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�nser Cau�rr <br />This report is a(n) (check one): <br />REGISTRATION AND STATEMENT OF ORGANIZATION <br />(All data on this form is public information) <br />� <br />The organization is for a(check one): <br />(Please Print or Type) <br />New Registration _ Amendment <br />� Candidate Political Committee Office Holder <br />Name of Committee: <br />D <br />�� � I ►�. n -'�� �._�� � �- .��� � �� ���r1 <br />Mailing Address of Committee (include city state & zip code) Phone Num er: <br />���J� ��`l�� 1�� )v� l"�% - �7��- <br />�. 4 ' �� � �� �� <br />� �? � � �'l � j � � <br />Purpose or Office <br />�c�5� �a � l� C-y`'�- �� �c� �. � � `; ( <br />Geographic Area � � <br />�;�t,� � ��_t����+ I�� � - - <br />-� <br />Officers of Committee <br />Officer Name Address Phone Number <br />— --- — 1 l `�� /�.� � r��' i�-�. �5 %-- <br />Chair: � �� � � � � ��1'1 �(�.��..1� i � �� .� ����� —i��' � C7� <br />Co-Chair (If any) <br />Treasurer — -- -- r -- � -- � � � �'t_'� �t �r\S� c� ,C j `� � S/__ <br />� t� � C` � � r° � � � �S� ,� ; �l� ,� �Sri� ��� !�?� <br />-- - ---- --f <br />Deputy Treasurer <br />If an _ _ _ _ <br />Other Principal <br />Officers If an <br />Other Principal <br />Officers If an <br />Custodian of Name: Address: Phone Number: <br />Books <br />Depository(ies)/Bank Name: �,� i-..� � ��� Address: � � � , �,�,� �� � Phone Number: <br />Location of Committee / ��� ° ��� <br />Funds �' � t..- 1`� (1 C% �' i.% i l c' �/� ��� �.� <br />Depository(ies)/Bank Name: Address: Phone Number: <br />Location of Committee <br />Funds <br />