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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. Title A27. Email A28. Phone Treasurer/Administrator INFORMATION A14. Name A15. Email A16. Phone A17. Mailing Address A18. City A19. State A20. Zip Depository Institution INFORMATION A9. Institution Name A10. Street Address A11.

Note: Use of this form is required by the Ethics Commission for registration of a political committee or conduit under Chapter 11 of Wisconsin Statute. Completion of this form is mandatory for committees that file on paper.

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Transcription of SECTION A: GENERAL INFORMATION - Ethics Home

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