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FEC FORM 2

STATEMENT OF CANDIDACY

FILING FEC-417631

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1. Brad Ellsworth

PO Box 62
Evansville, IN 47708

2. Identification Number: H6IN08210

3. Party: Democratic Party

4. Office Sought: House of Representatives

5-6. State & District of Candidate: Indiana - 8

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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 2010 election(s).

    Ellsworth for Congress
    FEC ID #: C00412346

    PO Box 62
    Evansville, IN 47708

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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.

    Jared Polis Victory Fund
    FEC ID #: C00461913

    PO Box 1174
    Springfield, VA 22151

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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: Brad Ellsworth
Signed by the candidate on: 05/19/2009

Filed: 05/19/2009

(End FEC FORM 2)

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