FEC Form 1 for TOM DAVIS FOR CONGRESSForm 1 for TOM DAVIS FOR CONGRESS

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-69821

1. TOM DAVIS FOR CONGRESS

6429 DOWNING COURT
ANNANDALE, VA 22003
Email: wsarg@cox.net

2. Date: 01/01/2003

3. FEC Committee ID #: C00285932 This committee is a Principal Campaign Committee. Candidate:
Party: National
Office Sought: House of Representatives
State is Virginia in District: 11

Affiliated Committees/Organizations

Custodian of Records:

Mary Jane Sargent
6429 Downing Court
Annandale, VA 22003
Title: Treasurer
Phone # (703) 256-4703

Treasurer:

Mary Jane Sargent
6429 Downing Court
Annandale, Virginia 22003
Title: Treasurer
Phone # (703) 256-4703

Designated Agent(s):

William H. Sargent
6429 Downing Court
Annandale, Virginia 22003
Title: Assistant Treasurer
Phone # (703) 256-4703

Banks or Depositories

First Virginia Bank
7205 Little River Turnpike
Annandale, Virginia 22003

Signed: Mary Jane Sargent
Date Signed: 01/01/2003

(End FEC FORM 1)

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