Form Cc-4 - Statement Of Intent To Seek Public Funds
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1
2STATE OF HAWAII
CAMPAIGN SPENDING COMMISSION
STATEMENT OF INTENT
TO SEEK PUBLIC FUNDS
1
. CANDIDATE INFORMATION:
2.
Office Sought:
(a
) Candidate Name:
3.
District/County (if applicable):
/
4.
Minimum Amount of Qualifying Campaign Contributions
(b) Mailing Address:
$
(See the back of this form for this amount):
5.
Maximum Amount of Public Funds Available for Each Election (Primary, General)
$
(See the back of this form for this amount):
I hereby notify the Campaign Spending Commission (“Commission”) of my intent to seek public funds for the purpose of defraying authorized
campaign expenses. As a condition of receiving public funds for each election, I agree:
1.
To voluntarily comply with the campaign expenditure limit set for my respective office for each election as determined under Section 11-209,
Hawaii Revised Statutes (“HRS”), by filing the “Affidavit to Voluntarily Agree with Campaign Expenditure Limits” form (Form CC-2);
2.
To obtain the required “minimum amount of qualifying campaign contributions” for my respective office from individual residents of Hawaii as
set forth in Section 11-219, HRS, once for the election period. A qualifying campaign contribution means an aggregate monetary contribution
of $100 or less but does not include loans or in-kind contributions;
3.
That contributions received prior to the filing of this form shall not be considered qualifying campaign contributions;
4.
That contributions considered qualifying campaign contributions must be received during any matching payment period:
•
For a primary election, from January 1 of the year of a general election through the day of the primary election; and
•
For a general election, from January 1 of the year of a general election through the day of the general election.
Qualifying campaign contributions may be attributed to a primary or general election during the overlapping period;
5.
That at least one other qualified candidate for the same elective seat and I must have our names on the election ballot in the same election. A
primary and general election are considered distinct elections;
6.
To obtain and furnish to the Commission any evidence of my campaign expenses which the Commission may require;
7.
To keep and furnish records, books, and other information which the Commission may request;
8.
To an audit and examination by the Commission under Section 11-225, HRS, and to pay any amounts required to be paid pursuant to such
section.
I, the undersigned candidate for election to public office in the State of Hawaii, have read and understood the conditions of this statement.
Candidate Signature
Date
Form CC-4 (Rev. 12/08)
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