Get D1 Form Example 2022-2025

NAME AND ADDRESS OF EACH SPONSORING ENTITY PURPOSE OF THE POLITICAL COMMITTEE. CANDIDATE S THE COMMITTEE IS SUPPORTING OR OPPOSING. IF AMENDING LIST ALL AS OF TODAY S DATE. SUPPORT OPPOSE OFFICE PARTY AFFILIATION IF MORE SPACE FOR INFORMATION IS REQUIRED PLEASE ATTACH ADDITIONAL SHEETS. PAGE 1 OF 2 THIS FORM MAY BE REPRODUCED Revised 7/9/12 COMMITTEE NAME REQUIRED COMMITTEE OFFICERS. POSITION MAILING ADDRESS DAYTIME PHONE NUMBER AND E-MAIL ADDRESS NAME CHAIRMAN TREASURER POSITION NAME MAILING ADDRESS OF EACH CUSTODIAN OF THE COMMITTEE S BOOKS AND ACCOUNTS. LIST OF ALL FINANCIAL INSTITUTIONS AND OTHER REPOSITORIES OF THE COMMITTEE FUNDS. IF AMENDING LIST ALL AS OF TODAY S DATE. DISPOSITION OF RESIDUAL FUNDS IN THE EVENT OF DISSOLUTION OR TERMINATION OF THE COMMITTEE RETURN TO CONTRIBUTORS IN AMOUNTS NOT TO EXCEED THEIR INDIVIDUAL CONTRIBUTIONS. TRANSFER TO ANOTHER POLITICAL COMMITTEE TRANSFER TO A CHARITABLE ORGANIZATION VERIFICATION- BALLOT INITIATIVE COMMITTEES ONLY I DECLARE THAT THIS BALLOT INITIATIVE COMMITTEE IS FORMED FOR THE PURPOSE OF SUPPORTING OR OPPOSING A QUESTION OF PUBLIC POLICY ALL CONTRIBUTIONS AND EXPENDITURES OF THE COMMITTEE WILL BE USED FOR THE PURPOSE DESCRIBED IN THIS STATEMENT OF ORGANIZATION THE COMMITTEE MAY ACCEPT UNLIMITED CONTRIBUTIONS FROM ANY SOURCE PROVIDED THAT THIS BALLOT INITIATIVE COMMITTEE DOES NOT MAKE CONTRIBUTIONS OR EXPENDITURES IN SUPPORT OF OR OPPOSITION TO A CANDIDATE OR CANDIDATES FOR NOMINATION FOR ELECTION ELECTION OR RETENTION AND FAILURE TO ABIDE BY THESE REQUIREMENTS SHALL DEEM THIS COMMITTEE IN VIOLATION OF THIS ARTICLE. 10 ILCS 5/9 PRINTED AND WRITTEN SIGNATURE OF COMMITTEE CHAIRPERSON DATE VERIFICATION INDEPENDENT EXPENDITURE COMMITTEES ONLY FROM ANY SOURCE PROVIDED THAT THE INDEPENDENT EXPENDITURE COMMITTEE DOES NOT MAKE CONTRIBUTIONS TO ANY CANDIDATE POLITICAL COMMITTEE POLITICAL PARTY COMMITTEE AND BELIEF IS A TRUE CORRECT AND COMPLETE STATEMENT OF ORGANIZATION AS REQUIRED BY ARTICLE 9 OF THE ELECTION CODE. I UNDERSTAND THAT WILLFULLY FILING A FALSE OR INCOMPLETE STATEMENT IS SUBJECT TO A CIVIL PENALTY OF AT LEAST 1001 AND UP TO 5000. THE ILLINOIS STATE BOARD OF ELECTIONS REQUIRES THE DISCLOSURE OF INFORMATION THAT IS NECESSARY IF YOU QUALIFY AS A POLITICAL COMMITTEE AS OUTLINED UNDER PUBLIC ACT 78-1183. WILLFUL FAILURE TO FILE OR WILLFUL FILING OF FALSE OR INCOMPLETE INFORMATION REQUIRED BY THIS ARTICLE SHALL CONSTITUTE A BUSINESS OFFENSE SUBJECT TO A FINE OF UP TO 5000. A. THIS COMMITTEE WILL PRIMARILY OPERATE IN THE FOLLOWING COUNTY IES OR DISTRICT S not applicable if operating statewide or supporting/opposing statewide candidates or ballot initiatives C. NAME AND ADDRESS OF EACH SPONSORING ENTITY PURPOSE OF THE POLITICAL COMMITTEE. CANDIDATE S THE COMMITTEE IS SUPPORTING OR OPPOSING. IF AMENDING LIST ALL AS OF TODAY S DATE. SUPPORT OPPOSE OFFICE PARTY AFFILIATION IF MORE SPACE FOR INFORMATION IS REQUIRED PLEASE ATTACH ADDITIONAL SHEETS. PAGE 1 OF 2 THIS FORM MAY BE REPRODUCED Revised 7/9/12 COMMITTEE NAME REQUIRED COMMITTEE OFFICERS. POSITION MAILING ADDRESS DAYTIME PHONE NUMBER AND E-MAIL ADDRESS NAME CHAIRMAN TREASURER POSITION NAME MAILING ADDRESS OF EACH CUSTODIAN OF THE COMMITTEE S BOOKS AND ACCOUNTS. LIST OF ALL FINANCIAL INSTITUTIONS AND OTHER REPOSITORIES OF THE COMMITTEE FUNDS. IF AMENDING LIST ALL AS OF TODAY S DATE. DISPOSITION OF RESIDUAL FUNDS IN THE EVENT OF DISSOLUTION OR TERMINATION OF THE COMMITTEE RETURN TO CONTRIBUTORS IN AMOUNTS NOT TO EXCEED THEIR INDIVIDUAL CONTRIBUTIONS. TRANSFER TO ANOTHER POLITICAL COMMITTEE TRANSFER TO A CHARITABLE ORGANIZATION VERIFICATION- BALLOT INITIATIVE COMMITTEES ONLY I DECLARE THAT THIS BALLOT INITIATIVE COMMITTEE IS FORMED FOR THE PURPOSE OF SUPPORTING OR OPPOSING A QUESTION OF PUBLIC POLICY ALL CONTRIBUTIONS AND EXPENDITURES OF THE COMMITTEE WILL BE USED FOR THE PURPOSE DESCRIBED IN THIS STATEMENT OF ORGANIZATION THE COMMITTEE MAY ACCEPT UNLIMITED CONTRIBUTIONS FROM ANY SOURCE PROVIDED THAT THIS BALLOT INITIATIVE COMMITTEE DOES NOT MAKE CONTRIBUTIONS OR EXPENDITURES IN SUPPORT OF OR OPPOSITION TO A CANDIDATE OR CANDIDATES FOR NOMINATION FOR ELECTION ELECTION OR RETENTION AND FAILURE TO ABIDE BY THESE REQUIREMENTS SHALL DEEM THIS COMMITTEE IN VIOLATION OF THIS ARTICLE. 10 ILCS 5/9 PRINTED AND WRITTEN SIGNATURE OF COMMITTEE CHAIRPERSON DATE VERIFICATION INDEPENDENT EXPENDITURE COMMITTEES ONLY FROM ANY SOURCE PROVIDED THAT THE INDEPENDENT EXPENDITURE COMMITTEE DOES NOT MAKE CONTRIBUTIONS TO ANY CANDIDATE POLITICAL COMMITTEE POLITICAL PARTY COMMITTEE AND BELIEF IS A TRUE CORRECT AND COMPLETE STATEMENT OF ORGANIZATION AS REQUIRED BY ARTICLE 9 OF THE ELECTION CODE. I UNDERSTAND THAT WILLFULLY FILING A FALSE OR INCOMPLETE STATEMENT IS SUBJECT TO A CIVIL PENALTY OF AT LEAST 1001 AND UP TO 5000. THE ILLINOIS STATE BOARD OF ELECTIONS REQUIRES THE DISCLOSURE OF INFORMATION THAT IS NECESSARY IF YOU QUALIFY AS A POLITICAL COMMITTEE AS OUTLINED UNDER PUBLIC ACT 78-1183.