Lobbying Complaint Form - The State Of Montana
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1
2FOR OFFICE USE ONLY
THE STATE OF MONTANA
FOR OFFICE USE ONLY
Commissioner of Political Practices
1205 Eighth Avenue
Post Office Box 202401
Helena, MT 59620-2401
Phone: 406-444-2942
Fax : 406-444-1643
HAND DELIVERED
CERTIFIED MAIL
Lobbying
SIGNED/NOTARIZED
Complaint Form
(10/09)
Type or print in ink all information on this form except for verificaiton signature
Person bringing complaint (Complainant):
Complete Na me
______________________________________________________________
Complete Mailing Address
_______________________________________________________________
_______________________________________________________________
Phone Numbers:
Work
Ho me
__________________________
__________________________
Person or organization against whom complaint is brought (Respondent):
Complete Na me
_______________________________________________________________
Complete Mailing Address
_______________________________________________________________
_______________________________________________________________
Phone Numbers:
Work
Home
__________________________
__________________________
Please complete the second page of this form and describe in
detail the facts of the alledged violation.
Verification by oath or affirmation
State of Montana, County of ______________________
I, ___________________________________, being duly sworn, state that the information in this
Complaint is complete, true, and correct, to the best of my knowledge and belief.
_________________________________________
(SEAL)
Signature of Complainant
Subscribed and sworn to before me this ____ day of
_________________, ________.
_________________________________________
Notary Public
My Commission Expires:
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