Yavapai County Elections - Committee Termination Statement

Yavapai County Elections

Committee Termination Statement
Yavapai County Elections
1015 Fair St, RM 228
Prescott, AZ 86305
(928) 771-3248 x8
yavapaivotes.gov
elections@yavapaiaz.gov
Date/Time
Committee ID # *
Committee Name*
Committee Address*

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Committee Website*
Chairperson's Name*

First NameLast Name
Treasurer's Name*

First NameLast Name
DECLARATION AND SIGNATURES

I declare under penalty of perjury that the foregoing information is true and correct. I further declare that: (1) the committee will no longer receive any
contributions or make any disbursements; (2) the committee either (a) has no outstanding debts or obligations, or (b) has outstanding debts or
obligations that are all more than five years old, and the committee’s creditors have agreed to discharge the debts and obligations and have agreed to
the termination of the committee; (3) any surplus monies have been disposed of and that the committee has no cash on hand; and (4) all contributions
and expenditures have been reported, including any disposal of surplus monies.
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