El Dorado County, CA · El Dorado County
Statement of Facts Roster of Public Agencies Filing
Public agencies use this form to file a new roster or update agency information with the California Secretary of State.
At a glance
- Issued by
- City of El Dorado County · El Dorado County, El Dorado County, California
- Notarization
- Not required: file this form without a notary.
- Official source
- eldoradocounty.ca.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This form lets a public agency file a new roster or update its information with the California Secretary of State. It asks for the agency’s legal name, county, mailing address, governing board members and their addresses, and the presiding officer and secretary or clerk. The form also provides space to request that an acknowledgment be returned.
Who needs it
A public agency submitting a new roster or updating its filed agency information uses this form.
How to submit it
Complete the form and mail it to the Secretary of State, P.O. Box 942870, Sacramento, CA 94277-2870.
About notarization
This document is signed without a notary; the signer just signs and dates it, and the form does not identify a notarized or sworn attachment.
How to submit this form
- 1
Download the Form
Download the Statement of Facts Roster of Public Agencies Filing.
- 2
Complete the Form
Mark new filing or update, then enter the agency information and requested names and addresses.
- 3
Gather Additional Information
If more space is needed, attach information on a one-sided, legible 8½-by-11-inch page.
- 4
Mail the Form
Mail the completed form to the Secretary of State at the address printed on the form.
Frequently asked questions
- What is the Statement of Facts Roster of Public Agencies Filing?
- It is a form for a public agency to file a new roster or update its information with the California Secretary of State.
- Who uses this public agency roster form?
- A public agency filing a new roster or updating its information uses the form. It requests agency details, addresses, and names of governing board members and officers.
- How do I submit the public agency roster form?
- Complete the form and mail it to the Secretary of State, P.O. Box 942870, Sacramento, CA 94277-2870.
- Do I need a notary for the public agency roster form?
- No. This document is signed without a notary; the signer signs and dates it, and the form does not identify a notarized or sworn attachment.