FEC Form 1 for Moore For CongressForm 1 for Moore For Congress

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-98721

1. Moore For Congress

PO BOX 16031
Shawnee Mission, KS 66285
Fax: 9138940903
Email: jay@mooreforcongress.com

2. Date: 10/20/2003

3. FEC Committee ID #: C00331066 This committee is a Principal Campaign Committee. Candidate: Dennis Moore
Party:
Office Sought: House of Representatives
State is Kansas in District: 3

Affiliated Committees/Organizations

Responsible Government 2004
1401 H Street NW Suite 1200
Washington, DC 20005
Relationship: Joint Fundraising Representative

Custodian of Records:

Constance Shidler
PO BOX 14631
Shawnee Mission, KS 66285
Title: Treasurer
Phone # (913) 888-3848

Treasurer:

Constance Shidler
PO BOX 14631
Shawnee Mission, Kansas 66285
Title: Treasurer
Phone # (913) 888-4838

Designated Agent(s):

Jay Swearingen
PO BOX 14631
Shawnee Mission, Kansas 66285
Title: Assistant Treasurer
Phone # (913) 888-4838

Banks or Depositories

Wachovia Bank
740 15th Street NW
Washington, DC 20005

Signed: Constance Shidler
Date Signed: 10/21/2003
Official Committee URL: http://www.mooreforcongress.com
Official Committee FAX: 9138940903

(End FEC FORM 1)

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