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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-96867

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1. Putnam for Congress

    Post Office Box 2257
    Bartow, FL 33831
    Fax: 863-534-3559
    Email: putnam4congress@aol.com

2. Date: 10/10/2003

3. FEC Committee ID #: C00364117 This committee is a Principal Campaign Committee. Candidate: Adam H Putnam
Party: National
Office Sought: House of Representatives
State is Florida in District: 12

Affiliated Committees/Organizations

Custodian of Records:

Treasurer:

David Wright
550 E Davidson St
Bartow, Florida 33830
Title: Treasurer
Phone # (863) 533-7191

Designated Agent(s):

Banks or Depositories

Citrus and Chemical Bank
P. O. Box 90
Bartow, Florida 33831

Signed: David Wright
Date Signed: 10/10/2003
Official Committee FAX: 863-534-3559

(End FEC FORM 1)

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