Name of Organization *

Mailing Address, City, State, ZIP *

Type of District *

District Number *

County Name(s) * 🛈

1. ID Numbers

What is the Organization's Federal Tax ID Number? (do not use the Social Security No. of an Individual) *

What is the Committee number assigned to the Organization by Federal Election Commission? *

What is the committee number assigned to the Organization by the California Secretary of State? (FPPC No.) *

2. Type of Organization

Please indicate the type of organizational charter for which this application is made and answer applicable questions.

If you make a mistake and want to start over, please make sure to uncheck every box.

Type of Organization *

District or Area Organization

Statewide Organization

Democratic Club

Council of Democratic Clubs

Has any other organization serving the same district or area applied for, or are you aware of one that might apply for, a charter from the California Democratic Party (CDP)? *

Yes

No

Please identify *

What similar interest (other than being Democrats) do members of the Organization share or represent? *

Do you share this interest substantially with any currently certified Caucus of the CDP? *

Yes

No

Which? *

Does your County Party charter Democratic clubs? *

Yes

No

On what date did the Organization apply to it for a charter? *

What was the disposition of that application? *

Delayed

Denied

Revoked

What extraordinary circumstances do you believe justify the CDP intervening in the chartering of the organization? Please attach file:

Please indicate below the number of clubs included from which districts (indicating whether AD, SD, or CD) and the chartering Counties of those Clubs.

	District No.	AD, SD, or CD?	Number of Clubs	Chartering Counties
1.	District No.	AD, SD, or CD?	Number of Clubs	Chartering Counties
2.	District No.	AD, SD, or CD?	Number of Clubs	Chartering Counties
3.	District No.	AD, SD, or CD?	Number of Clubs	Chartering Counties
4.	District No.	AD, SD, or CD?	Number of Clubs	Chartering Counties
5.	District No.	AD, SD, or CD?	Number of Clubs	Chartering Counties

Upload additional pages if necessary

3. Purpose and Program

Please attach to this application a statement of organization purpose, inteneded activity and planned means of effectuating as well as standards on which Organization will base annual reports to the Rules Committee on activites and program.

For Example (yours might be different):

The Organization’s purpose is to establish a permanent Democratic campaign apparatus within the 00th Assembly District. We envision achieving our purpose through the following on-going activities:

Activity	Means	Standards
Voter Registration	Table at stationary sites; Door-to-door; Mail with follow-up	Register at least __ Democrats per month outside the election cycle and at least __ Democrats per month during the 120-day period prior to election
Precinct organization	Assign 1 officer to coordinate activities within geographic subdivisions	Recruit precinct and block captains during election campaigns and retain increasing numbers of them for permanent activity until entire geographic area is covered; Develop informational material on local Democratic and community organizations
Fund raising to meet estimated costs of activities	Mail appeals letters; Host events; Distribute memorabilia in recognition of contributions	$x from appeals letters during odd-numbered years and $y during even-numbered years; Etc.

Please upload as Exhibit A

4. Officers and/or Committee Chairs of the Organization

Please list all Officers and/or Committee Chairs of the Organization, including Precinct Captains, or other persons charged with organizational responsibility (attach additional pages if necessary)"

Executive Officer

Executive Officer Name *

Title *

Email Address *

Mailing Address *

City/Zip *

Daytime Phone Number *

Evening Phone Number *

Fax Number

List History of Party activities *

Treasurer

Treasurer Name *

Email Address *

Mailing Address *

City/Zip *

Daytime Phone Number *

Evening Phone Number *

Fax Number

List History of Party activities *

Other Officers

(include any person listed on statement of organization filed with Secretary of State or Federal Election commission; attach additional pages if necessary)

Additional Officer 1 Name

Responsibility

Email Address

Mailing Address

City/Zip

Daytime Phone Number

Evening Phone Number

Fax Number

List History of Party activities

Additional Officer 2 Name

Responsibility

Email Address

Mailing Address

City/Zip

Daytime Phone Number

Evening Phone Number

Fax Number

List History of Party activities

Additional Officer 3 Name

Responsibility

Email Address

Mailing Address

City/Zip

Daytime Phone Number

Evening Phone Number

Fax Number

List History of Party activities

Upload any additional officers, their contact information, and history of their party activities

Exhibit B: Roster of Members

Please upload a roster of members using this format:

First Name

Last Name

Mailing Address

City

Zip

AD

Telephone

Home

Work

Mobile

Fax

Email

Precinct or Block Captain

Upload Roster

Exhibit C: Constitution/Bylaws

Please upload your Constitution or Bylaws

5. Fees and Documents

We attach the following to this application: *

Check for $50 in payment of charger fee effective until charter is revoked for cause

Roster of members of the Organization using form provided, attached as Exhibit C

Certification by Executive Officer and one other officer of Orgnaization that each regular member has affirmed his/her registration to vote as a Democrat

Copy of the Constitution and/or Bylaws of the California Democratic Party, and if the Organization is incorporated, a copy of its Articles of Incorporation. Please attach as Exhibit D

6. Acknowledgements

In making this Application for Charter, the Organization agrees:

to provide the Chair(s) of the Rules Committee and the Secretary of the CDP written reports on its activities and
to give ten (10) days written or electronic notice of each of its meetings to the Secretary of the CDP
to advise the CDP within ten (10) days of any changes in its officers or its officers’ contact information, or of any changes in the Constitution
to update the Organization’s roster of members on file with the CDP annually, by February 7th of each year.
that the Roster of Members of the Organization shall be made available by the CDP to all candidates the CDP endorses
that the CDP may deny or revoke the charter of the Organization for cause, and such causes for revocation include:

having fewer than thirty (30) members in the geographical area from which the Organization draws its membership
failing to grant membership to any registered Democrat resident in the geographical area from which the Organization draws its membership
the knowing enrollment of a person as a voting member of the Organization who is registered as anything other than a member of the Democratic Party
the endorsement of a non-Democrat for elective office
the endorsement of any candidate for public office running against an endorsed candidate of the CDP
transfer of funds from the Organization’s accounts to an account of a non-Democrat running for elective office
acting in violation of State or Federal laws or regulations, and/or
a finding of fact having been made by the CDP that the Organization has failed to act in and/or has acted in a manner adverse or detrimental to the best interests of the Democratic Party
failure to submit the annual written report of progress and update of roster

that the charters of geographically based organizations shall be automatically revoked thirty (30) days after the effective date of any reapportionment law altering the boundaries of that Organization’s defined district boundary.

I agree to the Acknowledgements *

Yes

Certification

As Officers of the Organization, we herby certify that all information provided in this application is to the best of our knowledge true and correct as of the date and that the Organization freely undertakes agreement to all points listed under item 6. of this Application for charter:

Executive Officer *

Second certifying officer *

Title of second certifying office *

Date * +