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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-245526

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1. Ellsworth for Congress Committee

    P.O. Box 62
    Evansville, IN 47701
    Fax: 8124346765
    Email: jay@ellsworthforcongress.com

2. Date: 10/18/2006

3. FEC Committee ID #: C00412346 This committee is a Principal Campaign Committee. Candidate: Brad Ellsworth
Party: National
Office Sought: House of Representatives
State is Indiana in District: 8

Affiliated Committees/Organizations

Committee ID# C00429522
Indiana House Victory Fund
607 14th Street NW
Suite 800
Washington, DC 20006
Relationship: Joint Fundraising Committee

Custodian of Records:

Treasurer:

, ____

Designated Agent(s):

Banks or Depositories

Bank of America
730 15th Street NW
Washington, DC 20005

Signed: Robert Rock
Date Signed: 10/18/2006
Official Committee FAX: 8124346765

(End FEC FORM 1)

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