Form Cfa-11 - Supplemental "Large Contribution" Report By A Candidate'S Committee - 1999

Download a blank fillable Form Cfa-11 - Supplemental "Large Contribution" Report By A Candidate'S Committee - 1999 in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form Cfa-11 - Supplemental "Large Contribution" Report By A Candidate'S Committee - 1999 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

(CFA-11)
SUPPLEMENTAL "LARGE CONTRIBUTION"
REPORT BY A CANDIDATE'S COMMITTEE
(
$1,000 CONTRIBUTIONS OR MORE)
FILE NUMBER
State Form 48492 (R / 11-99)
Indiana Election Commission (IC 3-9-5-20)
Approved by State Board of Accounts 1999
TOTAL PAGES IN ENTIRE CFA-11 REPORT
INSTRUCTIONS: Only candidates receiving a “large contribution” are required to
file this report. Please type or print legibly IN BLACK INK all information on this form.
For assistance in completing this form, see instructions on the reverse side.
COMMITTEE INFORMATION
1. Full name of candidate (Include any nickname )
Check if this is a new name
2. Committee telephone number
(
)
3. Mailing address (address where all campaign finance correspondence is received)
Check if this is a new address
4. City, state, ZIP code
5. Party affiliation or if independent
6. Office sought (Include district number, if any. Not required for exploratory committee.)
7. County of residence
8. Reporting period:
From:
Through:
For classification, enter INDV for individual; PAC for political action committee; CORP for corporation; LAB for labor organization;
NO NE for a ll en trie s w h ich a re n ot o ne of the a bov e ca teg orie s.
CONVENTION CANDIDATES ONLY
TYPE OF CONTRIBUTION
DATE RECEIVED
COLUMN A
CONTRIBUTOR'S FULL NAME AND OCCUPATION
OR OTHER RECEIPT
AMOUNT OF
FULL MAILING ADDRESS
CONTRIBUTION
RECEIVED BY
(street, number, city, state, ZIP code)
Contributions:
Classification
1.
Contributions:
Direct
In-Kind (describe)
________________________
Other Receipts:
Interest
Loan
Misc (specify)
________________________
Contributor's Occupation
(if applicable)_________________________________________
Classification
2.
Contributions:
Direct
In-Kind (describe)
________________________
Other Receipts:
Interest
Loan
Misc (specify)
Contributor's Occupation
________________________
(if applicable)_________________________________________
Classification
3.
Contributions:
Direct
In-Kind (describe)
________________________
Other Receipts:
Loan
Interest
Misc (specify)
Contributor's Occupation
(if applicable)_________________________________________
________________________
CERTIFICATION
I CERTIFY THAT I HAVE EXAMINED THIS STATEMENT. TO THE BEST OF MY KNOWLEDGE AND BELIEF IT IS
FOR OFFICE USE ONLY
TRUE, CORRECT AND COMPLETE.
Signature of Treasurer
Title
Date
Signature of Candidate (if applicable)
Date
WARNING: Any information contained in this report may not be copied for sale or used for any commercial purpose.
(IC 3-9-4-5) A person who knowingly files a fraudulent report commits a Class D Felony. (IC 3-14-1-13) A person who fails
to file a complete or accurate report as required by the Indiana Campaign Finance Law commits a Class B Misdemeanor
(IC 3-14-1-14) and may be subject to civil penalties (IC 3-9-4-16, 3-9-4-17, 3-9-4-18).

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Form 48492 - Supplemental Form 48492 - Supplemental "large Contribution"report By A Candidate's Committee Legal
State Form 48492 - Supplemental Large Contribution Report By A Candidate's Committee (1,000 Contributions Or More) - Indiana Election Commission State Form 48492 - Supplemental Large Contribution Report By A Candidate's Committee (1,000 Contributions Or More) - Indiana Election Commission Legal
Form Nj-2210 - Underpayment Of Estimated Tax By Individuals, Estates Or Trusts - 1999 Form Nj-2210 - Underpayment Of Estimated Tax By Individuals, Estates Or Trusts - 1999 Financial
Form 777 - Resident Credit For Tax Imposed By A Canadian Province - 1999 Form 777 - Resident Credit For Tax Imposed By A Canadian Province - 1999 Financial
Form Ct-6 - Election By A Federal S Corporation To Be Treated As A New York S Corporation - New York State Department Of Taxation And Finance Form Ct-6 - Election By A Federal S Corporation To Be Treated As A New York S Corporation - New York State Department Of Taxation And Finance Financial
Form Ct-6 - Election By A Federal S Corporation To Be Treated As A New York S Corporation Form Ct-6 - Election By A Federal S Corporation To Be Treated As A New York S Corporation Financial
Form Ct-3-a/c - Report By A Corporation Included In A Combined Franchise Tax Return - New York State Department Of Taxation And Finance - 2012 Form Ct-3-a/c - Report By A Corporation Included In A Combined Franchise Tax Return - New York State Department Of Taxation And Finance - 2012 Financial
Form Ct-3-a/c - Report By A Corporation Included In A Combined Franchise Tax Return - 2011 Form Ct-3-a/c - Report By A Corporation Included In A Combined Franchise Tax Return - 2011 Financial
Form Ct-32-a/c - Report By A Banking Corporation Included In A Combined Franchise Tax Return - New York State Department Of Taxation And Finance - 2012 Form Ct-32-a/c - Report By A Banking Corporation Included In A Combined Franchise Tax Return - New York State Department Of Taxation And Finance - 2012 Financial
Form Ct-32-a/c - Report By A Banking Corporation Included In A Combined Franchise Tax Return - 2014 Form Ct-32-a/c - Report By A Banking Corporation Included In A Combined Franchise Tax Return - 2014 Financial

Related Categories

Parent category: Legal
Download
Go