FEC Form 1 for DAN LIPINSKI FOR CONGRESSForm 1 for DAN LIPINSKI FOR CONGRESS

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-746850

1. DAN LIPINSKI FOR CONGRESS

P.O. BOX 520
WESTERN SPRINGS, IL 60558
Email: lipinski@gmail.com

2. Date: 09/30/2011

3. FEC Committee ID #: C00405431 This committee is a Principal Campaign Committee. Candidate: DANIEL WILLIAM WILLIAM LIPINSKI
Party: Democratic Party
Office Sought: House of Representatives
State is Illinois in District: 03

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Jerome R. Hurckes
7036 West 96th Street
Oak Lawn, IL 604532013
Title: Treasurer
Phone # (708) 482-7065

Treasurer:

Jerome R. Hurckes
7036 West 96th Street
Oak Lawn, Illinois 604532013
Title: Treasurer
Phone # (708) 482-7065

Designated Agent(s):

Jerome R. Hurckes
7036 West 96th Street
Oak Lawn, Illinois 604532013
Title: Treasurer
Phone # (708) 482-7065

Banks or Depositories

Western Springs National Bank & Trust
4456 Wolf Road
Western Springs, Illinois 60558

State Bank of Countryside
6734 Joliet Road
Countryside, Illinois 60525

Burr Ridge Bank
7020 S. County Line Road
Willowbrook, Illinois 60527

Signed: Jerome R. Hurckes
Date Signed: 10/05/2011
Official Committee URL: lipinskiforcongress.com

(End FEC FORM 1)

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