FEC Form 1 for Jim Himes for CongressForm 1 for Jim Himes for Congress

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-747277

1. Jim Himes for Congress

857 Post Road, #312
Fairfield, CT 06824
Email: admin@evanskatz.com

NOTE: Email address is different than previously reported

2. Date: 10/11/2011

3. FEC Committee ID #: C00434191 This committee is a Principal Campaign Committee. Candidate: Jim Himes
Party: Democratic Party
Office Sought: House of Representatives
State is Connecticut in District: 04

Affiliated Committees/Organizations

Committee ID# C00501825
Jared Polis Victory Fund 2012
P.O. Box 1174
Springfield, Virginia 22151
Affiliated Relationship Code: Joint Fundraising Representative

Custodian of Records:

Laurie McTeague
468 Belden Hill Rd
Wilton, CT 06897
Title: Treasurer
Phone # (203) 761-0675

Treasurer:

Laurie McTeague
468 Belden Hill Rd
Wilton, Connecticut 06897
Title: Treasurer
Phone # (203) 761-0675

Designated Agent(s):

Banks or Depositories

Citibank, N.A.
1345 Avenue of the Americas
New York, New York 10105

Bank of America
1501 Pennsylvania Avenue, NW
Washington, DC 20005

Signed: Laurie McTeague
Date Signed: 10/11/2011
Official Committee URL: http://www.himesforcongress.com

(End FEC FORM 1)

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