FEC Form 1 for FRIENDS OF MAX BURNSForm 1 for FRIENDS OF MAX BURNS

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-184244

1. FRIENDS OF MAX BURNS

P.O. Box 1965
Sylvania, GA 30467
Fax: 7034258352
Email: info@maxburns.com

2. Date: 08/15/2005

3. FEC Committee ID #: C00412544 This committee is a Principal Campaign Committee. Candidate: O MAXIE BURNS
Party: National
Office Sought: House of Representatives
State is Georgia in District: 12

Affiliated Committees/Organizations

Committee ID# C00378448
MAX BURNS FOR CONGRESS
PO BOX 1965
SYLVANIA, Georgia 30467
Relationship: Affiliated Committee
Organization Type: Corporation

Custodian of Records:

Emelyn Hunter
115 South Main Street
Sylvania, GA 30467
Title: Treasurer
Phone # (912) 564-2678

Treasurer:

Emelyn Hunter
115 South Main Street
Sylvania, Georgia 30467
Title: Treasurer
Phone # (312) 564-2678

Designated Agent(s):

Banks or Depositories

Farmers & Merchants Bank
104 North Main Street
P.O. Box 559
Sylvania, Georgia 30467

First National Bank & Trust
616 West Ogeechee Street
Sylvania, Georgia 30467

Bank of Newington
224 Walton Street
P.O. Box 68
Newington, Georgia 30446

Signed: Emelyn Hunter
Date Signed: 08/15/2005
Official Committee FAX: 7034258352

(End FEC FORM 1)

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