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Committee Registration
Avon COLORADO qq,mmittee.Registration Form _TA Committee Name: Purpose/Office Supported:-ryvv/y c:,CJy/yc-/ L Committee Type (circle one): andidate Committee olitical Committee Issue Committee Registered Agent: C 141 L;u i H Ve, - Contact Phone Number: '3''70 3 L4 eo-7 Physical Address: }- t i Cry CD 1 1, z Mailing Address: 7• 0 - _F;bX 3 773 Ayt>7\J 9'1 (u -2_0 Affiliated Candidate or Committee (if applicable): C i4i Cc, i Hvo Authorization: Registered Agent's Name: cl- mii-t00-eli Registered Agent's Signature A_1 1 Date: 9-2_ 2- Candidate's Name (if applicable): C i4 i c _i -F N Job Candidate's Mailing Address (if applicable): 'tom. Q 73-57< T" 7_ A-vZr 1, C U a(6ZL7 Candidate's Signature (if applicable): Date: "92-2- o-r\-j Page 1 0f 1 Revised July 2022 Item 5.2—Committee Registration Form