HomeMy WebLinkAbout5/3/2021 - Melanie for Fort Collinsr
Reed by City Clerk 05/03/2021
‘p
C Small Scale Issue Committee
(Note:if you have not received contributions or made
expenditures in an aggregate amount exceeding
$200!no registration is required at this time.)
Iethi&aK%iWéiidthWiittd?ffr~l~àtióèftk’flf~I~tràtIóh?4
No.This is a new registration.
Yes.Reason for amendment:New election cycle;updated contact information
Yes.I wish to terminate the Committee and hereby state that the Committee has received no
contributions and made no expenditures since the original registration of the Committee.(Note:if the
Committee received contributions or made expenditures,you must file a final Campaign Finance Report
showing a zero balance and mark the form as a termination report.)
i__._ii i~PW&ñWNo~
2813 Mlchener Dr
Fort Collins,CO 80526
kErrài[AddrëSàL .liLLJ*VVéfrSit&Mdrd~I
Elevations Credit Union,2025 South College Avenue,Fort Collins CO 80525
kNam~bf Re titdWA~éhtfo(tdthñjjtte~f ]~RegistèrédAg’Wñt’éip1~öjiè’Nol
Ben Fields Johnson
~Acknowledgement and Cerhficatian of Candidateand RegIstered Agentf
I hereby acknowledge the foregoing information and certify and attest that all information above is true and
complete to the best of my knowledge,after reasonably diligent inquiry,I understand that any intentional
misrepresentation of facts may result in denial of a registration and that falsification of statements on and with
this attestation may be punishable by law.
Date of Election ~~l 2023 t’Jov
C
C
Candidate Committee
Issue Committee
Political Committee
C November _____I C Other
C
~1
C
Melanie for Fort Collins
SfréetAdd?E~(Tno)i1dibj(c,Istètéfj~S)W *MáiIiñ~MdiE(ifdiff&ebt)I
97o.2fl~Gj
melanieforfoco@gmail.com www.melanieforfoco.com
PUrpos&’bt Nátài-WoT(fltéj~èftftlWCthiiEiiittéél
Support (e.g.,fundraising,volunteer coordination)of Melanie Potyonclys campaign for Fort Collins City Council in District
4.
(970)430-6595
Registered Agents MauIing’~Addres~$Registered Agents’EmaII Addresfl
2955 Headwater Drive ebenjohnsonphd@gmail.com
Fort Collins,CO 80521
accepting or making any ~ntributions.(City Code §7-1 34)
ALL FIELDS ARE REQUIRED