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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-789032

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1. Common Values PAC

    901 N Washington St
    Suite 700
    Alexandria, VA 22314

    NOTE: Address is different than previously reported

    Email: tim@kochandhoos.com

2. Date: 06/07/2012

3. FEC Committee ID #: C00442368

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.
     In addition, this committee is a Leadership PAC.

Affiliated Committees/Organizations

John A Barrasso
6896 CASPER MOUNTAIN ROAD
CASPER, Wyoming 82601
Affiliated Relationship Code: Leadership PAC Sponsor

Custodian of Records:

Timothy A. Koch
901 N Washington St, Ste 700
Alexandria, VA 22314
Title: Treasurer
Phone # (703) 299-8571

Treasurer:

Timothy A. Koch
901 N Washington St, Ste 700
Alexandria, Virginia 22314
Title: Treasurer
Phone # (703) 299-8571

Designated Agent(s):

Banks or Depositories

Wells Fargo
330 N Washington St
Alexandria, Virginia 22314

Signed: Timothy A. Koch
Date Signed: 06/07/2012

(End FEC FORM 1)

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