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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-411129

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1. Jim Harlan for Congress

    59002 Pine Bay Lane
    Lacombe, LA 70445
    Email: Daryl.Pettit@gmail.com

    NOTE: Email address is different than previously reported

2. Date: 04/07/2009

3. FEC Committee ID #: C00451674 This committee is an Authorized Committee,
and is NOT a Principal Campaign Committee. Candidate: James K. Harlan
Party: Democratic Party
Office Sought: House of Representatives
State is Louisiana in District: 00

Affiliated Committees/Organizations

Custodian of Records:

Daryl Pettit
406 Browning Loop
Mandeville, LA 70448
Title: Treasurer

Treasurer:

Daryl Pettit
406 Browning Loop
Mandeville, Louisiana 70448
Title: Treasurer
Phone # (985) 951-8147

Designated Agent(s):

Banks or Depositories

Resource Bank
5100 Village Walk
Suite 102
Covington, Louisiana 70433

Signed: Daryl Pettit
Date Signed: 04/07/2009

NOTE: URL is different than previously reported

(End FEC FORM 1)

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