FEC Form 1 for Jerry Weller for Congress Inc.Form 1 for Jerry Weller for Congress Inc.

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-35908

1. Jerry Weller for Congress Inc.

P.O. Box 15283
Washington, DC 20003
Email: Weller4Congress@hotmail.com

2. Date: 05/10/2002

3. FEC Committee ID #: C00364349 This committee is a Principal Campaign Committee. Candidate: Gerald C. Jerry Weller
Party: National
Office Sought: House of Representatives
State is Illinois in District: 11

Affiliated Committees/Organizations

Gerald C. Jerry Weller
P.O. Box 15283
Washington, DC 20003
Relationship: Affiliated

Custodian of Records:

Roger C. Forcash
P.O. Box 15283
Washington, DC 20003
Title: Treasurer

Treasurer:

Roger C. Forcash
P.O. Box 15283
Wasington, DC 20003
Title: Treasurer

Designated Agent(s):

Banks or Depositories

First Union National Bank
215 Pennsylvania Avenue SE
Washington, DC 20003

Grundy County National Bank
201 Liberty Street
Morris, Illinois 60450

Signed: Roger C. Forcash
Date Signed: 05/10/2002

(End FEC FORM 1)

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