FEC Form 1 for Jim Costa For CongressForm 1 for Jim Costa For Congress

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-486061

1. Jim Costa For Congress

2037 W Bullard Avenue
# 355
Fresno, CA 937111200
Email: kencfresno@aol.com

2. Date: 08/06/2010

3. FEC Committee ID #: C00391029

This committee is an independent expenditure-only political committee (Super PAC).

Affiliated Committees/Organizations

Farr - Costa 2010
555 Capitol Mall
Suite 1425
Sacramento, California 958144602
Affiliated Relationship Code: Joint Fundraising Representative

Custodian of Records:

Ken Costa
1784 S Chateau Fresno Avenue
Fresno, CA 937069406
Title: Treasurer

Treasurer:

Ken Costa
1784 S Chateau Fresno Avenue
Fresno, California 937069406
Title: Treasurer

Designated Agent(s):

Banks or Depositories

Premier Valley Bank
8355 N Fresno Street
Suite 180
Fresno, California 937201541

U.S. Bank
621 Capitol Mall
Suite 800
Sacramento, California 958144726

Signed: Ken Costa
Date Signed: 08/06/2010

(End FEC FORM 1)

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