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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-114260

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1. Jim Davis for Congress

    PO Box 18143
    Tampa, FL 33679
    Fax: 8133483959
    Email: jbrill@jimdavisforcongress.com

2. Date: 04/07/2004

3. FEC Committee ID #: C00317974 This committee is a Principal Campaign Committee. Candidate: James Oscar Davis
Party:
Office Sought: House of Representatives
State is Florida in District: 11

Affiliated Committees/Organizations

Custodian of Records:

Jonathan Brill
PO Box 18143
Tampa, FL 33679
Title: Campaign Manager
Phone # (813) 354-1400

Treasurer:

Marc Sasser
PO Box 18143
Tampa, Florida 33679
Title: Treasurer
Phone # (813) 354-1400

Designated Agent(s):

Banks or Depositories

Suntrust Bank
PO Box 622227
Orlando, Florida 328622227

Signed: Marc Sasser
Date Signed: 04/07/2004
Official Committee FAX: 8133483959

(End FEC FORM 1)

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