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  • 8/7/2019 IWDA PAC 9761

    1/1

    FOR I NSTRUCTI ONS, SEE BACK OF FORMCHECKONE :VT h i s i s an i n i t i a l * S t a t e me n t o f Or g a ni z a t i o nDTh i s i s an amend ed" S t a t e me n t o f Or g a ni z a t i o nAn i n i t i a l St a t eme n t o f Or g a n i z a t i o n must b e f i l e d w i t h i n 1 0 dal ~ ~s n h f b u t i o n s ,ma k i n g e x p e n d i t u r e s , o r i n c u r r i n g i n de bt e dn es s e x c ee d i n g $75Qt I t A~i i r f u - n 3 0 d ay s o fa c h a n g e . Pe na l t i e s may b e i mp o s e d f o r l a t e - f i l e d St a t e me n t s o f Or g an i z a t i o n . A c a nd i d at e w i t h a n o pe nc o mmi t t e e t h a t e x c e e d s $ 7 5 0 i n a c h v d y f o r a n ot h e r o f f i c e s h a l l f i l e w i t h i n 1 0 d ay s e i t h e r a newo r amende dD R- 1 d i s c l o s i n g i n f o r ma t i o n c o n c er n i n g t h e c a mp a i g n f o r t h e new o f f i c e s o u g h t .COMMI TTEE NAME 1 1 ( A c a n d i d a t e ' s c o mmi t t e e must i n c l u d e t h e c a n d i d a t e ' s l a s t name i n t h e name o f t h e c o mmi t t e e . )I WDA PACI MPORTANT: I n d i c a t e t y pe o f c o mmi t t e e you a r e r e po r t i ng f o r.( 1 ) St a t e wi d ef L eg i s l a t i v e f J u d ge St a nd i n g f o r Re t e n t i o n Ca nd i d a t e ( 2 ) St a t e wi d e PAC ( 3 ) S t a t e Pa r t y ( 4 ) Co un t y Ce n t r a l Commi t t e e( 5 ) Co un t y Ca nd i d a t e ( 6 ) C i t y Ca nd i d a t e ( 7 ) Sc h o o l Bo a r d o r Ou t e r P o l i t i c a l Su bd i v i s i o n Ca nd i d a t e ( 0 ) Co u nt y PAC ( 9 ) C i t y PAC( 1 0 ) Sc h o o l Bo a r d o r Ot h e r P o l i t i c a l Su bd i v i s i o n PAC ( 1 1 ) L o c a l Ba l l o t I ssu e( i n c l ud i n g c o mmi t t e e i n vo l v e d i n mu l t i p l e c i t y / c oun t y b a l l o t i s s u es )COMMI TTEE TREASURER ( ma nd a t o r y f o r a l l c o mmi t t e e s )T o d d a n d t

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