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FEC FORM 2

STATEMENT OF CANDIDACY

FILING FEC-834197

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1. Jim Costa

C/O Scharton Jones & Sherman C.P.A
1318 East Shaw Suite 410
Fresno, CA 937103710

2. Identification Number: H4CA20082

3. Party: Democratic Party

4. Office Sought: House of Representatives

5-6. State & District of Candidate: California - 16

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DESIGNATION OF PRINCIPAL CAMPAIGN COMMITTEE

7. I hereby designate the following named political committee as my Principal Campaign Committee for the 2014 election(s).

    Jim Costa For Congress
    FEC ID #: C00391029

    2037 W Bullard Avenue
    # 355
    Fresno, CA 937111200

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DESIGNATION OF OTHER AUTHORIZED COMMITTEES

8. I hereby designate the following named committee, which is NOT my principal campaign committee, to receive and expend funds on behalf of my candidacy.

   

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DECLARATION OF INTENT TO EXPEND PERSONAL FUNDS (House or Senate Only)

9. I intend to expend personal funds exceeding the threshold amount (see 11 C.F.R. 400.9) by

    9A. 0.00 for the primary election, and
    9B. 0.00 for the general election

Signed as: Jim Costa
Signed by the candidate on: 11/20/2012

Filed: 11/20/2012

(End FEC FORM 2)

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