Slate Mailer Late Payment Report

Amounts may be rounded to whole dollars

Form 498 Instructions

If This is an Amendment





Part 1 of 3: Slate Mailer Organization Information

Slater Mailer Information










Part 2 of 3: Late Payment(s) Received From:

Late Payment(s)











Part 3 of 3: Name of Late Payment for Candidate or Ballot Measure

First Late Payment





Second Late Payment





Third Late Payment





Fourth Late Payment





Fifth Late Payment





Sixth Late Payment





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