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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1055839

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1. Kentucky Bourbon PAC, Inc.

    250 West Main Street
    Suite 1400
    Lexington, KY 40507
    Email: eric.lycan@dinsmore.com

2. Date: 03/16/2016

3. FEC Committee ID #: C00612200

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

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

David R Harrod
2 HMB Circle
Frankfort, KY 40601
Title: Treasurer
Phone # (502) 695-7300

Treasurer:

David R Harrod
2 HMB Circle
Frankfort, Kentucky 40601
Title: Treasurer
Phone # (502) 695-7300

Designated Agent(s):

D Eric Lycan
250 West Main Street
Suite 1400
Lexington, Kentucky 40507
Title: Asst. Treasurer
Phone # (859) 425-1047

Banks or Depositories

Republic Bank
100 HWY 676
Frankfort, Kentucky 40601

Signed: David R Harrod
Date Signed: 03/17/2016

(End FEC FORM 1)

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