FEC Form 1 for SOUTHERLAND FOR CONGRESSForm 1 for SOUTHERLAND FOR CONGRESS

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1076287

1. SOUTHERLAND FOR CONGRESS

100 E. 19th STREET
PANAMA CITY, FL 32405

NOTE: Address is different than previously reported

Email: kdavis@hdafec.com

NOTE: Email address is different than previously reported

2. Date: 06/06/2016

3. FEC Committee ID #: C00468959 This committee is a Principal Campaign Committee. Candidate: WILLIAM STEVE SOUTHERLAND, II
Party: Republican Party
Office Sought: House of Representatives
State is Florida in District: 02

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

J. Carey Scott
100 East 19th Street
Panama City, FL 32405
Title: Treasurer
Phone # (703) 549-7705

Treasurer:

J. Carey Scott
100 East 19th Street
Panama City, Florida 32405
Title: Treasurer
Phone # (703) 549-7705

Designated Agent(s):

Banks or Depositories

BankTrust
2315 Highway 77
Lynn Haven, Florida 32444

Signed: J. Carey Scott
Date Signed: 06/06/2016

(End FEC FORM 1)

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