FEC FORM 2
STATEMENT OF CANDIDACY
FILING FEC-789254
1. Keith Maurice Ellison
PO Box 6072Minneapolis, MN 55406
2. Identification Number: H6MN05183
3. Party: Democratic Party
4. Office Sought: House of Representatives
5-6. State & District of Candidate: Minnesota - 5
DESIGNATION OF PRINCIPAL CAMPAIGN COMMITTEE
7. I hereby designate the following named political committee as my Principal Campaign Committee for the 2012 election(s).
Ellison for Congress
FEC ID #: C00422410
PO Box 6072Minneapolis, MN 55406
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.
Jared Polis Victory Fund
FEC ID #: C00461913
PO Box 1174Springfield, VA 22151
Progressives Win 2012
FEC ID #: C00522433
1 Park Row 5th FlProvidence, RI 02906
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, and9B. 0.00 for the general election