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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-272077

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1. Charles Boustany Jr MD for Congress Inc

    Post Office Box 80126
    Lafayette, LA 705980126
    Fax: 337-265-2543
    Email: mgkelley@wms-jen.com

2. Date: 01/12/2007

3. FEC Committee ID #: C00394866 This committee is a Principal Campaign Committee. Candidate: Dr Charles Boustany Jr.
Party:
Office Sought: House of Representatives
State is Louisiana in District: 07

Affiliated Committees/Organizations

Committee ID# C00417022
Majority 2006
PO Box 40427
Washington, DC 20016
Relationship: Joint fundraising participant

Custodian of Records:

Alan D. Hebert
PO Box 53147
Lafayette, LA 705053147
Title: Treasurer
Phone # (337) 232-1000

Treasurer:

Alan D. Hebert
PO Box 53147
Lafayette, Louisiana 705053147
Title: Treasurer
Phone # (337) 232-1000

Designated Agent(s):

Lisa Heath
PO Box 53147
Lafayette, Louisiana 70505
Title: Assistant Treasurer
Phone # (337) 232-1000

Banks or Depositories

Iberia Bank
IB Tower
200 W. Congress
Lafayette, Louisiana 70503

Wachovia Bank
7901 Wisconsin Avenue
Bethesda, Maryland 20814

Signed: Alan D. Hebert
Date Signed: 01/12/2007
Official Committee URL: www.charlesboustany.com
Official Committee FAX: 337-265-2543

(End FEC FORM 1)

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