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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-809476

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1. DelBene for Congress

    PO Box 487
    Bothell, WA 98041

    NOTE: Address is different than previously reported

    Email: phil@seattlecfo.com

2. Date: 09/13/2012

3. FEC Committee ID #: C00459099 This committee is a Principal Campaign Committee. Candidate: Suzan K DelBene
Party: Democratic Party
Office Sought: House of Representatives
State is Washington in District: 01

Affiliated Committees/Organizations

Committee ID# C00528604
DelBene Victory 2012
603 Stewart St #819
Seattle, Washington 98101
Affiliated Relationship Code: Joint Fundraising Representative

Custodian of Records:

Philip E Lloyd
603 Stewart Street #819
Seattle, WA 98101
Title: Treasurer
Phone # (206) 382-5552

Treasurer:

Philip E Lloyd
603 Stewart Street #819
Seattle, Washington 98101
Title: Treasurer
Phone # (206) 382-5552

Designated Agent(s):

Philip E Lloyd
603 Stewart Street #819
Seattle, Washington 98101
Title: Treasurer
Phone # (206) 382-5552

Banks or Depositories

Bank of America
800 Fifth Avenue
Seattle, Washington 98104

Woodsboro Bank
900 N East Street
Fredrick, Maryland 21701

Signed: Philip E Lloyd
Date Signed: 09/13/2012
Official Committee URL: http://www.delbeneforcongress.com

(End FEC FORM 1)

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