Statement Of Contributions In-Kind - Colorado Secretary Of State
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1Statement of Contributions In-Kind
[CRS 1-45-103(4.5), CRS 1-45-108(1) 1-45-103(a)]
(
Enter on line 12 Detailed Summary)
TOTAL
$
Full Name of Committee:
Contributor's
Aggregate
Total of
Date
Monetary and
Name & Address of Contributor
In-Kind
Provided Brief Description
Fair Market Value
Jane Doe, 22 2nd St. Denver,
CO 80202
$
2,500.00
mm/dd/yy
$
2,500.00
Computer Terminal (Sample Only)
Page __of ___
Colorado Secretary of State Form, Rev: May 2000
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