FEC Form 1 for JD Hayworth For CongressForm 1 for JD Hayworth For Congress

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-233263

1. JD Hayworth For Congress

14300 N. Northsight Blvd. #105
Scottsdale, AZ 85260
Fax: 530-934-5776

2. Date: 08/10/2006

3. FEC Committee ID #: C00287987 This committee is a Principal Campaign Committee. Candidate: JD Hayworth
Party: National
Office Sought: House of Representatives
State is Arizona in District: 5

Affiliated Committees/Organizations

Committee ID# C00426239
ROMP IV 2006
228 S. Washington Street Suite 11
Alexandria, Virginia 22314
Relationship: Joint Fundraising Rep

Committee ID# C00427096
Spirit of 94 Victory Committe
PO Box 40177
Washington, DC 40177
Relationship: Joint Fundraising Rep
Organization Type: Membership Organization

BOMP - Bowling for Our Majorit
PO Box 40366
Washington, DC 20016
Relationship: Joint Fundraising Rep
Organization Type: Membership Organization

Custodian of Records:

Kelly Lawler
P.O. Box 984
Willows, CA 95988
Title: Treasurer
Phone # (530) 934-5823

Treasurer:

Kelly Lawler
P.O. Box 984
Willows, California 95988
Title: Treasurer
Phone # (530) 934-5823

Designated Agent(s):

Kelly Lawler
P.O. Box 984
Willows, California 95988
Title: Treasurer
Phone # (530) 934-5823

Banks or Depositories

Bank One
P.O. Box 71
Phoenix, Arizona 85001

BB&T
1909 K Street NW
Washington, DC 20006

Compass Bank
23305 North Pima Road
Scottsdale, Arizona 85255

Johnson Bank
8700 East Pinnacle Peak
Scottsdale, Arizona 85255

Wachovia Bank
7901 Wisconsin Avenue
Betheseda, Maryland 20814

Signed: Kelly Lawler
Date Signed: 08/10/2006
Official Committee FAX: 530-934-5776

(End FEC FORM 1)

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