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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-310016

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1. Adrian Smith for Congress

    3321 Avenue I
    Suite 6
    Scottsbluff, NE 69361
    Fax: 308-635-7412
    Email: sue@joinadrian.com

2. Date: 11/02/2007

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: 3

Affiliated Committees/Organizations

Committee ID# C00412890
Adrian Smith for Congress
3221 Avenue I
Suite 6
Scottsbluff, Nebraska 69361
Relationship: Candidate Committee

Custodian of Records:

Treasurer:

Lenora Sue Gompert
P.O. Box 46
Morrill, Nebraska 69358
Title: Treasurer
Phone # (308) 635-1111

Designated Agent(s):

Banks or Depositories

Platte Valley National Bank
1212 Circle Drive
Scottsbluff, Nebraska 69361

Signed: Lenora Sue Gompert
Date Signed: 11/02/2007
Official Committee FAX: 308-635-7412

(End FEC FORM 1)

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