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9950 Park AvenUe
Firestone, CO 80520
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FIRESTONE
inn. (303) 5 1-6 t FIRESTONE
Fax. (7 0)713410 Cal
NEW COMMITTEE REGISTRATION FORM
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Pleas use this form il`you are registering, a new committee for Colorado campaign finance pa rpos s.
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Select Only One Committee Type:
��Candidate CommitteeState Political Committee C - Small Donor Committee r Political Party
Issue Committee r, mall -Scale Issue Committee r 527 political Organization
Committee Name -
Name
should im descriptive. include utli . u x aivas dunes, eaca Hole. Colorado duns not have PACs, only Political F'oMxnftUvs.
Committee address (physical): _ � b.
ornnaittee Address(mailing);
me-
Plaonc itr: � It rn ate Phone l ber. Fax rnber;
Check Only One Jurisdiction: hAddress:
COUNTY
pcial istrlct Enter Applicable
Counties ...._
)(Municipal hills with Municipality) School District
Purpose/Office Sought (include party , P election year, if applicable).
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