HomeMy WebLinkAbout10/2/2025 - New Era Colorado Action FundRec’d by City Clerk _10-2-2025________
COMMITTEE REGISTRATION/TERMINATION FORM
Date of Election ☐April ______☐November _____☐Other _________
Type of Committee (check only one)
☐Candidate Committee
☐Issue Committee
☐Political Committee
☐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.)
Is this an amendment to, or termination of, a previous registration?
☐No. This is a new registration.
☐Yes. Reason for amendment: __________________________________________________
☐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.
Street Address (including city/state/zip) Mailing Address (if different)
Email Address Web Site Address
Purpose or Nature of Interest of the Committee
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.
Name of Registered Agent for Committee Registered Agent’s Phone No.
Registered Agent’s Mailing Address Registered Agent’s Email Address
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 ma be punishable b law.
Signature of Candidate Date Signature of Registered Agent Date
Must be filed with City Clerk before accepting or making any contributions. (City Code §7-134)
ALL FIELDS ARE REQUIRED