HomeMy WebLinkAbout3/10/2025 - Amy for CouncilC
Rec’d by City Clerk y—io—zç en,
COMMITTEE REGISTRATION/TERMINATION FORM
Date of thlection C Apnl ______~‘November _____D Other
Type of Committee (check only one)________________________________________
El Candidate Committee C Small Scale Issue Committee
C Issue Committee (Note;if you have not received contributions or madeexpendituresinanaggregateamountexceeding
C Political Committee n~,no registration is required at this time.)
Is this an amendment to,or termination of,a previous registration?
C No.This is a new registration.
El Yes.Reason for amendment:Update Registered Agent information
C Yes.I wish to terminate the Committee and hereby state that the Committee has received no
contributions and made no expenditures since the original registration of the Committee.(Note:if the
Committee received contributions or made expenditures,you must file a final Campaign Finance Report
showing a zero balance and mark the form as a termination report.)
Full Name of Committee (spell out acronyms)Phone No.
Amy for Council 970-281-7407
Street Address (including city/state/zip)Mailing Address (if different)
2101 Stover Street 1001 A East Harmony Road #502
Fort Collins,CO 80525 Fort Collins,CO 80525
Email Address Web Site Address
amyhoevenforcouncil@gmail.com amyforcouncil.com
Purpose or Nature of Interest of the Committee
To elect Amy Hoeven to Fort Collins City Council DistrictS
Name and Address of Financial Institution in which contributions are deposited (in a separate
account bearing the name of the Committee).Must provide written documentation of such account.
First Bank 2644 South limberline Rd Fort Collins,CO 80525
Name of Registered Agent for Committee Registered Agent’s Phone No.
Tracey Johnson 303-589-4133
Registered Agent’s Mailing Address Registered Agent’s Email Address
3033 Hackney Lane tracey-johnson@comcast.net
Fort Collins,CO 80525
Acknowledgement and Certification of Candidate and Registered Agent
I hereby acknowledge the foregoing information and certify and attest that all information above is true and
complete to the best of my knowledge,after reasonably diligent inquiry.I understand that any intentional
misrepresentation of facts may result in denial of a registration and that falsification of statements on and with
this attestation may be punishable by law.
Signature of Candidate Date Signature of Registered Agent Date
Must •e filed wit City Clerk befo accepting or making any contributions.(City Code §7-134)
ALL FIELDS ARE REQUIRED