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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-808755

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1. Missouri Farm Bureau Federation Statewide Farm PAC

    106 E. Locust Street
    Bowling Green, MO 63334

    NOTE: Address is different than previously reported

    Email: mfbpac@mofb.com

2. Date: 09/06/2012

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

Committee ID# C00019489
Missouri Farm Bureau Farm PAC, Northea
Route 1, Box 183
Knox City, Missouri 63446
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00040428
Missouri Farm Bureau Farm PAC, Northwe
9117 Highway 87
Prairie Home, Missouri 65068
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00089839
Missouri Farm Bureau Farm PAC, Southea
18880 State Highway D
Dexter, Missouri 63841
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00093898
Missouri Farm Bureau Farm PAC, Southwe
803 East Dawn
Ozark, Missouri 65721
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00170944
Missouri Farm Bureau Farm PAC, St. Lou
5520 Highway 94
St. Charles, Missouri 63301
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00038968
Missouri Farm Bureau Farm PAC, West Ce
32643 Highway E
Green Ridge, Missouri 65332
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

Chris Brundick
5355 Hwy T
Argyle, MO 65001
Title: Treasurer
Phone # (573) 728-6262

Treasurer:

Chris Brundick
5355 Hwy T
Argyle, Missouri 65001
Title: Treasurer
Phone # (573) 728-6262

Designated Agent(s):

Banks or Depositories

Central Bank
238 Madison Street
Jefferson City, Missouri 65101

Signed: Mr. Marcine Niemeyer
Date Signed: 09/06/2012

(End FEC FORM 1)

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