[City of Sacramento] Large Political Committee - Statement of Organization Form

Statement of Organization Form

Large Political Committee

Date Submitted

Large Political Committee Name

Secretary of State Issued Committee Number

Large Political Committee Date of Formation

Large Political Committee Contact Phone

Large Political Committee Contact Email

Date of Contribution

Receiving Candidate Name

Receiving Candidate Committee Name

Receiving Candidate Email

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Submitter Email

Signature of the submitter

First Name

Last Name

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I certify that pursuant to Section 2.13.040 and 2.13.055 of the Sacramento City Code and under penalty of perjury under the laws of the State of California, the committee identified above has: been in existence for more than six months, and receives contributions from 100 or more persons, and acting in concert makes contributions to one or more candidates for city elective office.