Fec Form 6 - 48-Hour Notice Of Contributions/loans Received
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248-HOUR NOTICE OF
CONTRIBUTIONS/LOANS RECEIVED
(See Reverse Side for Instructions)
To be used to report all contributions (including loans) of $1000 or more, received within 20 days of the election.
1.
NAME OF COMMITTEE IN FULL
ADDRESS (number and street)
CITY
STATE
ZIP CODE
2.
NAME OF CANDIDATE
3. OFFICE SOUGHT (State and District)
4. FEC IDENTIFICATION NUMBER
5.
IS THIS AN AMENDMENT?
NO, THIS IS A NEW FILING
YES, IT AMENDS THE NOTICE FILED ON
/
/
A. FULL NAME
Name of Employer
Date (month,
Amount
day, year)
MAILING ADDRESS
CITY
STATE
ZIP CODE
Occupation
Date (month,
Amount
Name of Employer
B. FULL NAME
day, year)
MAILING ADDRESS
Occupation
CITY
STATE
ZIP CODE
C. FULL NAME
Date (month,
Amount
Name of Employer
day, year)
MAILING ADDRESS
Occupation
CITY
STATE
ZIP CODE
Date (month,
Amount
D. FULL NAME
Name of Employer
day, year)
MAILING ADDRESS
Occupation
CITY
STATE
ZIP CODE
Date (month,
Amount
E. FULL NAME
Name of Employer
day, year)
MAILING ADDRESS
Occupation
CITY
STATE
ZIP CODE
SIGNATURE (optional)
DATE
For further information contact:
Federal Election Commission
999 E Street, NW, Washington, DC 20463
Toll Free 800-424-9530, Local 202-694-1100
FEC FORM 6
Any information copied from reports and statements filed under the Federal Election Campaign Act may not
be sold or used by any person for the purpose of soliciting contributions or for commercial purposes other
than using the name and address of any political committee to solicit contributions from such committee.
(Revised 03/2016)
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