Amended Statement of Organization
Amended Statement of Organization
Amended Statement of Organization
Statement of Organization
CANDIDATE COMMITTEE
*Please read instructions before completing this form.
Type of Statement
NEW
X AMENDED
This committee is registering with the This committee is filing an amended Statement of Organization.
Virginia State Board of Elections for the first
time. Date Changes Took Effect SBE-issued Committee ID
03/29/2022 CC-22-00162
Committee Information
Campaign Website
Candidate Information
X By checking this box, I certify that I am currently registered to vote at the address above.
Election Information
Republican 2023
X November May Special
Political Party Year of Election Type of Election
Statement of Organization
CANDIDATE COMMITTEE
Treasurer Information
McGuire Madelyn E.
Salutation Last Name First Name Middle Name Suffix
579 Reedy Creek Road
Residence Address Apt #
X By checking this box, I certify that I am currently registered to vote at the address above.
Campaign Depository
Please provide the following dates. (If an action has not yet occurred for this committee, write “N/A”)
03/01/2022
Date first contribution accepted: ______________________
03/01/2022
Date first expenditure made: ______________________
Dates of Activity 03/01/2022
Date campaign depository designated: ______________________
Statement of Organization
CANDIDATE COMMITTEE
Filing Method
Please indicate the method by which this committee will submit all required campaign finance reports:
________________________________ __________________________
Signature Date
Signatures
I affirm that, to the best of my knowledge, all of the information on this form is complete and truthful. I
understand that I am required to comply with the provisions of the Campaign Finance Disclosure Act (Title 24.2,
Chapter 9.3 of the Code of Virginia). I also understand that my Treasurer and I must truthfully report, in a timely
manner, all monies and things of value which this campaign committee receives or expends. Civil penalties shall
be assessed for late or un-filed reports in the manner required by the Code of Virginia. I further understand that if
Candidate’s I do not appoint a treasurer, or if at any time the treasurer’s position is vacant, that I, as the candidate, will assume
Signature and accept all of the Treasurer’s duties until the position is filled. I also understand that if I provide false
information on this or any document submitted to the State Board of Elections or local electoral boards that I may
be subject to the provisions of § 24.2-1016 which is punishable by a Class 5 felony.
____________________________________ ________________________
Candidate’s Signature Date
I accept the appointment of Treasurer of this campaign committee. I understand that I am required to comply
with the provisions of the Campaign Finance Disclosure Act (Title 24.2, Chapter 9.3 of the Code of Virginia). I
understand that I must truthfully report all monies and things of value which this campaign committee receives or
Treasurer’s expends in a timely manner. Civil penalties will be assessed in the manner required by the Code of Virginia for
Signature late or non-filed reports. I also understand that if I provide false information on this or any document submitted to
the State Board of Elections or local electoral boards that I may be subject to the provisions of § 24.2-1016 which
is punishable by a Class 5 felony.
____________________________________ ________________________
Treasurer’s Signature Date
Candidates for local office who indicate that they will be submitting their reports on paper must submit the original copy
of this form to the General Registrar or local electoral board’s office.
Candidates for local office who indicate that they will be submitting their reports electronically must submit the original
copy of this form to the General Registrar or local electoral board’s office and a copy to the State Board of Elections at
1100 Bank Street, Richmond, VA, 23219.
For General Assembly Candidates, an original of this form must be submitted to the State Board of Elections at 1100
Bank Street, Richmond, VA 23219 and a copy must be submitted with the local electoral board of the county or city in
which the candidate is a resident.
All requested information on the form is required unless otherwise noted below.
An amended Statement is required to be filed within 10 days of the change if any of the information reported on this
form changes. Failure to amend this form in a timely fashion may result in civil penalties of up to $500 to be assessed
according to the procedure described in §24.2-929 of the Code of Virginia.
Type of Statement
Check the box that best fits the type of Statement your committee is submitting.
Enter the name of the Campaign Committee (e.g. Friends of Candidate Smith).
Enter the home mailing address for the candidate (this should be the same as where you are registered to vote).
Enter the Campaign Committee’s primary mailing address (PO Boxes are acceptable.)
Enter the Campaign Committee’s email address
Enter the campaign’s primary daytime phone number.
Enter the Campaign Website (if none, enter N/A)
Candidate Information
Election Information
Enter the office sought by the candidate and the district (if one).
Enter the political party of the candidate (for candidates for statewide or General Assembly office, in the absence of a
political party please enter “Independent”).
Enter the year of the office’s General Election.
o If seeking election to a Special Election, check the next box. Please note that you should not check this box
prior to the official calling of the Special Election.
Treasurer Information
*The Treasurer must be a registered voter in Virginia.
Campaign Depository
Filing Method
Enter whether the candidate campaign committee intends to file all of their campaign finance disclosure reports
electronically.
Signatures
The candidate must read the agreement and sign the form accepting the conditions of the agreement.
The treasurer must read the agreement and sign the form accepting the conditions of the agreement.