Committee Registrationvon
C O L O R A D O
Committee Registration Form
Committee Name: `d T ,3.R .
Purpose/Office Supported: i'Z e f i V a/vv(Aallgcti v'0.w. 1,y Jt. 'vc,'
Committee Type (circle one): Candidate Committee -)Political Committee Issue Committee
Registered Agent:
Contact Phone Number: _)G\
Physical Address: q,510 V ck &,
Mailing Address: 7o T o G C k %j'Dy,_ co
Affiliated Candidate or Committee (if applicable): CA -WA loci i c V , ct. i + 1 3_c c t
Authorization:
Registered Agent's Name: j
Registered Agent's Signature ": `_) Z -' Date: 2-3 2Z
Candidate's Name (if applicable): mow. r. r+ 4ew l l
Candidate's Mailing Address (if applicable): oK 1,66 A Go e (62
Candidate's Signature (if applicable): v ' Date: 2- 2 2—
Page 1 0 f 1
Revised July 2022
Item 5.2—Committee Registration Form