FEC Form 1 for Crenshaw for Congress CampaignForm 1 for Crenshaw for Congress Campaign

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-142308

1. Crenshaw for Congress Campaign

5345 Ortega Boulevard
Suite 11
Jacksonville, FL 322108443

2. Date: 10/18/2004

3. FEC Committee ID #: C00352849 This committee is a Principal Campaign Committee. Candidate: Ander M. Crenshaw
Party:
Office Sought: House of Representatives
State is Florida in District: 04

Affiliated Committees/Organizations

Custodian of Records:

Mr. Thomas Fiorentino, Jr.
50 N Laura Street
Suite 2750
Jacksonville, FL 322023642

Treasurer:

Mr. Thomas Fiorentino, Jr.
50 N Laura Street
Suite 2750
Jacksonville, Florida 322023642
Title: Treasurer
Phone # (904) 246-9465

Designated Agent(s):

Banks or Depositories

Signed: T. Martin Fiorentino Jr.
Date Signed: 10/18/2004

(End FEC FORM 1)

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