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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-808177

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1. Friends of Jason Chaffetz

    315 Westfield Circle
    Alpine, UT 84004
    Email: campaignscc@gmail.com

2. Date: 08/28/2012

3. FEC Committee ID #: C00431684 This committee is a Principal Campaign Committee. Candidate: Jason Chaffetz
Party: Republican Party
Office Sought: House of Representatives
State is Utah in District: 03

Affiliated Committees/Organizations

Committee ID# C00520999
Beehive Victory Fund
315 Westfield Cir
Alpine, Utah 84004
Affiliated Relationship Code: Joint Fundraising Representative

Custodian of Records:

Corie Chan
PO Box 901483
Sandy, UT 84090
Title: Treasurer
Phone # (801) 842-1445

Treasurer:

Corie Chan
PO Box 901483
Sandy, Utah 84090
Title: Treasurer
Phone # (801) 842-1445

Designated Agent(s):

Banks or Depositories

Wells Fargo Bank
207 E. Main Street
American Fork, Utah 84003

Signed: Corie Chan
Date Signed: 08/28/2012

(End FEC FORM 1)

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