Declaration of Intent - Home - Houston County
CFC Form DOI Rev 02/2020 STATE
Filer ID: _____________________________
Georgia Government Transparency & Campaign Finance Commission
200 Piedmont Avenue S.E. | Suite 1416 - West Tower | Atlanta Georgia, 30334
DECLARATION OF INTENTION TO ACCEPT CAMPAIGN CONTRIBUTIONS (FORM DOI) - STATE/STATEWIDE FILERS
INCOMPLETE FORMS WILL NOT BE PROCESSED ? If form is handwritten, it must be legible.
STATEWIDE/STATE LEVEL FILERS: File this form directly with the Campaign Finance Commission via mail or hand-delivery
1 Today's Date:
2 Candidate (full name):
___________________________________________________________________
Address:
___________________________________________________________________
City, State, Zip:
___________________________________________________________________
Telephone (optional):
_________________________________ Email: ____________________________
3 Select Office Type:
Statewide
State
Party Affiliation (optional):
Name of Office Sought or Held: __________________________________________ (include office, district, post, or judicial seat)
Democrat
Non-Partisan
Republican Other
4 Next Election Year:
I CERTIFY THAT THIS STATEMENT IS COMPLETE, TRUE AND ACCURATE.
___________________________________________________ Signature of Candidate
_________________________________ Date
STATEWIDE/STATE LEVEL FILERS: File this form directly with the Campaign Finance Commission via mail or hand-delivery
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