Committee Registration 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
COMMITTEE REGISTRATION FORM
[CRS 1-45-109]
Check only one Committee Type box:
Candidate Committee
State Political Committee (PAC)
[
[
CRS 1-45-103(2)]
CRS 1-45-103(10)(a)]
Political Party
Federal Political Committee (PAC)
[
[CRS 1-45-103(12)]
CRS 1-45-103(10)(a)] (Must file disclosure reports with FEC)
Issue Committee
Is this an amendment? YES
NO
[CRS 1-45-103(8)]
(To a previous registration?)
Full Name of Organization:
Address
: ___________________________________________________________________________
(Physical)
Mailing Address
: ____________________________________________________________
(if different from above)
Telephone Number: ________________________
FAX Number: _____________________________
E-Mail:
____________________________
Web Site:
__________________________
(Optional)
(Optional)
NAME OF PERSON TO ACT AS REGISTERED AGENT:
List all affiliated Candidates and Committees (as applicable):
__________________________________________________________________________________________
__________________________________________________________________________________________
Purpose or Nature of Interest of the Committee:
__________________________________________________________________________________________
__________________________________________________________________________________________
___________________________________________
________________________
Signature of Candidate (required if Candidate Cmte)
Date
___________________________________________
________________________
Signature of Registered Agent
Date
Colorado Secretary of State Form Rev: May 2000
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