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<br /> <br />Campaign Account Information <br /> <br />SEL 223 <br /> <br />rev 12107: ORs 260,039, <br /> <br />Filing a New Committee: This form, along with the appropriate Statement of Organization form (SEL 220 or 221), must <br />be completed and filed within 3 business days of first receiving a contribution or making an expenditure. The 1I0riginal" <br />box should be marked on both forms. <br /> <br />Amending Information on this Form: Any change in the information on this form must be filed within 10 days <br />of the change. To notify the Elections Division of a change in information, submit this form, completed in its entirety, and <br />mark the IIAmendment" box. An amended SEL 220 or 221 should not be filed unless the information on that <br />form also changes. <br /> <br />Discontinuing: A final contribution and expenditure report that shows a zero balance must be filedl along with <br />the appropriate completed Statement of Organization (SEL 220 or 221) with the "Discontinuation" box marked. The final <br />report may be filed at any time. It is not necessary to submit this form when discontinuing a committee. <br /> <br />Confidentiality: A completed SEL 223 and any information it contains is exempt from public records disclosure <br />and shall be kept confidential by the Elections Division. <br /> <br />please type or print legibly in black ink <br /> <br />This filing is an: <br /> <br />o Original <br /> <br />OAmendment <br /> <br />J.. name of com mittee If changing committee name, please include former name, <br /> <br />name of Oregon financial institution <br /> <br />account number <br /> <br />name of account <br /> <br />name of account holder <br /> <br />names of persons who have signature authority <br /> <br />J, signature <br />By signing this document I attest that the above information is true and correct. <br /> <br />candidate's signature for candidate committee only <br /> <br />date signed <br /> <br />treasurer's signature <br /> <br />date slgneo <br /> <br />-rtant _ <br /> <br />_formation on this form is exempt from rds disclosure and shaff be kept confid <br /> <br />Elections Divisio <br /> <br /> <br />for office use on Iy <br /> <br />initials <br /> <br />committee ID number <br /> <br />office number <br /> <br />candidate <br />