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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-418987

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1. Kilroy for Congress

    P.O. Box 2582
    Columbus, OH 43216

    NOTE: Address is different than previously reported

    Email: jay@jaypetterson.com

    NOTE: Email address is different than previously reported

2. Date: 05/22/2009

3. FEC Committee ID #: C00416156 This committee is a Principal Campaign Committee. Candidate: Mary Jo Kilroy
Party: Democratic Party
Office Sought: House of Representatives
State is Ohio in District: 15

Affiliated Committees/Organizations

Committee ID# C00461913
Candidate ID# S0CO00211
Jared Polis Victory Fund
PO BOX 1174
Springfield, Virginia 22151
Affiliated Relationship Code: Joint Fundraising Representative

Custodian of Records:

Jay Petterson
7916 Ashworth Avenue, North
Seattle, WA 98103
Title: Compliance
Phone # (202) 249-2259

Treasurer:

Sanford A Meizlish
653 Crossing Creek S
Gahanna, Ohio 43230
Title: Treasurer

Designated Agent(s):

Banks or Depositories

Fifth Third Bank
PO Box 630900
Cincinnati, Ohio 45263

Bank of America
3 Dupont Cir, NW
Washington, DC 20036

Signed: Sanford A Meizlish
Date Signed: 06/01/2009

(End FEC FORM 1)

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