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2. For use by a candidate or committee who have not received any contributions nor made any expenditures.
4. Candidate Name
   as shown on registration
6. Address
8. City
9. State
10. Zip
12. Reporting Time Covered
    Reporting Time Covered Start Date

    —

    Reporting Time Covered End Date
16. CONTRIBUTIONS RECEIVED OR RECEIVABLE DURING THIS REPORTING PERIOD: $0.00
18. EXPENDITURES MADE OR INCURRED DURING THIS REPORTING PERIOD $0.00
22. I,
    Candidate's Name
24. affirm pursuant to Section 2-1-170 of the Greenwood Village Municipal Code; that no person received contributions or made any expenditures on my behalf. No contributions have been pledged to me nor on my behalf. I have not received any contributions nor have I made or incurred any expenditures on my own behalf during this election reporting period.
26. Candidate's Signature
27. Date
    Date
29. Note: Submission of false, erroneous, or incomplete information may be subject to sanctions in accord with the Greenwood Village Municipal Code.
31. Filing Requirements
    Chapter 2, Article 1, Section 130

    For the purpose of meeting the filing requirements for candidates or committees under the Village’s Fair Campaign Reporting, electronic copies shall be accepted; provided that original documents are received by the City Clerk within five (5) days from the date of the electronic filing pursuant to Chapter 2, Article 1, section 130 of the Village’s Municipal Code. Reports/ Forms required are deemed timely if received by the City Clerk no later than 5:00 p.m., local time, on the designated day for filing.
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33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit Submit and Print

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