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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-443046

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1. Dan Burton for Congress Committee

    P.O. Box 50593
    Indianapolis, IN 46250
    Email: bitkel@aol.com

2. Date: 12/22/2009

3. FEC Committee ID #: C00145862

Affiliated Committees/Organizations

Custodian of Records:

Elizabeth A. Tapia
8134 E. 50th Street
Indianapolis, IN 46226
Title: Secretary
Phone # (317) 546-5673

Treasurer:

Curtis L. Coonrod
5664 Caito Drive
Indianapolis, Indiana 46226
Title: Treasurer
Phone # (317) 562-4920

Designated Agent(s):

Curtis L. Coonrod
5664 Caito Drive
Indianapolis, Indiana 46226
Title: Treasurer
Phone # (317) 562-4920

Banks or Depositories

First Internet Bank of Indiana
8520 Allison Point Blvd., #210
Indianapolis, Indiana 0

Signed: Curtis L. Coonrod
Date Signed: 12/22/2009

(End FEC FORM 1)

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