County and Metro Township Candidates & Office Holders Statement of Organization

Candidate Information

First Shireen

Middle

Last Ghorbani

Suffix

Work Phone (xxx) xxx-xxxx

Cell Phone (xxx) xxx-xxxx

Home Phone (xxx) xxx-xxxx

Office Council

District #/County At Large A

Party Democratic

Street Address XXXXXXXXXX

Suite/PO Box XXXXXXXXXX

City XXXXXXXXXX

State XX

Zip 000000

Date Created 3/4/2019

Personal Campaign Committee Secretary

Name of Secretary

First Marla

Middle

Last Kennedy

Suffix

Work Phone (xxx) xxx-xxxx

Work Phone (xxx) xxx-xxxx

Work Phone (xxx) xxx-xxxx

Street Address XXXXXXXXXX

Suite/PO Box XXXXXXXXXX

City XXXXXXXXXX

State XX

Zip 000000

Personal Campaign Committee Members

Name of Committee Member

First Stephanie

Middle

Last Dolmat

Suffix

Work Phone (xxx) xxx-xxxx

Cell Phone (801) 688-3299

Home Phone (555) 555-5555

Street Address XXXXXXXXXX

Suite/PO Box XXXXXXXXXX

City XXXXXXXXXX

State XX

Zip 000000