FEC FORM 2
STATEMENT OF CANDIDACY
FILING FEC-1005783
1. Hon. Scott DesJarlais
NOTE: Address is different than previously reported
639 Sweetens Cove RoadSouth Pittsburg, TN 373806414
2. Identification Number: H0TN04195
3. Party: Republican Party
4. Office Sought: House of Representatives
5-6. State & District of Candidate: Tennessee - 4
DESIGNATION OF PRINCIPAL CAMPAIGN COMMITTEE
7. I hereby designate the following named political committee as my Principal Campaign Committee for the 2016 election(s).
Friends of Scott DesJarlais
FEC ID #: C00464073
95 White Bridge RdSuite 207
Nashville, TN 372051482
DESIGNATION OF OTHER AUTHORIZED COMMITTEES
8. I hereby designate the following named committee, which is NOT my principal campaign committee, to receive and expend funds on behalf of my candidacy.
DECLARATION OF INTENT TO EXPEND PERSONAL FUNDS (House or Senate Only)
9. I intend to expend personal funds exceeding the threshold amount (see 11 C.F.R. 400.9) by
9A. 0.00 for the primary election, and9B. 0.00 for the general election