FEC Form 1 for Roth for CongressForm 1 for Roth for Congress

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-214739

1. Roth for Congress

PO Box 1107
La Quinta, CA 92247
Fax: 2134526575

2. Date: 04/25/2006

3. FEC Committee ID #: C00412874 This committee is a Principal Campaign Committee. Candidate: David Roth
Party: National
Office Sought: House of Representatives
State is California in District: 45

Affiliated Committees/Organizations

Custodian of Records:

Stephen J. Kaufman
777 S. Figueroa Street Ste. 4050
Los Angeles, CA 90017
Title: Asst. Treasurer
Phone # (213) 452-6565

Treasurer:

Shaun Shenassa
9255 Sunset Blvd. Ste. 405
Los Angeles, California 90069
Title: Treasurer
Phone # (310) 550-8815

Designated Agent(s):

Stephen J. Kaufman
777 S. Figueroa Street Ste. 4050
Los Angeles, California 90017
Title: Asst. Treasurer
Phone # (213) 452-6565

Banks or Depositories

California Bank & Trust
550 S. Hope Street Ste. 100
Los Angeles, California 90071

Signed: Shaun Shenassa
Date Signed: 04/25/2006
Official Committee URL: http://www.rothforcongress.org
Official Committee FAX: 2134526575

(End FEC FORM 1)

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