CONDUIT CAMPAIGN FINANCE REPORT
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CONDUIT CAMPAIGN FINANCE REPORT STATE OF WISCONSIN CONDUIT IDENTIFICATION Name of Conduit Fund GAB ID Number ______________ Street Address Is This Report An Amendment? Yes No City, State, and Zip Code Is Address Different Than Previously Reported? Yes No NAME OF REPORT January Continuing ____ Pre-Primary ____ Spring Fall Special Election Office ________ July Continuing ____ Pre-Election ____ Spring Fall Special Election Office ________ GAB ID Number of Column A Column B Complete Name and Address of Registrant Receiving Amount This Calendar Date to Whom Funds Were Transferred Committee Period Year-to-Date SUBTOTAL CONTRIBUTIONS THIS PAGE TOTAL CONTRIBUTIONS GIVEN THIS REPORT PERIOD TOTAL CONTRIBUTIONS RETURNED THIS REPORT PERIOD I, ______________________________________________, certify that the information in this report is true and complete. (Print full name) ____________________________________________ ______________________ _________________ (Signature of Administrator) (Daytime phone) (Date) The information on this form is required by ss.11.06, 11.20, Stats. Failure to provide the information may subject you to the penalties of ss.11.60, 11.61, 11.66, Stats. rd This form is prescribed by the GOVERNMENT ACCOUNTABILITY BOARD, 212 E. Washington Ave, 3 Floor, P.O. Box 7984, Madison, WI 53707-7984. (608) 266-8005 Fax: (608) Website: http://cfis.wi.gov E-mail: firstname.lastname@example.org EB-10 (Rev.4/09) Instructions for Reporting Conduit Transfers (if under $20,000 per biennium AND not filing electronically) 1. Conduits that transfer contributions to candidates, personal campaign committees, legislative campaign committees, or political party committees are subject to registration and reporting requirements. 2. Conduits are required to file campaign finance reports at the times specified in s.11.20, Stats. The Government Accountability Board has determined that these reports shall consist of: a. Two (2) copies of the dated transmittal letters (required by s.11.06(11)(a), Stats.). One copy will be placed in the file of the registrant receiving the transferred contribution. (See #3 below.) b. A summary report listing the date of the transfer, complete name and address of each recipient, total amount transferred to each recipient in this report period (Column A), and the total amount transferred during the calendar year (Column B). c. A returned contributions schedule (EB-10 Returns) when applicable. (See #4 below.) 3. All contributions transferred by a conduit must be accompanied by a dated transmittal letter. The transmittal letter shall contain: a. A statement clearly identifying that the contribution is from a conduit. b. The name and address of the recipient to whom contributions are transferred, the date the transfer was made, and the total amount transferred. c. The complete name and address of each individual contributor and the amount of his or her contribution regardless of the amount. The total of all individual contributions reported must equal the total transfer. d. The contributor’s occupation and complete name and address of the principal place of employment, when an individual’s total contributions to the same recipient exceed $100 cumulatively in the calendar year. 4. If a contribution is returned, lost, or not cashed for other reasons, report these items on the Contributions Returned From Candidates and Committees (EB-10 Returns). List the name and address of the recipient committee, date of the original contribution, the date it was returned (or you stopped payment on the check), and the amount of the transfer. 5. A conduit must file a Pre-Primary or Pre-Election Report only when a contribution is transferred to a candidate who is in the election during that report period. 6. A conduit must file a Special Report of Late Contribution for Conduits (EB-4) if it transfers $500 or more to a candidate during the 15-day period prior to the Primary or Election, either in one transaction or cumulatively over the 15-day period. 7. If no contributions are transferred in a continuing report period (January 1-June 30, July 1-December 31), the conduit may file the Postcard Report Form (EB-10a) indicating no contributions during the report period. The information on this form is required by ss.11.06, 11.20, Stats., ElBd. 1.85, Wis. Adm. Code. This form is prescribed by the GOVERNMENT ACCOUNTABILITY BOARD, 212 E. Washington Ave, 3rd Floor, P.O. Box 7984, Madison, WI 53707-7984 608-266-8005.