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    S:tea1a11't11at A - ,: Committee Registration Form

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    Picon Press Media LLC
    1) The document is a committee registration form submitted to the Nevada Secretary of State's office. It provides information about registering or updating a Committee for Political Action (PAC). 2) The form is for the 1864 PAC committee based in Reno, NV. It lists the committee's purpose as political action and education. 3) It provides contact information for the registered agent, Cory Henderson, and lists him as the committee's president and contact.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    S:tea1a11't11at A - ,: Committee Registration Form

    Uploaded by

    Picon Press Media LLC
    330 views2 pages
    1) The document is a committee registration form submitted to the Nevada Secretary of State's office. It provides information about registering or updating a Committee for Political Action (PAC). 2) The form is for the 1864 PAC committee based in Reno, NV. It lists the committee's purpose as political action and education. 3) It provides contact information for the registered agent, Cory Henderson, and lists him as the committee's president and contact.

    Original Description:

    1864 PAC Original

    Original Title

    1864 PAC Original

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    1) The document is a committee registration form submitted to the Nevada Secretary of State's office. It provides information about registering or updating a Committee for Political Action (PAC). 2) The form is for the 1864 PAC committee based in Reno, NV. It lists the committee's purpose as political action and education. 3) It provides contact information for the registered agent, Cory Henderson, and lists him as the committee's president and contact.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    330 views2 pages

    S:tea1a11't11at A - ,: Committee Registration Form

    Uploaded by

    Picon Press Media LLC
    1) The document is a committee registration form submitted to the Nevada Secretary of State's office. It provides information about registering or updating a Committee for Political Action (PAC). 2) The form is for the 1864 PAC committee based in Reno, NV. It lists the committee's purpose as political action and education. 3) It provides contact information for the registered agent, Cory Henderson, and lists him as the committee's president and contact.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    BARBARA K.

    CEGAVSKE State of Nevada


    Secretary of State
    Committee Registration Form
    101 North Carson Street, Suite 3
    Use this form to register or make changes to a:
    Carson City, Nevada 89701
    • Committee for Political Action (PAC)
    (775) 684-5705
    • Committee for Political Action (PAC) Advocating Passage or Defeat
    Facsimile: (775) 684-5718 of a Ballot Question
    Email: nvelect@sos.nv.gov • Committee Sponsored by a Political Party
    Website: www.nvsos.gov • Recall Committee

    1!J Committee for Political Action (PAC) D Committee Sponsored by a Political Party D Recall Committee

    D Committee for Political Action (PAC) Advocating Passage


    ~~iori·:~eq11~~ted
    ·s:tea1a11't11at·a •· ·,
    D New Registration D PAC Annual Registration (Due on or before January 15th of each year- NRS 294A.230(4)(b))

    ~ Amended Registration (check all that apply):


    D Change Officers D Change Registered Agent D Change Address D Reactivation
    D Change Name (previous name of Committee)

    l!J Other
    PHONE NUMBER
    Name of Committee
    1864 PAC
    Mailing Address City State ZIP Code
    PO BOX 10904 RENO NV 89510
    Email Address Telephone Number
    1864PAC@GMAIL.COM (775) 583-5565
    PUPROSE: Briefly state the purpose for which the Committee was organized.

    POLITICAL ACTION AND EDUCTION


    Name of Public Officer to be Recalled (Include title of office held) *This section only applies to a Recall Committee*

    REGISTERED AGENT: Pursuant to NRS 294A.240, each PAC must appoint and keep In the State a registered agent, as provided In
    NRS 14.020, who must be a natural person who resides In the State of Nevada.
    •Recall Committees only need a Registered Agent If it is on organization located outside the State.•
    Name of Registered Agent Email Address Telephone Number
    CORY HENDERSON 1864PAC@GMAIL.COM (775) 583-5565
    Physical Address City State ZIP Code
    5355 KIETZKE LANE #200 RENO NV 89511

    (£ \..]/' .-
    R~TER"fG~N~ ACCEPTANCE: I hereby accept appointment as Registered Agent for the above-named Committee.
    For Office Use Only

    Signature of Registered Agent Office of the KRhynes


    Secretary of State
    04/26/2022 4/26/22 #9126
    Date
    Barbara Cegavske
    Elections Division
    EL400
    Revised: 02-05-2019
    Page 1 of2
    OFFICERS: Li~t the name, title, address and telephone number of each officer (attach .additional pages, if necessary).

    Officer Name and Title Telephone Number


    CORY HENDERSON, PRESIDENT (775) 583-5565
    Mailing Address IRENO
    City State IZIP Code
    PO BOX 10904 NV 89510
    Officer Name and Title Telephone Number

    Mailing Address I City State IZIP Code


    Officer Name and Title Telephone Number

    Mailing Address I City State IZIP Code

    Officer Name and Title Telephone Number

    Mailing Address I City State IZIP Code


    ~~•~~J"fqN§,:' l,f ttt,e P~C 1,, ~l!~_ecl ~ any 9~f 0111anlzatlons, list the narne, address and telephone number of each
    o-'-''1i'i~on'(attachacldltionaf'·""-es/lf
    ...~,..,.... , ,,.... .. ' .....,.... .. ,·-.- .•. ~ . . necessa
    . _ry). "'
    •tioiiilail Party Committees and Recoil Committees may skip this section.• '
    Name of Organization Telephone Number

    Mailing Address I City State I ZIP Code

    Name of Organization Telephone Number

    Mailing Address I City State IZIP Code


    SUBMITTED BY:

    CORY HENDERSON (775} 583-5565

    Printed N a ~ / Telephone Number

    04/26/2022
    s~ Date

    EL400
    Revised: 02-05-2019

    Page 2 of2

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