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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-772089

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1. Empower Nebraska

    NOTE:Commmittee Name is different than previously reported

    610 S. Boulevard
    Tampa, FL 33606
    Email: nwatkins@robertwatkins.com

2. Date: 03/21/2012

3. FEC Committee ID #: C00515890

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.

Affiliated Committees/Organizations

Committee ID# C00515882
Empower Wisconsin
610 S. Boulevard
Tampa, Florida 33606
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00515874
Empower Minnesota
610 S. Boulevard
Tampa, Florida 33606
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Nancy H. Watkins
610 S. Boulevard
Tampa, FL 33606
Title: Treasurer
Phone # (813) 254-3369

Treasurer:

Nancy H. Watkins
610 S. Boulevard
Tampa, Florida 33606
Title: Treasurer
Phone # (813) 254-3369

Designated Agent(s):

Robert I. Watkins
610 S. Boulevard
Tampa, Florida 33606
Title: Treasurer
Phone # (813) 254-3369

Banks or Depositories

The Bank of Tampa
601 Bayshore Blvd.
Tampa, Florida 33606

Signed: Nancy H. Watkins
Date Signed: 03/21/2012
Official Committee URL: www.empowerne.org

(End FEC FORM 1)

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