HomeMy WebLinkAboutStatement of Organization
General 20
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Original
D Amendment
This filing is with:
~ Principal Filing Officer
o Secondary Filing Officer ~ I' ~-xpiiJAl
(Name ofPrinci al Filing Officer)
Name of political committee (if changing committee name, please include former name)
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Residence addre s (street/route, city, state, zip code) - no post office box numbers
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Abbreviation or acronym
Name of treasurer
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Home phone number
Fax number
E-mail address
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Mailing address to which all correspondence will be sent
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Additional address that may be used on political publications (post office box or street/route, city, state, zip code)
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o Miscellaneous
Support or oppose one or more of the
following:
. Specific candidates
. Entire ticket of a political party
. Candidate in a recall election (includes
chief petitioner of recall petition)
. Multiple candidates and measures
Type of Political Committee
~' (mark only one box)
!kj Measure
. Chief petitioners of initiative or referendum
petition
. Exclusively support or oppose one or more
measures on ballot
D Political Party
. A major or minor party defined in ORS
chapter 248
. A committee established by a major or
minor party under party bylaws (e,g"
county central committee)
Support Oppose
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D 0
0 0
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Political committee intends to solicit funds by (mark all that apply):
U2J Direct mail IEf Personal contact 0/Radio
[ffEvents [j~::rNewspaper [J'Website
[jJ'Television
[ZJ Other
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Committee Directors/Ch~ef Petitioners
Address (including zip code) Occupation
Phone Number
Name
If two or more directors of this political committee are also directors of another political committee, list the names of those
directors and the name 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.
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Treasurer's signature
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Date signed
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 chief petitioners of the petition.
Occupational information for chief petitioners is optional.
Discontinuing your committee
You must file a final contribution and expenditure report that shows a zero balance, along with a completed SEL 221 with the
"Discontinuation" box marked. The final report may be filed at any time.
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