CFC Form RC Rev 1/14 Filer ID: _____________________________
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
REGISTRATION FORM FOR A CANDIDATES CAMPAIGN COMMITTEE
Any substantive changes to the registration information of a committee must be updated within 7 business days
FORM RC
INCOMPLETE FORMS WILL NOT BE PROCESSED If form is handwritten, it must be legible.
1
Today’s Date:
Select Form Type: Original Amended
2
Committee
(Full Name): ___________________________________________________________________
Address: ___________________________________________________________________
___________________________________________________________________
City, State, Zip: ___________________________________________________________________
Telephone Number (optional): ________________________________ Email: _____________________________
3
Campaign Committee
Chairperson (full name): ___________________________________________________________________
Address: ___________________________________________________________________
___________________________________________________________________
City, State, Zip: _________________________________ Email : ___________________________
4
Treasurer
(full name): ___________________________________________________________________
Address: ___________________________________________________________________
___________________________________________________________________
City, State, Zip: _________________________________ Email : ___________________________
5
Candidate
(full name): ___________________________________________________________________
Address: ___________________________________________________________________
___________________________________________________________________
City, State, Zip: _________________________________ Email : ___________________________
6
Select Office Type:
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State
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County
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Municipal
Name of Office Sought or Held: __________________________________________
(include district, post, or judicial circuit if applicable)
7
Incumbent: Next Election Year:
I CERTIFY THAT THIS STATEMENT IS COMPLETE, TRUE AND ACCURATE.
___________________________________________________ _________________________________
Signature of Person Registering Committee Date
Party!Affiliation!(optional):!
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Democrat
Non Partisan
Republican
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Other
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signature
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