FEC Form 1 for Dr. Matt Heinz for ArizonaForm 1 for Dr. Matt Heinz for Arizona

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1107746

1. Dr. Matt Heinz for Arizona

PO Box 57698
Tucson, AZ 85732
Email: mattheinzcampaign@gmail.com;fec@cfoconsults.com

NOTE: Email address is different than previously reported

2. Date: 10/03/2016

3. FEC Committee ID #: C00582221 This committee is a Principal Campaign Committee. Candidate: Dr. Matthew Gerald Heinz
Party: Democratic Party
Office Sought: House of Representatives
State is Arizona in District: 02

Affiliated Committees/Organizations

Committee ID# C00626895
Southern Arizona Victory Fund
2910 E. Gary Way
Phoenix, Arizona 85042
Affiliated Relationship Code: Joint Fundraising Representative

Custodian of Records:

Brendan Galvin
One Park Row, 5th Floor
Providence, RI 02903
Title: Accountant

Treasurer:

David Braun
6125 E. Grant Rd
Tucson, Arizona 85712
Title: Treasurer

Designated Agent(s):

Banks or Depositories

National Bank of Arizona
335 N. Wilmot Rd.
Tucson, Arizona 85711

Wells Fargo, NA
PO Box 63020
San Francisco, California 94163

Signed: David Braun
Date Signed: 10/15/2016
Official Committee URL: www.heinzforarizona.com

(End FEC FORM 1)

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