FEC Form 1 for ADRIAN SMITH FOR CONGRESSForm 1 for ADRIAN SMITH FOR CONGRESS

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-223288

1. ADRIAN SMITH FOR CONGRESS

3321 AVENUE I
SUITE 6
SCOTTSBLUFF, NE 69361
Fax: 3086357412
Email: committee@joinadrian.com

2. Date: 06/20/2006

3. FEC Committee ID #: C00412890 This committee is a Principal Campaign Committee. Candidate: Adrian Smith
Party: National
Office Sought: House of Representatives
State is Nebraska in District: 03

Affiliated Committees/Organizations

Committee ID# C00425322
SMITH-NEBRASKA VICTORY '06 COMMITTEE
228 S WASHINGTON ST STE 115
ALEXANDRIA, Virginia 22314
Relationship: Joint Fundraising Co

Custodian of Records:

Denise Wright
1600 S St
Gering, NE 69341
Title: Asst. Treasurer
Phone # (308) 436-3876

Treasurer:

Mr. Tyler B Marshall
1155 Q St
Gering, Nebraska 69341
Title: Treasurer
Phone # (308) 220-3211

Designated Agent(s):

Denise Wright
1600 S St
Gering, Nebraska 69341
Title: Asst. Treasurer
Phone # (308) 436-3876

Banks or Depositories

Platte Valley National Bank
PO Box 2308
Scottsbluff, Nebraska 69361

Signed: Mr. Tyler B Marshall
Date Signed: 06/20/2006
Official Committee URL: www.joinadrian.com
Official Committee FAX: 3086357412

(End FEC FORM 1)

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