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FEC Form 2 for Report FEC-1004612FEC Form 2 for Report FEC-1004612

FEC FORM 2

STATEMENT OF CANDIDACY

FILING FEC-1004612


1. Douglas Allen Collins

4833 T. Martin Rd.
Gainesville, GA 30506

2. Identification Number: H2GA09150

3. Party: Republican Party

4. Office Sought: House of Representatives

5-6. State & District of Candidate: Georgia - 9


DESIGNATION OF PRINCIPAL CAMPAIGN COMMITTEE

7. I hereby designate the following named political committee as my Principal Campaign Committee for the 2016 election(s).

    Collins for Congress
    FEC ID #: C00502039

    PO Box 1295
    Gainesville, GA 30503


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.

    GEORGIA 2016
    FEC ID #: C00575464

    2470 DANIELS BRIDGE RD STE 121
    ATHENS, GA 30606


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: Douglas Allen Collins
Signed by the candidate on: 04/17/2015

Filed: 04/17/2015

(End FEC FORM 2)


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