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FEC FORM 2

STATEMENT OF CANDIDACY

FILING FEC-1126303

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1. Keith Maurice Ellison

PO Box 6072
Minneapolis, MN 55406

2. Identification Number: H6MN05183

3. Party: Democratic Party

4. Office Sought: House of Representatives

5-6. State & District of Candidate: Minnesota - 5

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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).

    Ellison for Congress
    FEC ID #: C00422410

    PO Box 6072
    Minneapolis, MN 55406

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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.

    Shared Vision Fund
    FEC ID #: C00587196

    PO Box 186
    Indianapolis, IN 46206

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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: Keith Maurice Ellison
Signed by the candidate on: 11/17/2016

Filed: 11/17/2016

(End FEC FORM 2)

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