Committee RegistrationAvon
C O O R A D O
Committee Registration Form \
Committee Name: 6cAA .Q- --\C F—_eCA
Purpose/Office Supported: \n t-%Z> C\ co I nC ,
Committee Type (circle on
Registered Agent:
Contact Phone Number:
Candidate Committek Political Committee Issue Committee
Physical Address: E3V-o 2S0
Mailing Address: qc)a G 2-c)
Affiliated Candidate or Committee (if applicable):
Authorization:
Registered Agent's Name:
Registered Agent's Signatu
Candidate's Name (if applicable):
Candidate's Mailing Address (if applicable):
Candidate's Signature (if applicable):
Date: Z2—
Date:
Page 1 of 1
Revised July 2022
Item 5.2 —Committee Registration Form