FEC Form 2 for Report FEC-1033153FEC Form 2 for Report FEC-1033153

FEC FORM 2

STATEMENT OF CANDIDACY

FILING FEC-1033153

1. Adrian Smith

3321 Avenue I
Scottsbluff, NE 693614586

2. Identification Number: H6NE03115

3. Party: Republican Party

4. Office Sought: House of Representatives

5-6. State & District of Candidate: Nebraska - 3

DESIGNATION OF PRINCIPAL CAMPAIGN COMMITTEE

7. I hereby designate the following named political committee as my Principal Campaign Committee for the 2016 election(s).

Adrian Smith for Congress
FEC ID #: C00412890

3321 Avenue I
Suite 6
Scottsbluff, NE 693614587

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.

Nebraska Joint Victory Fund
FEC ID #: C00543314

228 S Washington Street
Suite 115
Alexandria, VA 223145404

Adrian Smith Victory Fund
FEC ID #: C00591891

228 S Washington St
Ste 115
Alexandria, VA 223145404

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: Adrian Smith
Signed by the candidate on: 11/17/2015

Filed: 11/17/2015

(End FEC FORM 2)

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