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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-745300

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1. MISSOURI FARM BUREAU FARM PAC, ST LOUIS AREA

    5520 Highway 94
    St. Charles, MO 63301
    Email: mfbpac@mofb.com

    NOTE: Email address is different than previously reported

2. Date: 09/19/2011

3. FEC Committee ID #: C00170944 This committee is a separate segregated fund. Its connected organization is a Membership Organization

Affiliated Committees/Organizations

Missouri Farm Bureau
P O Box 658
Jefferson City, Missouri 65102
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Dawn Boerding
5520 N Highway 94
St. Charles, MO 63301
Title: TREASURER
Phone # (636) 250-3248

Treasurer:

Dawn Boerding
5520 N Highway 94
St. Charles, Missouri 63301
Title: Treasurer
Phone # (636) 250-3248

Designated Agent(s):

Banks or Depositories

FIRST STATE BANK OF ST CHARLES
206 NORTH FIFTH STREET
ST CHARLES, Missouri 633011897

Signed: Dawn Boerding
Date Signed: 09/19/2011

(End FEC FORM 1)

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