FEC Form 1 for Citizens for Tom PetriForm 1 for Citizens for Tom Petri

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-89904

1. Citizens for Tom Petri

P.O. Box 270
Fond du Lac, WI 54936
Fax: 920-923-4329
Email: tompetri@vbe.com

2. Date: 07/15/2003

3. FEC Committee ID #: C00107003 This committee is an Authorized Committee,
and is NOT a Principal Campaign Committee. Candidate: Tom Petri
Party: National
Office Sought: House of Representatives
State is Wisconsin in District: 6

Affiliated Committees/Organizations

Committee ID# C00107003
Citizens for Tom Petri
P.O. Box 270
Fond du Lac, Wisconsin 54936-027

Custodian of Records:

Treasurer:

Louis Andrew Jr.
153 S. Macy Street
Fond du Lac, Wisconsin 54935
Title: Treasurer
Phone # (920) 923-4050

Designated Agent(s):

Banks or Depositories

National Exchange Bank & Trust
130 S. Main Steet
Fond du Lac, Wisconsin 54935

Signed: Louis Andrew Jr.
Date Signed: 07/15/2003
Official Committee FAX: 920-923-4329

(End FEC FORM 1)

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