FEC Form 1 for Mike Ross for Congress CommitteeForm 1 for Mike Ross for Congress Committee

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-112653

1. Mike Ross for Congress Committee

PO Box 360
Prescott, AR 71857
Fax: 8708873260
Email: mike.ross@ross4congress.com

2. Date: 03/21/2004

3. FEC Committee ID #: C00345710 This committee is a Principal Campaign Committee. Candidate: Michael Avery Ross
Party: National
Office Sought: House of Representatives
State is Arkansas in District: 4

Affiliated Committees/Organizations

Custodian of Records:

Vickie Winpisinger
315 Inspiration Lane
Gaithersburg, MD 20878
Title: Assistant Treasurer
Phone # (301) 947-0278

Treasurer:

W. Herman Brown
PO Box 360
Prescott, Arkansas 71857
Title: Treasurer
Phone # (870) 887-8194

Designated Agent(s):

Banks or Depositories

Bank of Prescott
PO Box 490
Prescott, Arkansas 71857

Signed: W. Herman Brown
Date Signed: 03/21/2004
Official Committee URL: www.ross4congress.com
Official Committee FAX: 8708873260

(End FEC FORM 1)

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