FEC Form 1 for KISSELL FOR CONGRESSForm 1 for KISSELL FOR CONGRESS

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-768487

1. KISSELL FOR CONGRESS

P.O. Box 1530
Biscoe, NC 27209
Email: info@larrykissell.com

2. Date: 03/01/2012

3. FEC Committee ID #: C00433763 This committee is a Principal Campaign Committee. Candidate: LARRY W KISSELL
Party: Democratic Party
Office Sought: House of Representatives
State is North Carolina in District: 08

Affiliated Committees/Organizations

Committee ID# C00501825
JARED POLIS VICTORY FUND 2012
P.O. BOX 1174
SPRINGFIELD, Virginia 22151
Affiliated Relationship Code: Leadership PAC Sponsor

Custodian of Records:

Walter Butch Ingram Jenkins
c/o Thigpen & Jenkins
P.O. Box 1208
Biscoe, NC 27209
Title: Treasurer

Treasurer:

Walter Butch Ingram Jenkins
c/o Thigpen & Jenkins
P.O. Box 1208
Biscoe, North Carolina 27209
Title: Treasurer

Designated Agent(s):

Banks or Depositories

Fidelity Bank
520 North Main Street
Biscoe, North Carolina 27209

Bank of America
730 15th Street NW
Washington, DC 20005

Signed: Walter Butch Ingram Jenkins
Date Signed: 03/01/2012
Official Committee URL: http://www.larrykissell.com

(End FEC FORM 1)

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