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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.

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. It is not the Commission’s intention to use any personally identifiable information from this form for any other purpose.

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