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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-745301

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1. Missouri Farm Bureau Federation Statewide Farm PAC

    106 E. Locust Street
    Bowling Green, MO 63334
    Email: mfbpac@mofb.com

    NOTE: Email address is different than previously reported

2. Date: 09/19/2011

3. FEC Committee ID #: C00405761 This committee is a separate segregated fund. Its connected organization is a Membership Organization

Affiliated Committees/Organizations

Missouri Farm Bureau Federation
PO Box 658
Jefferson City, Missouri 65102
Affiliated Relationship Code: Connected Organization

Custodian of Records:

Mr. Marcine Niemeyer
28962 Highway 161
New Hartford, MO 63364
Title: Treasurer

Treasurer:

Mr. Marcine Niemeyer
28962 Highway 161
New Hartford, Missouri 63364
Title: Treasurer

Designated Agent(s):

Banks or Depositories

Central Bank
238 Madison Street
Jefferson City, Missouri 65101

Signed: Mr. Marcine Niemeyer
Date Signed: 09/19/2011

(End FEC FORM 1)

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