not undergo the process to become an endorsed AGP
9 candidate. [See Ex. 27.]
10 58. Voters rely on political party designations in deciding for whom to vote.
11 59. Upon information and belief, the scheme to place the Sham Candidates on
12 the ballot is intended to confuse voters and draw votes away from candidates affiliated
13 with the Arizona Democratic Party:
14 a. Campbell admitted that he is running as a Green candidate to take
15 votes away from the Democratic nominee in District 10. [Exs. 22-23.]
16 b. In 2008, a sham Green candidate ran against Democrat Jackie
17 Thrasher for the same office and in the same district that Campbell is running. The sham
18 Green candidate obtained over 2,000 votes, which caused Thrasher to lose the election to
19 Jim Weiers by 553 votes. [See Declaration of Jackie Thrasher attached hereto as Ex. 30.]
20 c. Republicans have used Sham candidates in prior elections to divert
21 votes away from Democratic candidates. [See, e.g. Mary Jo Pitzl, Dems see red as
22 Republicans run as Greens, The Arizona Republic, Oct. 11, 2008, attached hereto as
23 Ex. 31.]
24 d. Angel Reyes, an East Coast political operative who frequently works
25 for the Republican Party or its members, has called registered members of the AGP and
26 introduced himself as “Angel,” a representative calling on behalf of the AGP, to garner
27 votes for the Sham Candidates. [See Ex. 27; Declaration of Jerry Joslyn attached hereto
28 as Ex. 32).] The Co-Chair of the AGP is Angel Torres.

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1 e. The Sham Candidates switched their party affiliation to the AGP for
2 the purpose of directing votes from Democratic Party candidates.
3 60. A.R.S. § 16-645(D), Arizona’s statutory framework for AGP write-in
4 candidates, (i) forces the AGP to associate with sham candidates in violation of their
5 constitutional right to exclude individuals; and (ii) treats the AGP differently than the
6 Republican, Democratic, and Libertarian Parties in violation of the Plaintiffs’
7 constitutional right to equal protection:
8 a. Blackman secured the AGP nomination and will advance to the
9 general election as the Green candidate for the U.S. House of Representatives in District
10 5 with only four votes. [See 2010 Primary Election Official Write-In Results Summary
11 attached hereto as Ex. 33.] A Republican write-in candidate would have had to obtain
12 739 votes, a Democratic write-in candidate would have had to obtain 559 votes, and a
13 Libertarian write-in candidate would have had to obtain 17 votes. If the AGP was subject
14 to the same statutory requirement for write-in candidates as the other parties, Blackman
15 would have had to obtain 154 votes. [See Arizona Secretary of State minimum signature
16 requirements for each party attached hereto as Ex. 34.]
17 b. Grayson secured the AGP nomination and will advance to the
18 general election as the Green candidate for the U.S. House of Representatives in District
19 6 with only 3 votes. [See Ex. 33.] A Republican write-in candidate would have had to
20 obtain 1,055 votes, a Democratic write-in candidate would have had to obtain 610 votes,
21 and a Libertarian write-in candidate would have had to obtain 17 votes. If the AGP was
22 subject to the same statutory requirement for write-in candidates as the other parties,
23 Grayson would have had to obtain 154 votes. [See Ex. 34.]
24 c. Campbell secured the AGP nomination and will advance to the
25 general election as the Green candidate for State Senator in District 10 with only one
26 vote, presumably his own. [See Ex. 33.] A Republican write-in candidate would have
27 had to obtain 262 votes, a Democratic write-in candidate would have had to obtain 251
28 votes, and a Libertarian write-in candidate would have had to obtain 9 votes. If the AGP

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1 was subject to the same statutory requirement for write-in candidates as the other parties,
2 Campbell would have had to obtain 29 votes. [See Ex. 34.]
3 d. Goshorn secured the AGP nomination and will advance to the
4 general election as the Green candidate for State Senator in District 17 with only four
5 votes. [See Ex. 33.] A Republican write-in candidate would have had to obtain 264
6 votes, a Democratic write-in candidate would have had to obtain 312 votes, and a
7 Libertarian write-in candidate would have had to obtain 12 votes. If the AGP was subject
8 to the same statutory requirement for write-in candidates as the other parties, Goshorn
9 would have had to obtain 37 votes. [See Ex. 34.]
10 e. Shusta secured the AGP nomination and will advance to the general
11 election as the Green candidate for State Senator in District 23 with only five votes. [See
12 Ex. 33.] A Republican write-in candidate would have had to obtain 441 votes, a
13 Democratic write-in candidate would have had to obtain 522 votes, and a Libertarian
14 write-in candidate would have had to obtain 10 votes. If the AGP was subject to the
15 same statutory requirement for write-in candidates as the other parties, Shusta would
16 have had to obtain 50 votes. [See Ex. 34.]
17 f. Clement secured the AGP nomination and will advance to the
18 general election as the Green candidate for State Representative in District 17 with only
19 two votes. [See Ex. 33.] A Republican write-in candidate would have had to obtain 264
20 votes, a Democratic write-in candidate would have had to obtain 312 votes, and a
21 Libertarian write-in candidate would have had to obtain 12 votes. If the AGP was subject
22 to the same statutory requirement for write-in candidates as the other parties, Clement
23 would have had to obtain 37 votes. [See Ex. 34.]
24 g. Blischak secured the AGP nomination and will advance to the
25 general election as the Green candidate for State Representative in District 20 with only
26 one vote, presumably his own. [See Ex. 33.] A Republican write-in candidate would
27 have had to obtain 409 votes, a Democratic write-in candidate would have had to obtain
28 324 votes, and a Libertarian write-in candidate would have had to obtain 9 votes. If the

19
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1 AGP was subject to the same statutory requirement for write-in candidates as the other
2 parties, Blischak would have had to obtain 44 votes. [See Ex. 34.]
3 h. Lochmann secured the AGP nomination and will advance to the
4 general election as the Green candidate for Secretary of State with only 17 votes. [See
5 Ex. 33.] A Republican write-in candidate would have had to obtain 5,609 votes, a
6 Democratic write-in candidate would have had to obtain 5,124 votes, and a Libertarian
7 write-in candidate would have had to obtain 124 votes. If the AGP was subject to the
8 same statutory requirement for write-in candidates as the other parties, Lochmann would
9 have had to obtain 1231 votes. [See Ex. 34.]
10 i. Meadows secured the AGP nomination and will advance to the
11 general election as the Green candidate for State Treasurer with only 21 votes. [See
12 Ex. 33.] A Republican write-in candidate would have had to obtain 5,609 votes, a
13 Democratic write-in candidate would have had to obtain 5,124 votes, and a Libertarian
14 write-in candidate would have had to obtain 124 votes. If the AGP was subject to the
15 same statutory requirement for write-in candidates as the other parties, Meadows would
16 have had to obtain 1231 votes. [See Ex. 34.]
17 j. Gomez secured the AGP nomination and will advance to the general
18 election as the Green candidate for Corporation Commissioner with only 13 votes. [See
19 Ex. 33.] A Republican write-in candidate would have had to obtain 5,609 votes, a
20 Democratic write-in candidate would have had to obtain 5,124 votes, and a Libertarian
21 write-in candidate would have had to obtain 124 votes. If the AGP was subject to the
22 same statutory requirement for write-in candidates as the other parties, Gomez would
23 have had to obtain 1231 votes. [See Ex. 34.]
24 k. Pearcy secured the AGP nomination and will advance to the general
25 election as the Green candidate for Corporation Commissioner with only 11 votes. [See
26 Ex. 33.] A Republican write-in candidate would have had to obtain 5,609 votes, a
27 Democratic write-in candidate would have had to obtain 5,124 votes, and a Libertarian
28 write-in candidate would have had to obtain 124 votes. If the AGP was subject to the

20
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1 same statutory requirement for write-in candidates as the other parties, Pearcy would
2 have had to obtain 1231 votes. [See Ex. 34.]
3 ARIZONA’S STATUTORY FRAMEWORK RELATING TO POLITICAL
PARTIES AND WRITE-IN CANDIDATES
4
5 61. In Arizona, a political party with continued representation is entitled to

6 representation as a political party on the official ballot for state and local officers.

7 62. Pursuant to A.R.S. § 16-804(A), a political party is qualified for continued

8 representation to appear on the official general election ballot if “[a] political

9 organization that at the last preceding general election cast for governor or presidential

10 electors[,] . . . whichever applies, not less than five per cent of the total votes cast for

11 governor or presidential electors, in the state.”

12 63. Alternatively, under A.R.S. § 16-804(B), “a political organization is

13 entitled to continued representation as a political party on the official ballot . . . if . . .

14 such party has registered electors in the party equal to at least two-thirds of one per cent

15 of the total registered electors in such jurisdiction.”

16 64. The Arizona Democratic Party, the Arizona Republican Party, and the

17 Arizona Libertarian Party are entitled to continued representation.

18 65. The AGP failed to obtain the requisite number of votes in the 2008 general

19 election to be entitled to continued representation as a political party in Arizona.

20 66. Pursuant to A.R.S. § 16-803(A), a political party that is not entitled to

21 continued representation may become a recognized political party that can be represented

22 by an official party ballot and have access to the statewide ballot if the political party files

23 a petition for recognition not less than 140 days before the primary election.

24 67. The AGP is a recognized political party with ballot access in Arizona.

25 68. Under A.R.S. § 16-645(D), the State of Arizona permits a write-in

26 candidate for a party not qualified for continued representation to become the party’s

27 nominee and to appear on the general election ballot by obtaining a plurality of the votes

28 of the party for the office for which he or she is a candidate.

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


2 qualified for continued representation may become the party’s nominee and appear on the
3 general election ballot only if he receives a number of votes equivalent to at least the
4 same number of signatures required for nominating petitions for the same office.
5 70. Thus, A.R.S. § 16-645 permits an uncontested AGP write-in candidate to
6 qualify for the general election by virtue of a single vote, whereas Democrat, Republican,
7 and Libertarian write-in candidates are required to obtain significantly more votes to
8 qualify for the general election.
9 71. Accordingly, it is very difficult to qualify for the general election as a
10 Democrat, Republican, and Libertarian write-in candidate; however, unopposed Green
11 write-in candidates are able to qualify for the general election if they simply vote for
12 themselves.
13 72. This discrepancy makes it easy for other political parties or non-AGP
14 members to hijack the AGP.
15 73. Qualified electors can change their political party affiliation up to twenty-
16 nine days preceding a primary or general election.
17 74. The defendants named in their official capacities administered the partisan
18 primary elections on August 24, 2010 and will administer the general election on
19 November 2, 2010.
20 75. Upon information and belief, the County Recorder Defendants are currently
21 preparing the ballot for the November 2, 2010 general election, which will include the
22 names of the Sham Candidates.
23 76. Within a matter of days, the County Recorder Defendants will send the
24 ballots to the printer and then begin mailing ballots to military personnel, out-of-state
25 voters, and early ballot voters.
26 THE AGP IS A MINOR POLITICAL PARTY
27 77. In a democracy, the political ideologies of the major political parties,
28 representing the majority of the constituents, are likely to prevail in an election.

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1 However, the majority is expressly limited when its actions jeopardize or violate the
2 constitutional rights of minor parties and their constituents.
3 78. Minor parties face a greater danger that their constitutional rights will be
4 violated simply because they operate against the ideology of the majority. Even one
5 election in which the AGP is forced to associate with unwanted and possibly antithetical
6 candidates is sufficient to irreparably damage the party.
7 79. The very fact that the AGP has not qualified for continued representation
8 on the ballot illustrates that the AGP is a minor political party with a small constituency,
9 as does its registration of only approximately 4,000 members.
10 THE STATE OF ARIZONA HAS FORCED THE AGP TO ASSOCIATE WITH
11 INDIVIDUALS WHO DO NOT SHARE ITS POLITICAL IDEALS

12 80. Although states have broad power to regulate elections, they may not
13 exercise that power in a manner that violates the constitutional rights of their citizens and
14 may not force political parties to associate with individuals who do not share their
15 ideologies.
16 81. Arizona election laws severely burden the First Amendment rights of the
17 AGP and its constituents by forcing them to associate with candidates who have not been
18 selected by the AGP and who do not represent the AGP’s values and platform.
19 82. Because state law permits any individual to represent the AGP by simply
20 filing as a write-in candidate and voting for himself or herself, Arizona has permitted the
21 AGP to be infiltrated by sham candidates who do not share the same beliefs as the party
22 platform and who are running under the AGP name to steal votes away from non-
23 Republican candidates.
24 83. By forcing the AGP to associate with unwanted nominees, Arizona has
25 deprived the AGP of its First Amendment freedom to choose its own nominees and to
26 limit its association to those nominees.
27
28

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1 84. The State has no compelling interest in severely burdening the right of its
2 citizens to freely associate in the selection of their own political party nominees in a
3 manner that prevents the political party from being hijacked.
4 85. A.R.S. § 16-645(D) sweeps too broadly in trying to achieve the State’s
5 ends. This statute is not narrowly tailored to meet the State’s alleged interests because it
6 has allowed ill-intentioned, non-endorsed candidates to infiltrate the AGP and become
7 the AGP’s nominees on the general election ballot.
8 THE STATE DENIES EQUAL PROTECTION TO MINOR PARTIES
9 86. All political parties, whether large or small, are associations of individuals
10 that seek to advance some form of political ideology. In this way, they are similarly
11 situated under the United States Constitution.
12 87. Minor political parties that do not qualify for continued representation on
13 the Arizona ballot are subject to the plurality requirement in A.R.S. § 16-645(D), whereas
14 major political parties are not.
15 88. A candidate for a political party qualified for continued representation on
16 the official ballot gains write-in candidate status pursuant to A.R.S. § 16-645(E), and that
17 candidate must receive the required number of votes as calculated by the nomination
18 petition requirements set forth in A.R.S. § 16-322.
19 89. Because Arizona allows certain write-in candidates to appear on the general
20 election ballot by obtaining only a plurality of the votes cast for that party and for that
21 office in the primary, and because this rule does not apply to major political parties,
22 Arizona is protecting major parties’ First Amendment right to associate while denying
23 that same right to minor political parties. This state action invidiously discriminates
24 against minor parties in violation of the Equal Protection Clause of the Fourteenth
25 Amendment to the United States Constitution.
26
27
28

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1
FIRST CAUSE OF ACTION
2 (Violation of 42 U.S.C. § 1983 – First Amendment)

3 90. Plaintiffs re-allege and incorporate all of the allegations contained in the

4 preceding paragraphs of this verified complaint as though fully set forth herein.

5 91. A.R.S. § 16-645(D) is unconstitutional under the First Amendment on its

6 face and as applied to the AGP.

7 92. A.R.S. § 16-645(D) is facially unconstitutional because it compels political

8 parties that have not qualified for continued representation to put forward in the general

9 election, and thereby associate with, candidates who receive only a plurality of the votes,

10 as opposed to a number of votes equivalent to at least the same number of signatures

11 required by A.R.S. § 16-322, which is what is required of Republican, Democrat, and

12 Libertarian write-in candidates. Thus, A.R.S. § 16-645(D) compels minor political

13 parties to associate with candidates that did not garner any modicum of support from the

14 party.

15 93. A.R.S. § 16-645(D) is unconstitutional as applied to the AGP because it

16 compels the AGP, following a primary election, to publicly associate with candidates

17 other than those with whom the AGP has freely associated, including candidates whose

18 views are diametrically opposed to those of the AGP. When, as with these Sham

19 Candidates, a write-in prevails in obtaining the AGP nomination despite holding views

20 antithetical to those of the AGP, the State has impermissibly forced the AGP to publicly

21 associate with those whom it would otherwise have chosen to exclude.

22 94. This statutory scheme enables an unwanted and possibly antithetical

23 candidate to be placed on the official general election ballot through a voting system that

24 deprives the AGP of its ability to control its association and the identity of its nominees.

25 This statutory scheme violates the AGP’s First Amendment right to free association.

26
27
28

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1
SECOND CAUSE OF ACTION
2 (Violation of 42 U.S.C. § 1983 – Fourteenth Amendment, Equal Protection Clause)

3 95. Plaintiffs re-allege and incorporate all of the allegations contained in the

4 preceding paragraphs of this verified complaint as though fully set forth herein.

5 96. The Equal Protection Clause of the Fourteenth Amendment prohibits state

6 actors from discriminating against similarly situated individuals or groups unless the state

7 can demonstrate that its interest can withstand the appropriate level of scrutiny.

8 97. The State discriminates among political parties by subjecting minor parties

9 to a statutory mechanism that forces them to associate with unwanted nominees while

10 simultaneously shielding major parties from this same mechanism. In doing so, the State

11 invidiously discriminates between two similarly situated, constitutionally protected

12 organizations, and thus violates the Equal Protection Clause of the Fourteenth

13 Amendment.

14 THIRD CAUSE OF ACTION


15 (Violation of 42 U.S.C. § 1983 – Fourteenth Amendment, Substantive Due Process)

16 98. Plaintiffs re-allege and incorporate all of the allegations contained in the

17 preceding paragraphs of this verified complaint as though fully set forth herein.

18 99. The Fourteenth Amendment to the United States Constitution, enforceable

19 pursuant to 42 U.S.C. § 1983, provides that no state shall deprive any person of life,

20 liberty, or property without due process of law. The above-described conduct by

21 Defendants infringes upon Plaintiffs’ fundamental rights and protected liberty interests,

22 and in so doing violates Plaintiffs’ right not to be deprived of substantive due process.

23 100. The Fourteenth Amendment’s Due Process Clause has a substantive

24 component that protects against government interference with fundamental rights and

25 protected liberty interests. Plaintiffs have a protected, fundamental right and liberty

26 interest in being able to meaningfully exercise their right to vote. In fact, there are few

27 rights more fundamental to a functioning democracy than the right to participate in the

28 election of government officials.

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1 101. Arizona law interferes with and deprives Plaintiffs of their fundamental
2 right to meaningfully vote because those individuals wishing to support a nominee of the
3 AGP will be unable to distinguish between those candidates who are legitimate AGP
4 nominees and those who have nominated themselves to the ballot in pursuit of ulterior
5 motives. These individuals are forced under A.R.S. § 16-645(D) to cast a meaningless,
6 possibly antithetical vote.
7
FOURTH CAUSE OF ACTION
8 (Violation of Ariz. Const. Art. 7, Section 12 – Purity of Elections)

9 102. Plaintiffs re-allege and incorporate all of the allegations contained in the
10 preceding paragraphs of this verified complaint as though fully set forth herein.
11 103. A.R.S. § 16-645(D) does not “secure the purity of elections and guard
12 against abuses of the elective franchise” and, therefore, it violates Article 7, Section 12 of
13 the Arizona Constitution.
14 104. The State of Arizona, by subjecting minority political parties to the
15 plurality requirement contained in A.R.S. § 16-645(D) to select party nominees, has
16 failed to preserve the purity of elections in violation of the Arizona Constitution.
17
FIFTH CAUSE OF ACTION
18 (Violation of A.R.S. §§ 16-1006, 16-1013)

19 105. Plaintiffs re-allege and incorporate all of the allegations contained in the
20 preceding paragraphs of this verified complaint as though fully set forth herein.
21 106. Defendants acted in violation of A.R.S. § 16-1006 because they
22 “knowingly by … corrupt means, either directly or indirectly … attempt[ed] to influence
23 an elector in casting his vote or to deter him from casting his vote … attempt[ed] to awe,
24 restrain, hinder or disturb an elector in the free exercise of the right of suffrage … [or]
25 defraud[ed] an elector by deceiving and causing him to vote for a different person for an
26 office or for a different measure than he intended or desired to vote for.”
27 107. Defendants acted in violation of A.R.S. § 16-1013 because they
28 “knowingly … [b]y … fraudulent device or contrivance [], [] impede[d], prevent[ed] or

27
Case 2:10-cv-01902-DGC Document 1 Filed 09/06/10 Page 28 of 31

1 otherwise interfere[d] with the free exercise of the elective franchise of any voter, or to
2 compel, induce or to prevail upon a voter either to cast or refrain from casting his vote at
3 an election, or to cast or refrain from casting his vote for any particular person or measure
4 at an election.”
5
SIXTH CAUSE OF ACTION
6 (Injunctive Relief)

7 108. Plaintiffs re-allege and incorporate all of the allegations contained in the
8 preceding paragraphs of this verified complaint as though fully set forth herein.
9 109. As alleged herein, A.R.S. § 16-645(D) is unconstitutional on its face and as
10 applied to the AGP. Plaintiffs thus have a strong likelihood of success on the merits.
11 110. Given the nature of Plaintiffs’ claim that A.R.S. § 16-645(D) is
12 unconstitutional as applied to them, Plaintiffs lack an adequate remedy at law.
13 111. There exists an imminent and ongoing threat to the AGP by the Defendants
14 to deprive Plaintiffs of their constitutional rights by permitting unwanted and possibly
15 antithetical nominees to appear on the general election ballot such that Plaintiffs are
16 forced to associate with these sham candidates in violation of their constitutional rights.
17 112. The AGP faces irreparable injury if the party’s candidates and nominees are
18 selected in a process in which the AGP is deprived of its right to define its association.
19 Even if the political party has a chance to disavow any unwanted or antithetical
20 candidates following the primary election, the mere association with these candidates
21 could forever alter the message and positions taken by those associated with the AGP,
22 and could permanently alter the public’s perception of the AGP.
23 113. Moreover, granting the requested injunctive relief will promote the public
24 interest by protecting the electoral process and safeguarding the fundamental right to
25 vote.
26 114. Plaintiffs are entitled to preliminary and permanent injunctive relief
27 prohibiting the Secretary of State, County Boards of Supervisors, and County Recorders
28 from including the Defendant Sham Candidates on the general election ballot.

28
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1 115. In addition, Plaintiffs are entitled to preliminary and permanent injunctive


2 relief restraining Defendants from implementing A.R.S. § 16-645(D).
3 PRAYER FOR RELIEF
4 Plaintiffs respectfully request the Court enter judgment:
5 1. Declaring A.R.S. § 16-645(D) unconstitutional both on its face and as
6 applied to the Arizona Green Party;
7 2. Applying the same requirements relating to write-in candidates of parties
8 with continued representation, as set forth in A.R.S. § 16-645(E), to minority political
9 parties, or at least to the Arizona Green Party;
10 3. Preliminarily and permanently restraining the governmental defendants
11 named in their official capacities and all those acting in active concert and participation
12 with them from placing the names of the Defendant Sham Candidates on the official
13 general election ballot;
14 4. Awarding Plaintiffs’ their reasonable attorneys’ fees and costs pursuant to
15 42 U.S.C. § 1988; and
16 5. Granting such further relief as this Court deems appropriate.
17 RESPECTFULLY SUBMITTED this 6th day of September, 2010.
18 COPPERSMITH SCHERMER & BROCKELMAN PLC
19
20 By s/ Roopali H. Desai
Keith Beauchamp
21 James J. Belanger
Roopali H. Desai
22
Attorneys for Plaintiffs
23 Arizona Green Party and Claudia Ellquist
24
25
26
27
28

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OJS 44 (Rev. 12/07) CIVIL COVER SHEET
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 DEFENDANTS


Arizona Green Party, an Arizona political party; and Claudia Ken Bennett, in his official capacity as Secretary of State for
Ellquist, an individual, the State of Arizona; et al.
(b) County of Residence of First Listed Plaintiff Maricopa County of Residence of First Listed Defendant Maricopa
(EXCEPT IN U.S. PLAINTIFF CASES) (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
(For Diversity Cases Only) and One Box for Defendant)
’ 1 U.S. Government ’ 3 Federal Question PTF DEF PTF DEF
Plaintiff (U.S. Government Not a Party) Citizen of This State ’ 1 ’ 1 Incorporated or Principal Place ’ 4 ’ 4
of Business In This State

’ 2 U.S. Government ’ 4 Diversity Citizen of Another State ’ 2 ’ 2 Incorporated and Principal Place ’ 5 ’ 5
Defendant of Business In Another State
(Indicate Citizenship of Parties in Item III)
Citizen or Subject of a ’ 3 ’ 3 Foreign Nation ’ 6 ’ 6
Foreign Country
IV. NATURE OF SUIT (Place an “X” in One Box Only)
CONTRACT TORTS FORFEITURE/PENALTY BANKRUPTCY OTHER STATUTES
’ 110 Insurance PERSONAL INJURY PERSONAL INJURY ’ 610 Agriculture ’ 422 Appeal 28 USC 158 ’ 400 State Reapportionment
’ 120 Marine ’ 310 Airplane ’ 362 Personal Injury - ’ 620 Other Food & Drug ’ 423 Withdrawal ’ 410 Antitrust
’ 130 Miller Act ’ 315 Airplane Product Med. Malpractice ’ 625 Drug Related Seizure 28 USC 157 ’ 430 Banks and Banking
’ 140 Negotiable Instrument Liability ’ 365 Personal Injury - of Property 21 USC 881 ’ 450 Commerce
’ 150 Recovery of Overpayment ’ 320 Assault, Libel & Product Liability ’ 630 Liquor Laws PROPERTY RIGHTS ’ 460 Deportation
& Enforcement of Judgment Slander ’ 368 Asbestos Personal ’ 640 R.R. & Truck ’ 820 Copyrights ’ 470 Racketeer Influenced and
’ 151 Medicare Act ’ 330 Federal Employers’ Injury Product ’ 650 Airline Regs. ’ 830 Patent Corrupt Organizations
’ 152 Recovery of Defaulted Liability Liability ’ 660 Occupational ’ 840 Trademark ’ 480 Consumer Credit
Student Loans ’ 340 Marine PERSONAL PROPERTY Safety/Health ’ 490 Cable/Sat TV
(Excl. Veterans) ’ 345 Marine Product ’ 370 Other Fraud ’ 690 Other ’ 810 Selective Service
’ 153 Recovery of Overpayment Liability ’ 371 Truth in Lending LABOR SOCIAL SECURITY ’ 850 Securities/Commodities/
of Veteran’s Benefits ’ 350 Motor Vehicle ’ 380 Other Personal ’ 710 Fair Labor Standards ’ 861 HIA (1395ff) Exchange
’ 160 Stockholders’ Suits ’ 355 Motor Vehicle Property Damage Act ’ 862 Black Lung (923) ’ 875 Customer Challenge
’ 190 Other Contract Product Liability ’ 385 Property Damage ’ 720 Labor/Mgmt. Relations ’ 863 DIWC/DIWW (405(g)) 12 USC 3410
’ 195 Contract Product Liability ’ 360 Other Personal Product Liability ’ 730 Labor/Mgmt.Reporting ’ 864 SSID Title XVI ’ 890 Other Statutory Actions
’ 196 Franchise Injury & Disclosure Act ’ 865 RSI (405(g)) ’ 891 Agricultural Acts
REAL PROPERTY CIVIL RIGHTS PRISONER PETITIONS ’ 740 Railway Labor Act FEDERAL TAX SUITS ’ 892 Economic Stabilization Act
’ 210 Land Condemnation ’ 441 Voting ’ 510 Motions to Vacate ’ 790 Other Labor Litigation ’ 870 Taxes (U.S. Plaintiff ’ 893 Environmental Matters
’ 220 Foreclosure ’ 442 Employment Sentence ’ 791 Empl. Ret. Inc. or Defendant) ’ 894 Energy Allocation Act
’ 230 Rent Lease & Ejectment ’ 443 Housing/ Habeas Corpus: Security Act ’ 871 IRS—Third Party ’ 895 Freedom of Information
’ 240 Torts to Land Accommodations ’ 530 General 26 USC 7609 Act
’ 245 Tort Product Liability ’ 444 Welfare ’ 535 Death Penalty IMMIGRATION ’ 900Appeal of Fee Determination
’ 290 All Other Real Property ’ 445 Amer. w/Disabilities - ’ 540 Mandamus & Other ’ 462 Naturalization Application Under Equal Access
Employment ’ 550 Civil Rights ’ 463 Habeas Corpus - to Justice
’ 446 Amer. w/Disabilities - ’ 555 Prison Condition Alien Detainee ’ 950 Constitutionality of
Other ’ 465 Other Immigration State Statutes
’ 440 Other Civil Rights Actions

V. ORIGIN (Place an “X” in One Box Only) Appeal to District


’ 1 Original ’ 2 Removed from ’ 3 Remanded from ’ 4 Reinstated or ’ 5 Transferred from
another district ’ 6 Multidistrict ’ 7 Judge from
Magistrate
Proceeding State Court Appellate Court Reopened Litigation
(specify) Judgment
Cite the U.S. Civil Statute under which you are filing (Do not cite jurisdictional statutes unless diversity):
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
VII. REQUESTED IN ’ CHECK IF THIS IS A CLASS ACTION DEMAND $ CHECK YES only if demanded in complaint:
COMPLAINT: UNDER F.R.C.P. 23 JURY DEMAND: ’ Yes ’ No
VIII. RELATED CASE(S)
(See instructions):
IF ANY JUDGE DOCKET NUMBER

DATE SIGNATURE OF ATTORNEY OF RECORD


09/06/2010 s/ Roopali H. Desai
FOR OFFICE USE ONLY

RECEIPT # AMOUNT APPLYING IFP JUDGE MAG. JUDGE

Print Save As... Export as FDF Retrieve FDF File Reset


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. Document
1. Ryan Blackman Voter Registration
2. Ryan Blackman Write-In Candidate Filing Papers
3. Richard Grayson Write-In Candidate Filing Papers
4. Christopher Campbell Voter Registration
5. Christopher Campbell Write-In Candidate Filing Papers
6. Anthony Goshorn Voter Registration
7. Anthony Goshorn Write-In Candidate Filing Papers
8. Matthew Shusta Write-In Candidate Filing Papers
9. Clint Clement Voter Registration
10. Clint Clement Write-In Candidate Filing Papers
11. Andrew (“Drew”) Blischak Voter Registration
12. Andrew (“Drew”) Blischak Write-In Candidate Filing Papers
13. Michelle Lochmann Voter Registration
14. Michelle Lochmann Write-In Candidate Filing Papers
15. Thomas Meadows Voter Registration
16. Thomas Meadows Write-In Candidate Filing Papers
17. Theodore Gomez Voter Registration
18. Theodore Gomez Write-In Candidate Filing Papers
19. Benjamin Pearcy Voter Registration
20. Benjamin Pearcy Write-In Candidate Filing Papers
21. Facebook Message from Matt Salmon
22. Transcript of Phone Conversation with Christopher Campbell
23. 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. Document
24. Mary Jo Pitzl, Arizona Democratic Party Alleges Fraud,
The Arizona Republic, Aug. 31, 2010
25. Transcript of Phone Conversation with Gail Ginger
26. Transcript of Phone Conversation with John Mills
27. Declaration of Luisa Valdez
28. Screenshot of May’s Facebook Page Showing a Picture of Goshorn and May
29. Steve May Filing Papers
30. Declaration of Jackie Thrasher
31. Mary Jo Pitzl, Dems see red as Republicans run as Greens,
The Arizona Republic, Oct. 11, 2008
32. Declaration of Jerry Joslyn
33. 2010 Primary Election Official Write-In Results Summary
34. 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 CountyCase
Elections
2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 4 of 121 Page 1 of 2

Name: RVAN.KINGSLEY BLACIMAN Statue: A


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

Birth

Y! TEXAS RelstratIon Date 7113/2010


BIrthotiy ModIfIcatIon Date: 7/13/2010
Occupadon; OCCUPATION NOT DESIGNATED Polling Place Volunteer N
Preclnct 0167 SALT RIVER Party GREEN
qrmarenl EV List: N
Case
Maricopa County 2:10-cv-01902-DGC Document 1-2
Elections -
Filed 09/06/10 Page 5 of 121 Page 1 of 2

VOTER ON HISTORY

Prhnary 2004 Previous P&nary: 2006 Current Prtmar’: 2008

Nod General: 2004 PrevIous Qenercl: 2008 Current Genere 2003

VTjGRANGE HISTORY

AIE Date Type Reason Assoo ID

713112oG;1200:00 AM-70326319 7131/2010 12:00:00 AM U COR NONCRITICAL

7/2812010 12:00:00 AM-70326319 7/13/2010 12:00:00 AM N ORIG REG

_ ;

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
\LLL L
RECEIPT
SECRETARY OF STATE
WRITE-IN CANDIDATE
FILING OF REQUIRED FORMS 201JUL 13 PM 252
(PRIMARY ELECTION)

NAME OF
CANDIDATE Blackman. Ryan

ADDRESS 8155 East Roosevelt Street #217 Scottsdale 85257


Residence City Zip

MAILING ADDRESS Same as Above


City Zip
(575) 6357-968
( Phone Number Fax Number

EMAIL ADDRESS:

OFFICE SOUGHT United States Conaressman 5


District Number

FORMS TO BE FILED WITH PETITIONS:


STATE CANDIDATE FEDERAL CANDIDATE
NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION, NOMINATION PAPER, AFFIDAVIT OF
LI CAMPAIGN FINANCE LAWS STATEMENT
II

I QUALIFICATION
El FINANCIAL DISCLOSURE STATEMENT El 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 FOR OFFICE I BE ONI ’
(A.R.S. §§ 16-311,16-312)

You are hereby notified that I, the undersigned ,A


auqlified elect ate for the office of
A5 h the (if applicable)
to beyoted on at thAR GENERAL (circle one) election to be .held on the _______day
of_

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 (city or town) (zip)

Post office
address -
(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:

421de&a’I 1
4411
LAST NAME FIRST NAME

CANDIDATE SIGNATURE

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

EAL
NION
.L.JUNION Notary Public
=
N te ol Adzona
UNTY My Commission Expires
MiiI 16, 2012

(Seal)

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 Grayson, Richard

ADDRESS 1093W. 14th Avenue Apache Junction 85120


Residence City Zip

MAILING ADDRESS Same as Above


City - :i;

Phone Number Fax Number

EMAIL ADDRESS:

OFFICE SOUGHT United States Conaressman S

District Number

FORMS TO BE FILED WITH PETITIONS:


STATE CANDIDATE FEDERAL CANDIDATE
NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION, NOMINATION PAPER, AFFIDAVIT OF
LI CAMPAIGN FINANCE LAWS STATEMENT II QUALIFICATION

El FINANCIAL DISCLOSURE STATEMENT 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 FOR OFFICE USE ONLY
(A.R.S. §§ 16-311,16-312)

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 GENERAL (circle one) election to be held on the -

day of. ,
12 0/2
will have been a citizen of the United States for a) years 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.

6,
Z0 / 3 iJ, /
Actual residence address or description of place of residence
-rLf 7,~~
(city or town) (zip)

Post office
address /__~? q7J 67 2
(city or (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:

/./c//7’
LAST NAME FIRST NAME

CANDIDATE SIGNATURE

Subscribed AND SWORN to (or affirmed) before me this ) /Y.of.__.1)I (if’ 2010

Notary Public My

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:

A. Prior to a primary or any election, a candidate for the office of United States senator, or
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 Filed 09/06/10 Page 14 of 121
Maricopa County Elections Page 1 of 2

- Name: CH1TOPHER 8ARL CAMPBELL Status: A


i..V&M 12303209

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


U4drs

Registration Date: 611912003


/U(rotit,y: Modification Date: 7/1512010
’tptin: STUDENT Polling Place Volunteec N
Prcinct: 0423- KINGS Party: GREEN
"rmanenLEV List: N

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 Filed 09/06/10 Page 15 of 121 Page 1 of 2
Maricopa County Elections

\7QTER ELF.CLIUN H rsT )RY

Date Type Reason AssolD


1Q00:00 AM-60417835 7/22/2010 12:00:00 AM U COR NON - 0 Rt.TIQAL
712112010,(2:00:00 AM-60417835 7/15/2010 12:00:00 AM M MOD PlY
"30/200812;00:00 AM-201012667 7127/2008 12:000AM M MOD RES
J51200:100:00 AM-200005604 15/2003 12:0000 AM U Added DLN to StatelDs
AM-200005604 6/9/2003 12:QO;00 AM N ORIG REG

-
-.
;.

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
I
SCREThRY OF STATE
-

Write-in Candidate
UJ1JL5 PM 2:07
NOMINATION PAPER
AFFIDAVIT OF QUALIFICATION FOR OFFICE USE.ONLY
CAMPAIGN FINANCE LAWS STATEMENT
[A.R.S. §§ 16-311,16-312,16.;905(K)(5)]

You are hereby notified that I, the undersigned, a qualified elector, am a candidate for the office of
vJr Ljc1 /0 for the
- -ire..evu Party (if applicable) to be voted on at the
RYr GENERAL (circle one) election to be held on t
Iwill have been.a citizen of the United States for year(s) next preceding my election and will
have been a citizen of Arizona for -.5 year(s) next preceding my election and that my age is
and my date of birth is the ,25 day of /Yla/ , 19 _., and have resided in
/.J4arscc2\.. County for Z5 year(s) and in precinct
tiLa 5 for .....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 AoehI


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

Post office
address
(S
. (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: I I 9.
(Seat)
I have read all applicable laws relating to campaig ,financing and eporting.

J SEAL

Notary Public - stc1 t, of Z. ATE SIGNATURE


ono
My Comm. Exp;res No C)PIO Office Revision 9/30/2002
- 2, 2011
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
F CF V ED
RECEIPT
WRITE-IN CANDIDATE SECRETARY OF STP1E
FILING OF REQUIRED FORMS
(PRIMARY ELECTION) ZflIU JUL 15 FM 2:

NAME OF
CANDIDATE Campbell, Christopher

ADDRESS 3305 West Sandra Ter Phoenix 85053


Residence City Zip

MAILING ADDRESS Same as Above


City

(623) 332-0525
Phone Number Fax Number

EMAIL ADDRESS chris.campbe11525@grnail.com

OFFICE SOUGHT State Senator 10


District Number

FORMS TO BE FILED WITH PETITIONS:


STATE CANDIDATE FEDERAL CANDIDATE
NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION, NOMINATION PAPER, AFFIDAVIT OF
’’ CAMPAIGN FINANCE LAWS STATEMENT .LII1 QUALIFICATION
FINANCIAL DISCLOSURE STATEMENT 0 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
’.

Lu
-

SECRETARY OF STATE

2010 JUL 15 PN 2:07

FINANCIAL DISCLOSURE STATEMENT


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

Name of Public Officer or Candidate d~ r, ~3 he dattz2i’e 1/


Address 3 7.Ter P4 12 o3

ublic Office Held or Sought .5Me 5vi6L7’ r District 1

Check one:

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

month of 20 16
/
I have been appointed to fill a vacancy in a public office and am filing this Financial Disclosure
Lii
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

and sworn to (or affirmed) before me this


Subscribed and
I .dayof 20 I.

.1 1
OFFIC IA
-
L SEAL
My Commission expires LEYVA
My Comm Expire
(Seal) s 11jov.
2, 2077

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.

PUBLIC OFFICER OR
HOUSEHOLD MEMBER
TYPE OF LICENSE NAME IN WHICH HOLDING LICENSE, IF NOT JURISDICTION(S)
OR PERMIT LICENSE IS ISSUED ISSUED IF OWN NAME 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 PUBLIC OFFICER OR MEMBER OF DATE INCURRED AND/OR
TO WHOM PAYMENTS ARE MADE) HOUSEHOLD OWING THE DEBT 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 AMOUNT BY VALUE DATE INCURRED AND/OR
NAME OF DEBTOR THE DEBT IS OWED CATEGORY 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.

VU 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.

NAME OF DONOR OF GIFTS OVER $500 11 PUBLIC OFFICER OR MEMBER OF HOUSEHOLD - RECIPIENT
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 NAME OF PUBLIC OFFICER OFFICE OR


AND ADDRESS OR MEMBER OF HOUSEHOLD 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.)

EQUITY BY
NAME AND ADDRESS OF BUSINESS OR PUBLIC OFFICER OR MEMBER OF DESCRIPTION OF VALUE
TRUST HOUSEHOLD INTEREST 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.

PUBLIC OFFICER OR
MEMBER OF VALUE DATE ACQUIRED AND/OR
BONDS OVER $1,000 ISSUING AGENCY HOUSEHOLD CATEGORY 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 PUBLIC OFFICER OR MEMBER OF EQUITY BY VALUE DATE ACQUIRED OR
OF ARIZONA REALTY HOUSEHOLD OR BUSINESS CATEGORY 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 CONTROLLED AND/OR


OF HOUSEHOLD BUSINESS NAME BUSINESS ADDRESS 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.

GOODS OR SERVICES WHAT YOUR BUSINESS BUSINESS AcTlvrr’y’ OF


NAME OF YOUR PROVIDED BY YOUR PROVIDES TO YOUR MAJOR MAJOR CUSTOMER OR
CONTROLLED BUSINESS BUSINESS CUSTOMER OR CLIENT 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.

GOODS OR SERVICES BUSINESS ACTIVITY OF THE


NAME OF DEPENDENT GOODS OR SERVICES PROVIDED TO THE MAJOR MAJOR CUSTOMER OR
BUSINESS PROVIDED BY THE BUSINESS CUSTOMER OR CLIENT 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 PUBLIC OFFICER OR MEMBER OF EQUITY BY VALUE DATE ACQUIRED OR
OF ARIZONA REALTY HOUSEHOLD OR BUSINESS CATEGORY DIVESTED

AcquiredDivested

LilAcquired []Divested

Acquired flDivested

]Acquired ]Divested
[:
Case 2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 26 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 NAME OF CONTROLLED OR DEPENDENT DATE INCURRED AND/OR
TO WHOM PAYMENTS ARE .MADE) BUSINESS (FROM ITEM 3 OR 4) 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 AMOUNT BY DATE INCURRED AND/OR
DEPENDENT BUSINESS TO WHOM VALUE DISCHARGED
NAME OF DEBTOR THE DEBT IS OWED CATEGORY

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
ED
flc,j L.
STATE OF ARIZONA SEC RETAR Y O F STA TE
0000070262 $500 THRESHOLD
EXEMPTION STATEMENfO JUL 15 PH 2:02

COMMITTEE ID NUMBER
Pursuant to A.R.S. §§ 16-902.01 and 16-903(A)
201000690
NAME OF POLITICAL COMMITTEE DATE
FRIENDS OF CHRIS CAMPBELL 07/1 512010

TYPE OF COMMITTEE
$500 THRESHOLD (CANDIDATE)

COMMITTEE ADDRESS CITY STATE ZIP


3305W SANDRA TER. PHOENIX AZ 85053

COMMITTEE MAILING ADDRESS (if different from above) CITY STATE ZIP
3305W SANDRA TER PHOENIX AZ 85053

"OMMITTEE TELEPHONE # COMMITTEE FAX # COMMITTEE EMAIL ADDRESS


d23) 332-0525 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 ELECTION CYCLE


STATE SENATOR - DISTRICT NO. 10 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 Fr/ b//


(Printed Naihe of Candidate/Committee Officer)
, 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 -10
Case 2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 29 of 121 Page 1 of 2
Maricopa County Elections

Naflie: ANTHONY EDWARD GOSHORN SR Status:R


Vot0rlDJ3337879

ResldentlÆlMdress:694$ E EARLL DR 3, SCOTTSDALE, AZ 85251


Malltnpfress:
SIM Year 1966
BfrthState OHIO Registration Date: 113012009
Irt1t Coiit: Modification Date: 5/1712010
Occupation SERVICE Polling Piece Volunteer N
Precinct 0571 PAIUTE Party: GREEN
rrnanent EV List: N

City Umlt $COTTSDALE Congressional 006


JuUeaco. M000WELL MOUNTAIN LatsIattve 011
Hlgt SchdOljCOTTSDALE Suparvlsortab 003
EepIcntw)Lt.ntffed School’ SCOTTSDALE UNIFIED #48 SpocIaP Q100 Vol

IW
.w .----.- .-

g.4.

https :1/156.42.40. 50/electioninfo/Voterinformation.aspx? Voterid=3 337879 8/6/2010


Case 2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 30 of 121 Page 1 of
Maricopa County Elections

HISTORY

Pna2004: . PPdn2Q06
.. .: .

PrevIous Generst 2000 Current GonraI 2008


xt !’r4oUs General 2004

VOTER CHANGE I1IS’FORY

Date Type Reason . Assoc ID

0001O’’JjOO.0D AM-60079697 61812010 120000 AM U COR NON CRITICAL

0/8/2010 1200 ODAM 60019697 5/17/2010 120000 AM M MOD RES PTY

12010 120000 AM 903337879 5/2712009 12.00:00 AM R RESTORATION

.41/2009 120000 AM 903337879 5127/2009 12:00 00 AM D REGISTRATION VERIFICATIO

31W200912:00o0 AM..70301813 3119/2009 120000 AM U COR NON CRITICAL

O24000AM 10301813 21712009 12:00:00 AM M MOD PTY

20t920000 AM-201 303520 2/3/2009 120000 AM U COR NON CRITICAL

N ORIOREG

01FOW
1/30/2009 12.00 OOAM

. W1.

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 Filed 09/06/10 Page 32 of 121

’1E

STATE OF ARIZONA 1E
SEC
i9lZ
Write-in Candidate i3
NOMINATION PAPER 7l) JUL 5
AFFIDAVIT OF QUALIFICATION FOR OFFICE USE ONLY
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( / for the
(r-clJ . Party (if applicable) to bevoted on at the
GENERAL (circle one) election lobe held on JU6_(} L( 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 L Zl O year(s) next preceding my election and that my age is
and my date of birth is the / 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 (city or town) (zip)

Post office
address
/ 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 _/_c/ /
LAST NAME FIRS- NAM

CANOIDATE SIGNATURE

Subscribed AND SWORN to (or affirmed) befoine this I_day of 20/o

ALEXANDRA DE LA PAZ
Notary Public - Arizona Notary Public
ricopa County
My Commission Expires: Sep _ 1__D 013
I have read all applicable laws relating to
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 SECRETARY OF STAlE
FILING OF REQUIRED FORMS
(PRIMARY ELECTION)
ZUlU JUL 15 PM I2 37

NAME OF
CANDIDATE Goshorn, Anthony "Grand Pa"

ADDRESS 6949 East Earil Drive #3 Scottsdale 85251


Residence City Zip

MAILING ADDRESS P. 0. Box 186 Tempe 85280


City Zip
(480)212-6924
Phone Number Fax Number

EMAIL ADDRESS: votegrandpagmail.com

OFFICE SOUGHT State Senator 17


District Number

FORMS TO BE FILED WITH PETITIONS:


STATE CANDIDATE FEDERAL CANDIDATE
! NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION, NOMINATION PAPER, AFFIDAVIT OF
VN CAMPAIGN FINANCE LAWS STATEMENT LI QUALIFICATION
FINANCIAL DISCLOSURE STATEMENT LI 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)

A
Name of Public Officer or Candid ate t?
Address

Public Office Held or Sought District# /7


Check one:

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
months precej the date of this star,pent, from the month of 20 , to the
month of J 1-’7-. 20 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 Aril 0 {)c )


County of ryAV --r
Subscribed and sworn to (or affirmed) before me this )2 day of JLLI’/ , 20 0

1
C-
Notary Public
I
a ___3
My Commission expires
4t, ALEXANDRA DE LA PAZ
(Seal)
Maricopa County
_17viy Comm. Expires Sep 10, 2013 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 A 2 1h av z: -
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 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


PUBLIC OFFICER OR EMPLOYER OR OTHER SOURCE DESCRIPTION OF EMPLOYER’S BUSINESS AND SERVICES
MEMBER OF HOUSEHOLD OF COMPENSATION OVER PROVIDED BY PUBLIC OFFICER OR MEMBER OFHOUSEHcLD
$1,000 -

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.

PUBLIC OFFICER OR
HOUSEHOLD MEMBER
TYPE OF LICENSE NAME IN WHICH HOLDING LICENSE, IF NOT JURISDICTION(S)
OR PERMIT LICENSE IS ISSUED ISSUED IF OWN NAME 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 PUBLIC OFFICER OR MEMBER OF _-DA1E INCURRED AND/OR
TO WHOM PAYMENTS ARE MADE) ,_
HOUSEHOLD OWING THE DEBT -- 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 AMOUNT BY VALUE ATE INCURRED AND/OR
NAME OF DEBTOR THE DEBT IS OWED CATDRr DISCHARGED

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 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, 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 NAME OF PUBLIC OFFICER OFFICE OR


AND ADDRESS OR MEMBER OF HOUSEHOLD 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 VALUE
NAME AND ADDRESS OF BUSINESS OR PUBLIC OFFICER OR MEMBER OF DEJSeW
TRUST HOUSEHOLD . - INTEREST
--’ 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.

PUBLIC OFFICER OR
MEMBER OF VALUE DATE ACQUIRED AND/OR
BONDS OvER $1,000 ISSUING AGENCY HOUSEHOLD CATEGORY 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 PUBLIC OFFICER OR MEMBER OF EQUITY BY VALUE DATE ACQUIRED OR
OF ARIZONA REALTY HOUSEHOLD OR BUSINESS CATEGORY 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 LED AND/OR


OF HOUSEHOLD BUSINESS NAME BUSINESS ADDESB- DEPENDENT BUSINESS

0 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.

GOODS OR SERVICES WHAT YOUR BUSINESS USNEtTlVffV-


NAME OF YOUR PROVIDED BY YOUR PROVIDES TO YOURMAe - MAJOR CUSTOMER OR
CONTROLLED BUSINESS BUSINESS CyMERbR CLIENT 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 BUSINESS Aciivnx OF THE


NAME OF DEPENDENT GOODS OR SERVICES PROVIDED TO THE MAJOR MAJOR CUSTOMER OR
BUSINESS PROVIDED BY THE BUSINESS CUSTOMER OR CLIENT CLIENT, IF 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 PUBLIC OFFICER OR MEMBER OF EQUITY BY VALUE DATE ACQUIRED OR
OF ARIZONA REALTY HOUSEHOLD OR BUSINESS CATEGORY DIVESTED
V V
V 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 NAME OF CONTROLLED OR DEPENDENT DATE INCURRED AND/DR-
TO WHOM PAYMENTS ARE MADE) BUSINESS (FROM ITEM 3 OR 4) SCHARGED

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 AMOUNT BY DATE INCURRED AND/OR


DEPENDENT BUSINESS TO WHOM VALUE DISCHARGED
NAME OF DEBTOR THE DEBT IS OWED CATEGORY __-------------
-
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

r r’- g"
I
r r * "-

111111111111111
--

SECRETARY OF STATE
0000069889

ZOlU JUL IS AM 11 35

COMMITTEE ID NUMBER
Pursuant to A.R.S. 16-902.01 and 16-903(A)
201000670
NAME OF POLITICAL COMMITTEE DATE
0711212010
VOTE GRANDPA! 2010

TYPE OF COMMITTEE
$500 THRESHOLD (CANDIDATE)
CITY STATE ZIP
COMMITTEE ADDRESS
SCOTTSDALE AZ 86251
6949 E EARLL DR

COMMITTEE MAILING ADDRESS (if different from above) CITY STATE ZIP
TEMPE AZ 85280
P0 BOX 186
COMMITTEE TELEPHONE # COMMITTEE FAX# COMMITTEE EMAIL ADDRESS

(480) 212-6924 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 ELECTION CYCLE


2010
STATE SENATOR - DISTRICT NO. 17

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
44
1 05
4
Case 2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 45 of 121

STATE OF ARIZONA

Write-in Candidate (
VLU
TTE
NOMINATION PAPER SCgE
AFFIDAVIT OF QUALIFICATION
CAMPAIGN FINANCE LAWS STATEMENT
ZUlU J L FOR M 3 02
5 OFFICE
(A.R.S. §§ 16-311,16-312,16-905(K)(5)] USE ONLY

You are hereby notified that I, the undersgned, a qualified elector, am a candidate for the office of
517 7 S’?A1 &7. for

the (C ee&) Party (if applicable) to be voted on at


GENERAL (circle one) election to be held on_
WI have been a citizen of the United States for ___ year(s) next preceding my election and will
have been a citizen of Arizona for 7 year(s) next precediyg my election and that my age is
YO
and my date of birth is the 9’ day. of Ai tJS7 _, 19 4_7, and have resided in
___________________________________________ County for f’ year(s) and in
precinct for 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 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 i1 fy _/’t
Actual residence address or description of place of residence
r / cOPa 4z
. (city or town)
5/-
. (zip)

Post office address


(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>.

CANDIDATE SI6NATU1RE
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 Filed 09/06/10 Page 46 of 121
/
,1

OFFICE OF THE SECRETARY OF STATE


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

NAME OF
CANDIDATE Shusta, Mafthew

ADDRESS 42543 West Avella Drive Maricopa 85138


Residence City Zip

MAILING ADDRESS Same as Above


City Zip

(520) 631-6764
Phone Number Fax Number

EMAIL ADDRESS mshustal I 'yahoo.com

OFFICE SOUGHT State Senator 23


District Number

FORMS TO BE FILED WITH PETITIONS:


STATE CANDIDATE FEDERAL CANDIDATE
NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION, NOMINATION PAPER, AFFIDAVIT OF
CAMPAIGN FINANCE LAWS STATEMENT LI QUALIFICATION
FINANCIAL DISCLOSURE STATEMENT LI 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&.(Office Revision 05/20/2010)
Case 2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 47 of 121

RECEJ"-P
SES4 ScRET!\R OF TME

z: :O JUL IS Ni3: O

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
Public Office Held or Sought District #

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
D 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

Signature of Public Officer or Candidate

State of Vi
)

County of___________

Subscribed and sworn to (or affirmed) before me this day of Lt _, 204.

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


PUBLIC OFFICER OR EMPLOYER OR OTHER SOURCE DESCRIPTION OF EMPLOYER’S BUSINESS AND SERVICES
MEMBER OF HOUSEHOLD OF COMPENSATION OVER PROVIDED BY PUBLIC OFFICER OR MEMBER OF HOUSEHOLD
$1,000

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.

PUBLIC OFFICER OR
HOUSEHOLD MEMBER
TYPE OF LICENSE NAME IN WHICH HOLDING LICENSE, IF NOT JURISDICTION(S)
OR PERMIT LICENSE IS ISSUED ISSUED IF OWN NAME 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 PUBLIC OFFICER OR MEMBER OF DATE INCURRED AND/OR
TO WHOM PMYMENTS ARE MADE) HOUSEHOLD OWING THE DEBT 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 AMOUNT BY VALUE DATE INCURRED AND/OR
NAME OF DEBTOR THE DEBT IS OWED CATEGORY 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.

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 PUBLIC OFFICER OR MEMBER OF HOUSEHOLD - RECIPIENT

Secretary of State 4
Office Revision September 2009
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 NAME OF PUBLIC OFFICER OFFICE OR


AND,ADDRESS OR MEMBER OF HOUSEHOLD 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.)

EQUITY BY
NAME AND ADDRESS OF BUSINESS OR PUBLIC OFFICER OR MEMBER OF DESCRIPTION OF VALUE
TRUST HOUSEHOLD INTEREST 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.

PUBLIC OFFICER OR
MEMBER OF VALUE DATE ACQUIRED AND/OR
BONDS OVER $1,000 ISSUING AGENCY HOUSEHOLD CATEGORY 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 PUBLIC OFFICER OR MEMBER OF EQUITY BY VALUE DATE ACQUIRED OR
OF ARIZONA REALTY HOUSEHOLD OR BUSINESS CATEGORY 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.

PUBLIC OFFICER OR MEMBER CONTROLLED AND/OR


OF HOUSEHOLD BUSINESS NAME BUSINESS ADDRESS DEPENDENT BUSINESS

UControHed
/
Dependent

/ 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.

GOODS OR SERVICES WHAT YOUR BUSINESS BUSINESS ACTIVITY OF


NAME OF YOUR PROVIDED BY YOUR PROVIDES TO YOUR MAJOR MAJOR CUSTOMER OR
CONTROLLEDBUSINESS BUSINESS CUSTOMER OR CLIENT CLIENT

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 BUSINESS ACTIVITY OF THE


NAME OF DEPENDENT GOODS OR SERVICES PROVIDED TO THE MAJOR MAJOR CUSTOMER OR
BUSINESS PROVIDED BY THE BUSINESS CUSTOMER OR CLIENT 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 PUBLIC OFFICER OR MEMBER OF EQUITY BY VALUE DATE ACQUIRED OR
OF ARIZONA REALTY HOUSEHOLD OR BUSINESS CATEGORY 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 $10,000 AND 30%


NAME AND ADDRESS OF CREDITOR (OR PERSON NAME OF CONTROLLED OR DEPENDENT DATE INCURRED AND/OR.
TO WHOM PAYMENTS ARE MADE) BUSINESS (FROM ITEM 3 OR 4) DISCHARGED

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


NAME OF CONTROLLED OR AMOUNT BY DATE INCURRED AND/OR
DEPENDENT BUSINESS TO WHOM VALUE DISCHARGED
NAME OF DEBTOR THE DEBT IS OWED CATEGORY

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)
201000675
NAME OF POLITICAL COMMITTEE DATE
MATT FOR SENATE 07/13/2010

TYPE OF COMMITTEE
$500 THRESHOLD (CANDIDATE)
COMMITTEE ADDRESS CITY STATE ZIP
42543 WAVELLA DRIVE MARICOPA AZ 86138

COMMITTEE MAILING ADDRESS (if different from above) CITY STATE ZIP
42543 WAVELLA DR MARICOPA AZ 85138

COMMITTEE TELEPHONE # COMMITTEE FAX # COMMITTEE EMAIL ADDRESS


(620) 631-6764 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 ELECTION CYCLE


STATE SENATOR - DISTRICT NO. 23 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, J , certify that this Exemption Statement is true and complete.


(Printed Name of Candidate/Committe Oer)

7-/I- /o
Signature Date

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 Filed 09/06/10 Page 58 of 121
Maricopa County Elections Page 1 of 2
Case 2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 59 of 121
Maricopa County Elections Page 1 of

rrIoN NW
-PRY,

wroua Pflmary 2004 N Previous Pilmavy 2006 N Current Primary: 2008 N


Next Previous General: 2004 N Previous General: 2006 N Current General: 2008 N

VOTER CHANGE HISTORY

*0
A. 69
7/1012JM012.0000 AM-70326318
Date
7/1312010 12 0000 AM
Type
M
Reason

MOD PTY
Assoc ID

7/8/20101200 GUAM 200957423 1/8/2010120000 AM U COR NON CRITICAL


"2f2010 12.0000 AM 200057423 712/2010 12.0000 AM U RESTORED TO ACTIVE
124/100S.,12;00;00 AM-902880629 11812008 112:00:00 AM R RESTORATION
AM 200967423 5/1912003 12:0000 AM M MOD RE8 PT?
i/oaitoo-oo AM-902880629 1/8/2008120000 AM 0 REGISTRATION VERIFICATIO
10/8P2008 120000 AM 200526267 101812006 12:00:00 AM U COR NON CRITICAL
10/7/2008120000 AM 200526257 10/6/2006 120000 AM N ORIG REG.
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 2010 JUL
’(A.R.S. §§ 16-311,16-312,16-905(K)(5)]
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 c’J- I for
the CQQj\ Party (if applicable) to be voted on at
the CI MARY GENERAL (circle one) election to be held on 2 ’1 ,4c. A
-Oho
WI have been a citizen of the United States for Q9 year(s) next preceding my election and will
have been a citizen of Arizona for ’9’ year(s) next preceding my election and that my age is 28’
and my date of birth is the / ( day of _ , 19 f , and have resided in
County for year(s) and in
precinct &./f /,yr for 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 £ 1 S’ c//cJc /a 525’7
Actual residence address or description of place of residence (city or town) (zip)
’S

Post office address


(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.

CL’EMfvy C-LrA!r
LAST NAME FIRST NAME

CANDIDATE SIGNATURE

Subscribed AND SWORN to (or affirmed) before me this _


20_______
(’

ago
OFFICIAL SEAL I Notary Public

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

(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
tEtVED
RECEIPT SECRETARY OF STATE
WRITE-IN CANDIDATE
FILING OF REQUIRED FORMS
(PRIMARY ELECTION)
20JULI3 PM 2: 18

NAME OF
CANDIDATE Clement, Clint

ADDRESS 8155 East Roosevelt Street #217 Scottsdale 85257


Residence City Zip

MAILING ADDRESS Same as Above


City

(575) 650-0522
Phone Number Fax Number

EMAIL ADDRESS: maiI.com

OFFICE SOUGHT State Representative 17


District Number

FORMS TO BE FILED WITH PETITIONS:


STATE CANDIDATE FEDERAL CANDIDATE
NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION, NOMINATION PAPER, AFFIDAVIT OF
CAMPAIGN FINANCE LAWS STATEMENT D QUALIFICATION
Z FINANCIAL DISCLOSURE STATEMENT LI 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 E
SE1
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 L\q1

Address
9c~ F- tZoose-ve-1+

Public Office’ Held or Sought District # L7


Check one:

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 4
/ 61a /-I )
County of /fl a C-
,

Subscribed and sworn to (or affirmed) before me this ( 7 day of ) 1 , 20

Not blic

My Commission expires

OFFICIAL S
TRAVIS L. JSYN
NOTARY PUBLIC State of Anzona Secretary of State
MARICOPA COUNTY
My Comm. Expires April 16, 2012 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 lIA _p 2 æ1


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


PUBLIC OFFICER OR EMPLOYER OR OTHER SOURCE DESCRIPTION OF EMPLOYER’S BUSINESS AND SERVICES
MEMBER OF HOUSEHOLD OF COMPENSATION OVER PROVIDED BY PUBLIC OFFICER OR MEMBER OF HOUSEHOLD
$1,000

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.

PUBLIC OFFICER OR
HOUSEHOLD MEMBER
TYPE OF LICENSE NAME IN WHICH HOLDING LICENSE, IF NOT JURISDICTION(S)
OR PERMIT LICENSE IS ISSUED ISSUED IF OWN NAME 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 PUBLIC OFFICER OR MEMBER OF DATE INCURRED.AND/OR
TO WHOM PAYMENTS ARE MADE) HOUSEHOLD OWING THE DEBT 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 AMOUNT BY VALUE DATE INCURRED AND/OR
NAME OF DEBTOR THE DEBT IS OWED CATEGORY 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 , NAME OF PUBLIC OFFICER OFFICE OR


AND ADDRESS OR MEMBER OF HOUSEHOLD 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.)

EQUITY BY
NAME AND ADDRESS OF BUSINESS OR PUBLIC OFFICER OR MEMBER OF DESCRIPTION OF VALUE
TRUST HOUSEHOLD INTEREST CATEGORY

GvA C( //

FI hLcJ\ /

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.

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

[]Acquired ODivested

acquired Ojivested

jAcquired OJivested

Secretary of State 6
Office Revision September 2009
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

.cj
f
i1A
/ /
BUSINESS NAME BUSINESS ADDRESS
CONTROLLED AND/OR
DEPENDENT BUSINESS

RCon trolled
flDependent

U Controlled
ODependent
DControlled
O 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 WHAT YOUR BUSINESS BUSINESS ACTIVITY OF


NAME OF YOUR PROVIDED BY YOUR PROVIDES TO YOUR MAJOR MAJOR CUSTOMER OR
CONTROLLED BUSINESS BUSINESS CUSTOMER OR CLIENT 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.

GOODS OR SERVICES BUSINESS ACTIVITY OF THE


NAME OF DEPENDENT GOODS OR SERVICES PROVIDED TO THE MAJOR MAJOR CUSTOMER OR
BUSINESS PROVIDED BY THE BUSINESS CUSTOMER OR CLIENT 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 PUBLIC OFFICER OR MEMBER OF EQUITY BY VALUE DATE ACQUIRED OR
OF ARIZONA REALTY HOUSEHOLD OR BUSINESS CATEGORY 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 NAME OF CONTROLLED OR DEPENDENT DATE INCURRED AND/OR
TO WHOM PAYMENTS ARE MADE) BUSINESS (FROM ITEM 3 OR 4) 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 AMOUNT BY DATE INCURRED AND/OR


DEPENDENT BUSINESS TO WHOM VALUE DISCHARGED
NAME OF DEBTOR THE DEBT IS OWED CATEGORY

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

REi;i U
11N11111111111111111111
0000069901
STATE OF ARIZONA
$500 THRESHOLD
SECERY OF
TE

148
EXEMPTION STATEMENT 2010 JUL 13 ’M 1:

COMMITTEE ID NUMBER
Pursuant to A.R.S. §§ 16-902.01 and 16-903(A)
201000671
NAME OF POLITICAL COMMITTEE DATE
VOTE CJ - STATE HOUSE DISTRICT 17 07/12/2010

TYPE OF COMMITTEE
$500 THRESHOLD (CANDIDATE)

COMMITTEE ADDRESS CITY STATE ZIP


8155 E. ROOSEVELT STREET Z.l 7 SCOUSDALE AZ 85257

COMMITTEE MAILING ADDRESS (if different from above) CITY STATE ZIP
8155 E ROOSEVELT ST 40 2-1 -7 SCOTfSDALE AZ 85257

COMMITTEE TELEPHONE 9 COMMITTEE FAX # COMMITTEE EMAIL ADDRESS


(575) 650-0522
I CLCLEMEN@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 ELECTION CYCLE


STATE REPRESENTATIVE - 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, C I/A C/Qf-/E , certify that this Exemption Statement is true and complete.
(Printed Name of Candidate/Committee Officer)

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 Filed 09/06/10 Page 74 of 121 Page 1 of
.-Maric6pa County Elections
Case 2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 75 of 121 Page 1 of 2
Maricopa County Elections
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 Filed 09/06/10 Page 77 of 121

TAB 8

SE\ TE
STATE OF ARIZONA
E).flfl
U UL IS I0 27
Write-in Candidate
NOMINATION PAPER
AFFIDAVIT OF QUALIFICATION FOR OFFICE USE ONLY
CAMPAIGN FINANCE LAWS STATEMENT
[A.R.S. §§ 16-311,16-312,16-905(K)(5)]

You are hereby notified that I, the undersigned, a qualified elector, am a candidate for the office of
pt e p ki Q jV for the
C? r Party (if applicable) to be voted on at the
RfvtAY1 or GENERAL (circle one) election to be held on /? yM & g 1’ Z_1 t i-i
I will have been a citizen of the United States for 2.. LI year(s) next preceding my election and will
have been a citizen of Arizona for year(s) next preceding my election and that my age is 24
and my date of birth is the ,t day of Dcernkr , 19 __ , and have resided in
0 r. ’ C. 0 County for LI year(s) and in precinct
L/ II k-vt t 05 e for ?) 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 IRA 4 71 6 ke. n A (Cc 5 22


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

Post office
address
(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.

~ak Dce LAj


LAST NAME. - FIRST N AN

TE SIGNATURE

Subscribed AND SWORN to (or affirmed) before me this day of 20/ 0

STEPHEN PORPORA
MARICOPA COUNTY
MYmlon re. My Commission Expires: __ 3 /0’
March 10,
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 Blischak, Drew

ADDRESS 2727 North Price Road #71 Chandler 85224


Residence City Zip

MAILING ADDRESS Same as Above


Lip

(480) 269-3739
Phone Number Fax Number

EMAIL ADDRESS: bIischakqmaiI.com

OFFICE SOUGHT State Representative 20


District Number

FORMS TO BE FILED WITH PETITIONS:


STATE CANDIDATE FEDERAL CANDIDATE
; NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION, NOMINATION PAPER, AFFIDAVIT OF
CAMPAIGN FINANCE LAWS STATEMENT L] QUALIFICATION
FINANCIAL DISCLOSURE STATEMENT 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 -Pn ew h


G 5c,~6k
Address 2727 N. Pcv R * 71

Pub li c Office Held or Sought District #_____

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
months preceding the date of this statement from the month of 5u17 I 206I to the
month of lot 9 tI-I 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 _
)I
r STEPHEN PORPORA
NOTARY PUBUC ARIZONA
-

County of
L
Subscribed and sworn to (or affirmed) before me this
My Commission Expirea
March 10, 2014
I ay of 20 /0

3.

\ Notary Public

My Commission expires

(Seal)

1 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 Bt-k


:M
: E

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 -

PUBLIC
OFFICER OR EMPLOYER OR OTHER SOURCE DESCRIPTION OF EMPLOYER’S BUSINESS AND SERVICES
MEMBER OF HOUSEHOLD OF COMPENSATION OVER PROVIDED BY PUBLIC OFFICER OR MEMBER OF HOUSEHOLD
$1,000

Pc’e4e a1feA..
Sit itk 1 lOG’ P U41 C6 ?

OR D vSirr)ec c’v-ce
f’ht’cn

Secretary of State 2
Office Revision September 2009
Case 2:10-cv-01902-DGC Document 1-2 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
TYPE OF LICENSE NAME IN WHICH HOLDING LCENSEI IF NOT JURISDICTION(S)
OR PERMIT LICENSE IS ISSUED ISSUED IF OWN NAME 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 PUBLIC OFFICER OR MEMBER OF DATE INCURRED AND/OR
TO WHOM PAYMENTS ARE MADE) HOUSEHOLD OWING THE DEBT 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 OVER $1,000 OWED TO YOU PERSONALLY

-- PUBLIC OFFICER OR MEMBER OF


HOUSEHOLD TO WHOM AMOUNT BY VALUE DATE INCURRED AND/OR
NAME OF DEBTOR THE DEBT IS OWED g.EGORY 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 4
Office Revision September 2009
Case 2:10-cv-01902-DGC Document 1-2 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 NAME OF PUBLIC OFFICER OFFICE OR


AND ADDRESS OR MEMBER OF HOUSEHOLD 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.)

EQUITY BY
NAME AND ADDRESS OF BUSINESS OR PUBLIC OFFICER OR MEMBER OF DESCRIPTION OF VALUE -

TRUST HOUSEHOLD’ INTEREST CAT E GORY

- Pc’et.1j 0wrec
T133 .Li’Oo I f
-

Ifc 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
MEMBER OF VALUE DATE ACQUIRED AND/OR
BONDS OVER $1, 000 ISSUING AGENCY HOUSEHOLD CATEGORY 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 PUBLIC OFFICER OR MEMBER OF EQUITY BY VALUE DATE ACQUIRED OR
OF ARIZONA REALTY HOUSEHOLD OR BUSINESS CATEGORY DIVESTED

ia7NPc’kP1F71 . Pret-..i B14Ak


d&cZ529. S

Acquired 0 Dieted

f\IA 0 Acquired El Divested

fV 5,
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.

PUBLIC OFFICER OR MEMBER CONTROLLED AND/OR


OF HOUSEHOLD BUSINESS NAME BUSINESS ADDRESS DEPENDENT BUSINESS

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 BUSINESS ACTIVITY OF


GOODS OR SERVICES
PROVIDES TO YOUR MAJOR MAJOR CUSTOMER OR
NAME OF YOUR PROVIDED BY YOUR
CUSTOMER OR CLIENT CLIENT
CONTROLLED BUSINESS BUSINESS

Pe4e tr Flo-or

Secretary of State
Office Revision September 2009
Case 2:10-cv-01902-DGC Document 1-2 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 BUSINESS AcTlvrry’ OF THE


NAME OF DEPENDENT GOODS. OR.SERVICES PROVIDED TO THE MAJOR MAJOR CUSTOMER OR
BUSINESS PROVIDED BY THE BUSINESS CUSTOMER OR CLIENT CLIENT, IF A BUSINgSS

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 PUBLIC OFFICER OR MEMBER OF EQUITY BY VALUE DATE ACQUIRED OR
OF ARIZONA RE A LTY HOUSEHOLD OR BUSINESS CATEGORY DIVESTED

0 Acquired 0 Divested

O Acquired 0 Divested I

0 Acquired D Divested
7

o Acquired 0 Divested

Secretary of State 8
Office Revision September 2009
Case 2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 87 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 NAME OF CONTROLLED OR DEPENDENT DATE INCURRED AND/OR
TO WHOM PAYMENTS ARE MADE) BUSINESS (FROM ITEM 3 OR 4) 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 AMOUNT BY DATE INCURRED AND/OR


DEPENDENT BUSINESS TO WHOM VALUE DISCHARGED
NAME OF DEBTOR THE DEBT IS OWED CATEGORY

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
SECRE
OF STME

EXEMPTION STATEMENT ZOJULt5 M1O:Zl

COMMITTEE ID NUMBER
Pursuant to A.R.S. 16-902.01 and 16-903(A)
201000686
NAME OF POLITICAL COMMITTEE DATE
ELECT DREW BLISCHAK 07/14/2010

TYPE OF COMMITTEE
$500 THRESHOLD (CANDIDATE)

COMMITTEE ADDRESS CITY STATE ZIP


2727 N. PRICE #71 CHANDLER AZ 85224

COMMITTEE MAILING ADDRESS (if different from above) CITY STATE ZIP
2727 N PRICE RD UNIT 71 CHANDLER AZ 85224

COMMITTEE TELEPHONE # COMMITTEE FAX # COMMITTEE EMAIL ADDRESS


(480) 2693739 BLISCHAK@GMAIL.COM

NAME OF SPONSORING ORGANIZATION (if applicable) TYPE OF ORGANIZATION


NA
ADDRESS OF SPONSORING ORGANIZATION RELATONSHIP TO POLITICAL COMMITTEE

nA VA
FOR A CANDIDATE’S $500 THRESHOLD COMMITTEE, PLEASE PROVIDE THE FOLLOWING INFORMATION:

OFFICE SOUGHT ELECTION CYCLE


STATE REPRESENTATIVE - 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 ) 5c,ha, k
(Printed Name of Candidate/Committee Officer)
, 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 Filed 09/06/10 Page 90 of 121
Maricopa County Elections 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 COLORADO Registration Data: 9/28/2008
Blh ModifIcatIon M6: 7111=0110
O9thpAWPRQF:OTHER Polling Place Volunteer N
Pxnct 0246 EL CAMINO Party: GREEN
Permanent EV List Y
Case 2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 91 of 121
Maricopa County Elections Page 1 of 2

aoN BIs’roRy

: -

ke4jPsIs General: 2004 PravIou3 General: 2000 : currentGeneral: 208 V

VGWEWBANGE HISTORY

Date Type Reason Assoc ID

7/19/2 20000 AM-70042839 7/1512010 12:00:00 AM M MOD PTY


7m/20iOi2O0:0O AM-202000363 716/2010 12:00:00 AM U COR NON CRITICAL

’7/201Q 12:0 0:00 AM-202090363 6/1412010 12:00:00 AM M PTV


MOD PTY
S~o 0:00 iWiI2000 12:00:00 AM U COR NON CRITICAL

AM-201116099 0/26/2008 12:00:00AM N 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

[" el 1 1
M
jum
001
-
E
IA
Case 2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 93 of 121

STATE OF ARIZONA

Write-in Candidate SECRE IA OF S TT E


NOMINATION PAPER
AFFIDAVIT OF QUALIFICATION g JUL 5 PM t: L3
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
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 a year(s) next preceding my election and that my age is 3 5
and my date of birth is the I day of , 19, and have resided in
/ 14 vcl_ o., County for 2 year(s) and in
precinct V( for . 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)
7
Post office address
(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.

CANDIDATE SIGNATURE

Subscribed AND SWORN to (or affirmed) before me this /) day of ’-’- _k 20

BRIAN McGRATH
f
NOTAR TA Urizona Notary Public
Comm. Expires Nov.
I 21, 2010
My Commission Expires:
(Seal)
I have read all applicable laws relating to campaign financing,.and reporting.

k
CANDIDATE SIGNATURE
Office Revision 9/3012002
Case 2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 94 of 121

OFFICE OF THE SECRETARY OF STATE


STATE OF ARIZONA RECEVLD
SECREThRY OF STATE
RECEIPT
WRITE-IN CANDIDATE
FILING OF REQUIRED FORMS 2010 JUL 15 pj t: 43
(PRIMARY ELECTION)

NAME OF
CANDIDATE Lochmann, Michelle

ADDRESS 1550 East Thunderbird Road #1076 Phoenix 85022


Residence City Zip

MAILING ADDRESS 13236 North 7th Street Suite 4 #263 Phoenix 85022
City Zip
(602) 441-4063
Phone Number Fax Number

EMAIL ADDRESS: micheIIeIochmannyahoo.com

OFFICE SOUGHT Secretary of State


District Number

FORMS TO BE FILED WITH PETITIONS:


STATE CANDIDATE FEDERAL CANDIDATE
NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION, NOMINATION PAPER, AFFIDAVIT OF
CAMPAIGN FINANCE LAWS STATEMENT QUALIFICATION
FINANCIAL DISCLOSURE STATEMENT El 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
R 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’ // ko c X wi itna


Address /o7i oeiY

ublic Office Held or Sought c v’ e -h 7 ’ S6 ./--- District #

Check one:

El 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 i j 200 g , to the
month of _.20 0
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


Ail,
State ofJ’i , itc )
)

County of

Subscribed and sworn to (or affirmed) before me this / day of ,20 /7


OFFICIAL SEAL

0 BRIAN .MGGRATFJ
NOTARY PUBUC Slate ojzona
MAR166PA COUNTY
Myomm.ExpirosNov.21,2o1 j

I
/( /7_i ( Ct_7
,
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 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


PUBLIC OFFICER OR EMPLOYER OR OTHER SOURCE DESCRIPTION OF EMPLOYER’S BUSINESS AND SERVICES
MEMBER OF HOUSEHOLD OF COMPENSATION OVER PROVIDED BY PUBLIC OFFICER OR MEMBER OF HOUSEHOLD
$1,000

b) cLE$L3fl kO ro Lq Qc(rjYce

Secretary of State
Office Revision September 2009
Case 2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 97 of 121

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.

PUBLIC OFFICER OR
HOUSEHOLD MEMBER
TYPE OF LICENSE NAME IN WHICH HOLDING LICENSE, IF NOT JURISDICTION(S)
OR PERMIT LICENSE IS ISSUED ISSUED IF OWN NAME 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 PUBLIC OFFICER OR MEMBER OF DATE INCURRED AND/OR
TOW HOM PAYMENTS ARE MADE) HOUSEHOLD OWING THE DEBT DISCHARGED

C-ftUQO J\QYUWQ
Incurred El Discharged

4Qth1\0O 4 i9
RT) X.S t3K’D)\V( 11 f5i)Q ??\ (DCi’-\ J’ fl Incurred 0 Discharged

fl(2 L(
ho eny - C) 4cdIM 1 gfncurredE]Disch arged
LL9 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 AMOUNT BY VALUE DATE INCURRED AND/OR
NAME OF DEBTOR THE DEBT IS OWED CATEGORY 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 4
Office Revision September 2009
Case 2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 99 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 NAME OF PUBLIC OFFICER OFFICE OR


AND ADDRESS OR MEMBER OF HOUSEHOLD 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.)

EQUITY BY
NAME AND ADDRESS OF BUSINESS OR PUBLIC OFFICER OR MEMBER OF DESCRIPTION OF VALUE
TRUST . HOUSEHOLD INTEREST CATEGORY

Secretary of State
Office Revision September 2009
Case 2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 100 of 121

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.

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

DAcquired DDivested

]Acquired JDivested

Acquired DDivested

Secretary of State 6
Office Revision September 2009
Case 2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 101 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 CONTROLLED AND/OR


OF HOUSEHOLD BUSINESS NAME BUSINESS ADDRESS DEPENDENT BUSINESS
Qorp -4Q 1323 )7SkY?+ ControlIed

A - -
CAA Lkox h jcorz LJ- & L9N-0 6V Dependent

[]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 WHAT YOUR BUSINESS BUSINESS. ACTIVITY OF


NAME OF YOUR PROVIDED BY YOUR PROVIDES TO YOUR MAJOR MAJOR CUSTOMER OR
CONTROLLED BUSINESS BUSINESS CUSTOMER OR CLIENT CLIENT

Secretary of State
Office Revision September 2009
Case 2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 102 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 BusiNEss AcTivrrr’ OF THE


NAME OF DEPENDENT GOODS OR SERVICES PROVIDED TO THE MAJOR MAJOR CUSTOMER OR
BUSINESS PROVIDED BY THE BusiNEss CUSTOMER OR CLIENT 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 PUBLIC OFFICER OR MEMBER OF EQUITY BY VALUE DATE ACQUIRED OR
OF ARIZONA REALTY HOUSEHOLD OR BUSINESS CATEGORY 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 Filed 09/06/10 Page 103 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 NAME OF CONTROLLED OR DEPENDENT DATE INCURRED AND/OR
TO WHOM PAYMENTS ARE MADE) BUSINESS (FROM ITEM 3 OR 4) 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 AMOUNT BY DATE INCURRED AND/OR


DEPENDENT BUSINESS TO WHOM VALUE DISCHARGED
NAME OF DEBTOR THE DEBT IS OWED CATEGORY

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
Case 2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 104 of 121

I I11i11IJli1 Ull Il !
0000070338

Initial Registration
STATE OF ARIZONA
POLITICAL COMMITTEE
SECRET?RY Ip - S1iTE

STATEMENT OF ORGANJ93 15 4:38


0 Amended Statement
r1 Out M State Committee
o Standing Political Committee COMMITTEE ID NUMBER
Titles 16 & 19, Arizona Revised Statutes
Definitions, statutory references and important information on page 2. 201000697
NAME OF POLITICAL COMMITTEE (For ballot measure committee, name shall include official petition serial number) DATE

LOCHMANN FOR SECRETARY OF STATE 07/16/2010

TYPE OF COMMITTEE BALLOT MEASURE 0 SUPPORT 0 OPPOSE

CANDIDATE (NON-PARTICIPATING)
COMMITTEE ADDRESS CITY STATE ZIP

1550 E THUNDERBIRD RD APT 1076 PHOENIX AZ 85022

COMMITTEE MAILING ADDRESS (if different from above) CITY STATE ZIP

13236 N 7TH ST SUITE 4 #263 PHOENIX AZ 85022

COMMITTEE TELEPHONE # COMMITTEE FAX # COMMITTEE EMAIL ADDRESS

(602) 441-4063 . 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 CHAIRMAN’S TELEPHONE # CHAIRMAN’S FAX #

MICHELLE LOCI-IMANN (602)441-4063

CHAIRMAN’S ADDRESS CITY STATE ZIP

13236 N 7TH ST SUITE 4#263 PHOENIX I AZ 85022

CHAIRMAN’S OCCUPATION CHAIRMAN’S EMPLOYER CHAIRMAN’S EMAIL ADDRESS

INSURANCE BROKER CORPORATE BENEFIT CONSULTING MICHELLELOCHMANNcYAHOO.COM

NAME OF COMMITTEE TREASURER TREASURER’S TELEPHONE It TREASURER’S FAX It

MIKE GARLIKOV . (602) 441-4063 __________________

TREASURER’S ADDRESS CITY STATE ZIP

17606 N 17TH PL PHOENIX AZ 85022

TREASURER’S OCCUPATION TREASURER’S EMPLOYER TREASURER’S EMAIL ADDRESS

MARKETING SELF . 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. 2. 3.

BANK OF AMERICA

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") ELECTION CYCLE

MICHELLE LOCHMANN 2010

CANDIDATE OR D/I’S TELEPHONE # CANDIDATE OR DII’S FAX it COUNTY OF RESIDENCE

(602)441-4063 MARICOPA

CANDIDATE OR 0/I’S ADDRESS CITY STATE ZIP

13236 N 7TH ST SUITE 4 #263 PHOENIX AZ 85022

CANDIDATE OR D/I’S EMAIL ADDRESS PARTY AFFILIATION OFFICE SOUGHT

PJHCHELLELOCHMANNYAHOO.COM GREEN SECRETARY OF STATE

PAGE 1 of 2 Office Revision 9/07


Case 2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 105 of 121

[Committee ID: 201000697

S
Date: 0711512010
STATE OF ARIZONA
POLITICAL COMMITTEE
Form ID: 0000070338
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: 7-1 $"--/ c9 Chairman’s

Date: 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 D/I’s or Candidate’s

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: Chairman’s BRIAN . Mc 33RA


Date: 7 /$ 7’V Treasurer’s MARICOPACO NTY
’I
State of Arizona ) . q1@4f Arizona
NOTAjy PUBLIC )ss.
0fAri7Qn ii
Conty of )L ’ M,IP.MOPA flycbUfly of It< p_) /
SU$CRIBED AND rORN.XQ before me this Lll &JRIBED AND SWORN TO before me this j Ji _;c7 ,
My Commission Expi Commission Expires/i_/
otalY Public ’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.

PAGE 2 of 2 Office Revision 9/07


Case 2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 106 of 121

EXHIBIT 15
Case
Maricopa County 2:10-cv-01902-DGC Document 1-2
Elections Filed 09/06/10 Page 107 of 121 Page 1 of 2
Case 2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 108 of 121 Page 1 of
Maricopa County Elections

VOTER ELECrION HISTORY

Preous Pdma,y 2008 Current Prtmary 2008


Next Pevtbus Primary: 2004
Next Pj’evfr,tue General 2004 PrevIous General 2008 Current General 2008

VCANGE.HISTORY S

Reason Assoc ID
E
At’#’SS Data Type

712W2010 12:00:00 AM-202112975 712812010 12:00:00 AM U COR NON CRITICAL

7/201201012:00:00AM-202112975 7/16/201012:00:00AM N ORIGREG

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 TA p’I r c’TA"
CIO NOMINATION PAPER L L r/ U
AFFIDAVIT OF QUALIFICATION
CAMPAIGN FINANCE LAWS STATEMENT
16 311,16 312,16 905(K)(5)]
- -
zan JUL 15 PH (t 5J
-
FOROFFICEUSEONLY

You are hereby notified that I, the undersigned, a qualified elector, am a candidate for the office of
f’_ for
the Party (if applicable) to be voted on at
PRIMARY5? GENERAL (circle one) election to be held
-- --+wHJ-Iave been a citizen of the United States for -/1! 6 year(s) next preceding my election and will
,

have been a citizen of Arizona for year(s) next preceding my election and that my age is
and my date of birth is .the _ day of 1k O*’J’1’VflcL , I 9PZ-1’ and have resided in
’A/\ 01-1
C-O 24 County for year(s) and in
precinct 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.

Actual residence address or description of place of residence


lo~L
(city or town)
Y-O/9 (zip)

iP
office
(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 SIGNATURE

Subscribed AND SWO ed)


JONATHAN RAML
Notary Public Arizona
-

Maricopa County
My Commission Expires Notary Public
February 28, 2014
e
(Seal)
My Commission Expires:
\H
I have read all applicable laws relating to campaign financing and reporting.

CANDIDATE SIGNATURE
Office Revision 9/30/2002
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 \ / n
RECEIPT SECRE1AR’( OF S TME
WRITE-IN CANDIDATE
FILING OF REQUIRED FORMS
2019 JUL 15 FM b: 5
(PRIMARY ELECTION)

NAME OF
CANDIDATE Meadows. Thomas

ADDRESS 3200 East Hazelwood Phoenix 85018


Residence City Zip

MAILING ADDRESS P. 0. Box 186 Tempe 85280


City Zip
(480) 529-2041
Phone Number Fax Number

EMAIL ADDRESS: _
.ryoga imlost@yahoo.com

OFFICE SOUGHT State Treasurer


District Number

FORMS TO BE FILED WITH PETITIONS:


STATE CANDIDATE FEDERAL CANDIDATE
NOMINATION PAPER, AFFIDAVIT OF QUALIFICATION, NOMINATION PAPER, AFFIDAVIT OF
VN CAMPAIGN FINANCE LAWS STATEMENT L] QUALIFICATION
FINANCIAL DISCLOSURE STATEMENT LI 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&
( Af ~%

- -
(Office Revision 05/2012010)
Case 2:10-cv-01902-DGC Document 1-2 Filed 09/06/10 Page 112 of 121

¶ 4
RECEVNJ
SECRE1Ry OF STATE

20 JUL 15 PM : 5

FINANCIAL DISCLOSURE STATEMENT


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

Name of Public Officer or Candidate/ / Lpv1 p- (7?i t_J

Address

ublic Office Held or Sought - Sau


’-
District #______

Check one:

F-I 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 4 1 )Q Q 2%Q7L_ , to the
month of t. 20)(’l_. (J
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 Mk CU N

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


0 of , 20 tC
t.
jł 1 4 JONATHAN RAML
____ Notary Public . Art zOna

W
-4
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 /1L/Zffl yY? ei1 i

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.

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


PUBLIC OFFICER OR EMPLOYER OR OTHER SOURCE DESCRIPTION OF EMPLOYER’S BUSINESS AND SERVICES
MEMBER OF HOUSEHOLD OF COMPENSATION OVER PROVIDED BY PUBLIC OFFICER-OR MEMBER OF HOUSEHOLD
$1,000

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.

PUBLIC OFFICER OR
HOUSEHOLD MEMBER
TYPE OF LICENSE NAME IN WHICH HOLDING LICENSE, IF NOT JURISDICTION(S)
OR PERMIT LICENSE IS ISSUED ISSUED IF OWN NAME 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 PUBLIC OFFICER OR MEMBER OF DATE INCURRED AND/OR
TO WHOM PAYMENTS ARE MADE) HOUSEHOLD OWING THE DEBT 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 AMOUNT BY VALUE DATE INCURRED AND/OR
NAME OF DEBTOR THE DEBT IS OWED CATEGORY 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

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.

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
NAME AND ADDRESS OF BUSINESS OR PUBLIC OFFICER OR MEMBER OF DESCRIPTION OF VALUE
TRUST HOUSEHOLD INTEREST ATEGORY

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.

PUBLIC OFFICER OR
MEMBER OF VAI! DATE ACQUIRED AND/OR
BONDS OVER $1 ,000 ISSUING AGENCY HOUSEHOLD TEGORY 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 PUBLIC OFFICER OR MEMBER OF EQUITY BY VALUE DATE ACQUIRED OR
OF ARIZONA REALTY HOUSEHOLD OR BUSINESS CATEGORY 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 CONTROLLED


OF HOUSEHOLD BUSINESS NAME BUSINESS ADDRESS 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 BUSINESS ACTIVITY OF


GOODS OR SERVICES
PROVIDES TO YOUR MAJOR MAJOR CUSTOMER OR
NAME OF YOUR PROVIDED BY YOUR
CUSTOMER OR CLIENT CLIENT
CONTROLLED BUSINESS 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.

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

GOOD SERVICES BUSINESS ACTIVITY OF THE


NAME OF DEPENDENT GOODS OR SERVICES 8’TbED TO THE MAJOR MAJOR CUSTOMER OR
BUSINESS PROVIDED BY THE BUSINESS. CUSTOMER OR CLIENT 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 PUBLIC OFFICER OR MEMBER OF EQUITY BY VALUE ATE ACQUIRED OR
OF ARIZONA REALTY HOUSEHOLD OR BUSINESS CATEGORY .- 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 3

NAME AND ADDRESS OF CREDITOR (OR PERSON NAME OF CONTROLLED OR DEPENDENT ATE INCURRED AND/OR
TO WHOM PAYMENTS ARE MADE) ESS FROM lTEM3OR
( ’ AE

[-]Incurred D Discharged

fllncurredDischarged

fllncurredDischarged

4Business’
6. 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 BUSI


NAME OF CONTROLLED OR MOUNT BY DATE INCURRED AND/OR
DEPENDENT BUSINESS TO WI- VALUE DISCHARGED
NAME OF DEBTOR THE DEBT IS OWe’ CATEGORY

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
STATE OF ARIZONA.
$500 THRESHOLD
SECRETARY OF STATE
EXEMPTION STATEMENT
191
O 2010 JUL 15 PIM 14 32
COMMITTEE ID NUMBER
Pursuant to A.R:S. § 16-902.01 and 16-903(A)
201000694
NAME OF POLITICAL COMMITTEE DATE
VOTE THOMAS MEADOWS 2010 07115/2010

TYPE OF COMMITTEE
$500 THRESHOLD (CANDIDATE)

COMMITTEE ADDRESS CITY STATE ZIP


420 S MILL AVE TEMPE AZ 85281
COMMITTEE MAILING ADDRESS (if different from above) CITY STATE ZIP
P0 BOX 186 TEMPE AZ 85280

COMMITTEE TELEPHONE # COMMITTEE FAX # COMMITTEE EMAIL ADDRESS


80) 529-2041 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 ELECTION CYCLE
STATE TREASURER 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 . 7W’ ’ OW
(Printed Name of Gandidate7Committee Officer) /
certify that this Exemption Statement is true and complete.

VV Office Revision 9/07

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