922                              LAWS OF MARYLAND                       [CH. 392

REPORT OR STATEMENT OF

CAMPAIGN AND ELECTION CONTRIBUTIONS

AND EXPENDITURES

Registration No.

to be completed by
                                                                      Secretary of State

or
Clerk of Court

A. Report:                  B. Report period:

1.—Candidate                      4.—7 days prior to election

day                                (_P._G.)

2.—Organization                 5.—30 days post election

day                                (_P._G.)

3.—Individual                     6.—60 days post election

(mark one only)                   (if necessary)                 (—P.—G.)

7.—6 month post election

(if necessary)                (—P.—G.)

8.—1 year post election

(if necessary)                 (—P.—G.)

C.    Date of this report:..............................................................................

day             month              year

D.    Candidate, organization, group, individual, or for whom this
report is filed:

Name: ..................................................................................................

Address:..............................................................................................

No., Street, City or Post Office, State, Zip Code.

Phone No.: ................................................

Area Code           Number

E.    Party Affiliation:

9.—Name of Party:..........................................................................

(e.g., Democrat, Republican)

10.—If nonparty, specify:..................................................................

(e.g., Independent, COPE, Bar Assn., LWV, PTA)

F.    If organization or group, activities of organization filing report
are:

11.—National

12.—State-wide

13.—Congressional District

14.—City (specify) ............................................................................

15.—County (specify) ........................................................................

16.—Other (specify) ..........................................................................