HomeMy WebLinkAboutStatement of OrganizationSEL 27,1
Rev. I 1/01
()RS 260,(/42
STATEMENT OF ORGANIZATION ORs 260.1 Ix
Designation of
Political Committee and Appointment of Treasurer and Directors
Please type or print legibly in black ink.
Primary 20
General 200-/--" Otl~er election date
[] Will exist for more than one year
This filing is an: [~ Original [] Amendment [] Discontinuation
This filing is with:
[~'l¢rincipal Filing Officer
Name of political committee (if changing committee name, please include tbrmcr name) Abbreviation or acronym
Residence address (stre~t/r~te, city, state, zip code)- no post ~ce box nu~ers
Name of treasurer
Work phone nmnber Home phone number Fax number E-mail address
Mailing address to which all co~espondence will be scm
Additional address that may be used on political publications (post office box or street/route, city, state, zip code)
Type of Political Committee
(mark only one box)
~ Miscellaneous [] Measure [] Political Party
Support or oppose one or more of thc oCbief petitioners of initiative or referendum ·A mz0or or minor party defined in ()RS
fbllowing: petition chapter 248
· Specific candidates · Exclusively support or oppose one or more · A committee established by a major or
· Entire ticket o£a political party measures on ballot minor party under party bylaws (e.g.,
°Candidate in a recall election (includes county central commizlce)
chicfpetitioncr of recall petition)
· Multiple candidates and measures
Candidate Name/Party Name/Title of Measure or Petition Support Oppose
. F. ft []
. [] []
Naturejg polit'k~! committee
.... ,,,-
, r '~...~,~ ' '~ .' 5 J
Political committee int~p~solic~?~hd~ (mark all that apply):
~ Direct mail ~tact [~Radio
~ Events ~~Newsp~ [~ Website
[] Television
[] Other
Please complete and sign the back side of this form.
Committee Directors/Chief Petitioners
Name Address (including zip code) Occupation Phone Number
i
If two or more directors of this political committee are also directors of another political committee, list the names of those
directors and the ha]ne and address of the other political committee.
By signing this document I acknowledge that I am personally liable for any penalties imposed under ORS chapter 260.
Instructions
Filing a new committee
The completed form must be filed within three business days of first receiving a contribution or making an expenditure. A date
stamped copy, which includes your identification number, will be returned to you as an acknowledgment of your filing.
Amending information on this form
Any change in the information on this form must be filed within ten (10) days of the change. To notify the filing officer of a change in
information, submit this form, completed in its entirety, and mark the "Amendment" box.
Committee Directors/Chief Petitioners
All committees, other than chief petitioner committees, must designate ,at least one committee director who is not the treasurer. The
treasurer may be a committee director if the treasurer meets the definition of committee director in ORS 260.005(2), but the
treasurer may not be the only committee director. A chief petitioner committee must list all chie[ petitioners of the petition.
Occupational information for chief petitioners is optional.
You must file a final contribution and expenditure report that shows a zero balance, along
"Discontinuation" box marked. The final report may be filed at any time.
For Office Use
Initials Committee ID Number
Office Number