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FEC FORM 2

STATEMENT OF CANDIDACY

FILING FEC-1126265

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1. Nancy Pelosi

    NOTE: Address is different than previously reported

235 Montgomery Street
Suite 1169
San Francisco, CA 94104

2. Identification Number: H8CA05035

3. Party: Democratic Party

4. Office Sought: House of Representatives

5-6. State & District of Candidate: California - 12

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DESIGNATION OF PRINCIPAL CAMPAIGN COMMITTEE

7. I hereby designate the following named political committee as my Principal Campaign Committee for the 2018 election(s).

    Nancy Pelosi for Congress
    FEC ID #: C00213512

    700 13th Street NW
    Suite 600
    Washington, DC 20005

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DESIGNATION OF OTHER AUTHORIZED COMMITTEES

8. I hereby designate the following named committee, which is NOT my principal campaign committee, to receive and expend funds on behalf of my candidacy.

    Nancy Pelosi Victory Fund
    FEC ID #: C00492421

    430 South Capitol St, SE
    Washington, DC 20003

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DECLARATION OF INTENT TO EXPEND PERSONAL FUNDS (House or Senate Only)

9. I intend to expend personal funds exceeding the threshold amount (see 11 C.F.R. 400.9) by

    9A. 0.00 for the primary election, and
    9B. 0.00 for the general election

Signed as: Nancy Pelosi
Signed by the candidate on: 11/16/2016

Filed: 11/16/2016

(End FEC FORM 2)

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