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SECTION A: GENERAL INFORMATION - Ethics Home

Form: CF-1 (Rev. 11/2018) Prescribed by: STATE OF WISCONSIN, Ethics Commission Note: An amended registration statement must b e filed within 10 days of any changes in INFORMATION . 1. Is this an Amendment? No Yes If yes, please enter your committee number: Committee Number Other Officers (Optional) Independent and local non-partisan candidates: Indicate by an asterisk (*) which officers are authorized to fill a vacancy in nomination due to death of candidate. A21. Name A22. Title A23. Email A24. Phone A25. Name A26.

I am aware of the requirement to amend this registration statement within 10 days of any change of information contained within, as well as the requirement to register within 10 days of meeting the requirements to register under Chapter 11 of Wisconsin Statutes. Records Retention.

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Transcription of SECTION A: GENERAL INFORMATION - Ethics Home

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