Candidate Committee Funds Transfer Form - Colorado Secretary Of State
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1Colorado Secretary of State
1560 Broadway, Suite 200
Denver, CO 80202
(303) 894-2680
(303) 894-7732 Fax
CANDIDATE COMMITTEE FUNDS TRANSFER FORM
[CRS 1-45-106 (1)(a)(I)(B)]
Full Name of Committee: ____________________________________________________________________
Address
: ___________________________________________________________________________
(Physical)
Mailing Address
: ____________________________________________________________
(if different from above)
Telephone Number: ________________________
FAX Number: _____________________________
Purpose of Transfer:
TRANSFERS THE FOLLOWING:
(Check appropriate box(es) and fill in amount; then total)
Monetary Amount: $
Debt Balance: $
Loan Balance: $
TOTAL AMOUNT: $
TO
Full Name of Committee: ____________________________________________________________________
Address
: ___________________________________________________________________________
(Physical)
Mailing Address
: ____________________________________________________________
(if different from above)
Telephone Number: ________________________
FAX Number: _____________________________
Purpose of Receipt:
___________________________________________
________________________
Signature of Candidate
Date
___________________________________________
________________________
Signature of Registered Agent (Transferring Agent)
Date
___________________________________________
________________________
Signature of Registered Agent (Receiving Agent)
Date
Colorado Secretary of State Form Rev: May 2000
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