Fillable CFC Form DOI Rev 1/14 (Columbus Consolidated Government)

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CFC Form DOI Rev 1/14 (Columbus Consolidated Government)

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File type: PDF

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CFC Form DOI Rev 1/14
MAIL TO: Georgia Government Transparency and Campaign Finance Commission | 200 Piedmont Avenue S.E. | Suite 1402 - West Tower | Atlanta Georgia, 30334!
Georgia Government Transparency & Campaign Finance Commission
DECLARATION OF INTENTION TO ACCEPT CAMPAIGN CONTRIBUTIONS
FORM DOI
INCOMPLETE FORMS WILL NOT BE PROCESSED • If form is handwritten, it must be legible.
1
Today’s Date:
2
Candidate
(full name): ___________________________________________________________________
Address: ___________________________________________________________________
City, State, Zip: ___________________________________________________________________
Telephone (optional): _________________________________ Email : ____________________________
3
Select Office Type:
!
State
!
County
!
Municipal
Name of Office Sought or Held: __________________________________________
(include district, post, or judicial circuit if applicable)
4
Incumbent: Next Election Year:
Complete sections 5 and 6 ONLY if you have a campaign committee.
This information does not register a campaign committee. (Please use Form RC to register.)
5
Campaign Committee
Chairperson (full name): ___________________________________________________________________
Address: ___________________________________________________________________
City, State, Zip ___________________________________________________________________
Email : ___________________________________________________________________
6
Treasurer
(full name): ___________________________________________________________________
Address: ___________________________________________________________________
City, State, Zip ___________________________________________________________________
Email : ___________________________________________________________________
I CERTIFY THAT THIS STATEMENT IS COMPLETE, TRUE AND ACCURATE.
___________________________________________________ _________________________________
Signature of Candidate Date
Party!Affiliation!(optional):!
!
Democrat
!
Non Partisan
!
Republican
!
Other
!
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CFC Form DOI Rev 114 (Columbus Consolidated Government)

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Completed 2 August 2020

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