FEC FORM 1
STATEMENT OF ORGANIZATION
FILING FEC-718818
1. Free State PAC
NOTE:Commmittee Name is different than previously reported
P.O. Box 2712Topeka, KS 666012712
NOTE: Address is different than previously reported
Email: jtccpa@sunflower.com2. Date: 03/24/2011
3. FEC Committee ID #: C00455717This 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
Jerry Moran
2758 Thunderbird Lane
Hays, Kansas 67601
Affiliated Relationship Code: Leadership PAC Sponsor
Custodian of Records:
James T Clark
2116 Inverness Drive
Lawrence, KS 66047
Treasurer:
James T Clark
2116 Inverness Drive
Lawrence, Kansas 66047
Designated Agent(s):
Banks or Depositories
Intrust Bank
P.O Box One
Wichita, Kansas 67201
Signed: James T Clark
Date Signed: 03/24/2011
(End FEC FORM 1)
Date Signed: 03/24/2011