Campaign Finance Complaint Form
Michigan Department of State
‘This complaint form may be used to file a complaint alleging that someone violated the
Michiga paign Fi Act (the MCFA, 1976 PA 388, as amended; MCL 169.201 e¢ seq.).
All information on the form must be provided along with an original signature and evidence.
Please print or type all information
Lallege that the MCFA was violated as follows:
Section 1. Complainant
Taran Taine pho Taner
Lonnie Scott a 7) 999-3646
Mulise S915 S Washington Sq, Suite 135
oy 5 Sie Tp
Lansing MI 48933
Section 2. Alleged Violator
*=° Clean Ml Committee
Mallee ire 3602 Waverly Hills Road
Cay Tae Tip
Lansing MI 48917
Section 3. Alleged Violations (Use additional sheet if more space is needed.)
‘Section() of the MCTA violated:
169.226
Explain how those sections were violated
Aseries of ads, a total of seven, were released by MIPAC to promote an
announcement by Brian Calley on May 30, 2017. The announcement was the
ballot proposal for Clean MI Committee. In the most recent report from the
Clean MI Committee, they failed to report the ads in their Petition Proposal
Statement on June 19, 2017 as an in-kind contribution.
[idence that supports those allegations (tach copis of pertinent documents sn other infrmation}
| have attached to this document a series of links to the ads on Facebook
that show May 30, 2017 as the announcement date, as well as the actual
announcement by Brian Calley. Screenshots of the end of each ad are
attached to show the the date promoted for the announcement.Section 4. Certification (Required)
I certify that to the best of my knowledge, information, and belief, formed after
a reasonable inquiry under the circumstances, each factual contention of this
complaint is supported by evidence.
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Sig of Conant Dae
Section 5. Certification without Evidence (Supplemental to Section 4)
{i the MCA (MCL 169.215) requires that the signed certification found in
section 4 of this form be included in every complaint. However, if, after a reasonable inquiry
under the circumstances, you are unable to certify that certain factual contentions are supported
by evidence, you may also make the following certification:
I certify that to the best of my knowledge, information, or belief, there are
grounds to conclude that the following specifically identified factual
contentions are likely to be supported by evidence after a reasonable
opportunity for further inquiry. Those specific contentions are:
aes of Complaint Date
—ssSSSSssSs
Section 15(8) of the MCFA provides that a person who files a complaint with a false certification i
responsible for a civil violation of the MCFA. The person may be required to pay a civil fine of up
to $1,000.00 and some or all of the expenses incurred by the Michigan Department of State and the
alleged violator as a direct result of the filing of the complaint.
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Mail or deliver the completed complaint form with an original signature and evidence to the following
address:
Michigan Department of State
Bureau of Elections
Richard H. Austin Building ~ Ist Floor
430 West Allegan Street
Lansing, Michigan 48918
Revised: O16