FEC Form 1 for Dina Titus for CongressForm 1 for Dina Titus for Congress

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-496463

1. Dina Titus for Congress

PO Box 50614
Henderson, NV 89016
Email: Mike@DinaTitus.com

2. Date: 10/06/2010

3. FEC Committee ID #: C00450577 This committee is a Principal Campaign Committee. Candidate: Dina Titus
Party: Democratic Party
Office Sought: House of Representatives
State is Nevada in District: 03

Affiliated Committees/Organizations

Committee ID# C00479139
Jared Polis Majority Fund
PO Box 1174
Springfield, Virginia 22151
Affiliated Relationship Code: Joint Fundraising Representative

Custodian of Records:

Lisa Levine
PO Box 50614
Henderson, NV 89016
Title: Assistant Treasurer
Phone # (702) 256-3462

Treasurer:

Michael Naft
PO Box 50614
Henderson, Nevada 89016
Title: Treasurer
Phone # (702) 256-3462

Designated Agent(s):

Lisa Levine
PO Box 50614
Henderson, Nevada 89016
Title: Assistant Treasurer
Phone # (702) 256-3462

Banks or Depositories

Bank of America
730 15th Street
Washington, DC 20005

Wells Fargo Bank
3800 Howard Hughes Parkway
Las Vegas, Nevada 89169

Signed: Mike Naft
Date Signed: 10/06/2010
Official Committee URL: http://www.dinatitus.com

(End FEC FORM 1)

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