Information on Submitting Arguments

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Statement of Organization for Political Action Committee SEL 221 rev 11/05: ORS 280.042 Filing a New Committee: This form, along with the Campaign Account Information form (SEL 223), must be completed and filed within 3 business days offirst receiving a contribution or making an expenditure. The "Original" box should be marked on both forms. A date stamped copy of this form, which includes the committee's identification number, will be returned to the treasurer as an acknowledgment of the filing. Committee Directors: All political action committees must designate at least one committee director who is not the treasurer. The treasurer may be a committee director if the treasurer meets the definition of "committee director" in ORS 260.005(2), but the treasurer may not be the only committee director. If a committee has more than five directors, attach a list of additional directors and include all the information required on the form for each director. Amending Information on this Form: Any change in the information on this form must be filed within 10 days of the change. To notify the filing officer of a change in information, submit this form, completed in its entirety, and mark the "Amendment" box. An amended SEL 223 should not be filed unless the information on that form also changes. Discontinuing: A final contribution and expenditure report that shows a zero balance must be filed, along with a completed SEL 221 with the "Discontinuation" box marked. The final report may be filed at any time. please type or print legibly in black ink o Primary 20_ o General 20_ o Other election date: This filing is an: o Original o Principal Filing Officer OAmendment o Discontinuation This filing is with: o Secondary Filing Officer name of Principal Filing Officer ,j, name of committee If changing committee name, please include former name. abbreviation or acronym committee address street/route, city, state, zip code; no post office box numbers campaign phone name of treasurer OMr OMs mailing address for committee correspondence work phone home phone fax email address type of political action committee select only one o Miscellaneous 0 Measure 0 Political Party Support or oppose one or more of the following: -+ Specific candidates -+ Entire ticket of a political party -+ Candidate in a recall election -+ Multiple candidates and measures J. political party name/title or number of measure/recall candidate's name Exclusively support or oppose one or more measures on a ballot -+ A major or minor party defined in ORS chapter 248 -+ A committee established by a major or minor party under party bylaws o support 0 oppose o support 0 oppose o support 0 oppose continued on the reverse side of this form SEL 221