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2. Committee Name
4. Purpose
6. Web Address
8. Committee Type (check only one)

   1. Candidate Committee

   1. Political Committee

   1. Issue Committee

   1. Small Donor Committee
10. Name of Person Acting as Registered Agent (Treasurer)
12. Physical Address
14. City
15. State
16. Zip
18. Mailing Address
20. City
21. State
22. Zip
24. Phone Number
25. Email
27. Financial Institution Name
29. Financial Institution Physical Address
31. Registered Agent's Signature*
32. Date
    Date
34. Candidate's Name
36. Candidate's Signature*
37. Date
    Date
39. Note: Submission of false, erroneous, or incomplete information may be subject to sanctions in accord with the Greenwood Village Municipal Code.
41. 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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43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit Submit and Print

* indicates a required field