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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1537291

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1. Matt Jacobs for Congress

    PO Box 4723
    3435 East Thousand Oaks Blvd
    Thousand Oaks, CA 91359
    Email: info@mattjacobsforcongress.com;kellylawler@thekalgroup.com

2. Date: 09/08/2021

3. FEC Committee ID #: C00767046 This committee is an Authorized Committee,
and is NOT a Principal Campaign Committee. Candidate: Matthew Jacobs
Party: Republican Party
Office Sought: House of Representatives
State is California in District: 26

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Kelly Lawler
PO Box 730
Hilmar, CA 95324
Title: Record Keeper
Phone # (209) 656-1542

Treasurer:

Kelly Lawler
PO Box 730
Hilmar, California 95324
Title: Treasurer
Phone # (209) 656-1542

Designated Agent(s):

Banks or Depositories

Tri Counties Bank
2001 Geer Road
Turlock, California 95380

FVCBank
11325 Random Hills Road
Fairfax, Virginia 22030

Signed: Kelly Lawler
Date Signed: 09/08/2021

(End FEC FORM 1)

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