FEC Form 1 for LIPINSKI FOR CONGRESS COMMITTEEForm 1 for LIPINSKI FOR CONGRESS COMMITTEE

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-99391

1. LIPINSKI FOR CONGRESS COMMITTEE

6242 W 59TH STREET
CHICAGO, IL 60638
Fax: 7083860684
Email: Dennis@kennycpa.com

2. Date: 11/08/2003

3. FEC Committee ID #: C00148585 This committee is a Principal Campaign Committee. Candidate:
Party: National
Office Sought: House of Representatives
State is Illinois in District: 03

Affiliated Committees/Organizations

Custodian of Records:

John Mooney
6242 W. 59th Street
Chicago, IL 60638

Treasurer:

John Mooney
6242 W. 59th Street
Chicago, Illinois 60638

Designated Agent(s):

Banks or Depositories

Fifth Third Bank
5235 W. 63rd Street
Chicago, Illinois 60638

Signed: John Mooney
Date Signed: 11/08/2003
Official Committee FAX: 7083860684

(End FEC FORM 1)

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