Campaign Finance Report
Ethics ID Number
ρ Spring ρ Fall ρ Special Pre-Primary _____ ρ Continuing Report due Jan. 15, ______
ρ Spring ρ Fall ρ Special Pre-Election _____ ρ Continuing Report due July 15, ______
ρ Continuing Report due 4
th
Tues Sept., ______
____________________________________________________________________________
Name of Candidate or Committee (in full)
____________________________________________________________________________
Address
____________________________________________________________________________
I certify that the above named committee or candidate did not receive contributions or other income, make
disbursements, or incur obligations during the period covered by this report and that the cash balance remains
the same as previously reported. This report fulfills filing requirements under Sec. 11.0103(3)(d), Stats.
Signature of Committee Treasurer or Candidate
Date
Email Address
ETHCF-2a | Rev 01/2016 | Wisconsin Ethics Commission P.O. Box 7984, Madison, WI 53707-7984 |
Phone: (608) 266-8123 | F
ax: 608-264-9319 | Web: https://cfis.wi.gov | Email: GABCFIS@wi.gov
