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FEC FORM 2

STATEMENT OF CANDIDACY

FILING FEC-984001

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1. Honorable Jeffrey L. Fortenberry

6415 Rainier Dr
Lincoln, NE 685104128

2. Identification Number: H4NE01064

3. Party: Republican Party

4. Office Sought: House of Representatives

5-6. State & District of Candidate: Nebraska - 1

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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 2016 election(s).

    Jeff Fortenberry for United States Congress
    FEC ID #: C00395467

    PO Box 30265
    Lincoln, NE 68503

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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.

    None

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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: Honorable Jeffrey L. Fortenberry
Signed by the candidate on: 01/16/2015

Filed: 01/16/2015

(End FEC FORM 2)

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