FEC Form 1 for Vicky Hartzler for CongressForm 1 for Vicky Hartzler for Congress

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-716543

1. Vicky Hartzler for Congress

P.O. Box 415004
Kansas City, MO 64141

NOTE: Address is different than previously reported

Email: vicky@vickyhartzler.com

2. Date: 03/09/2011

3. FEC Committee ID #: C00464602 This committee is a Principal Campaign Committee. Candidate: Vicky Hartzler
Party: Republican Party
Office Sought: House of Representatives
State is Missouri in District: 04

Affiliated Committees/Organizations

Committee ID# C00492884
Lucky 13 Joint Fundraising Committee
228 S. Washington Street, Suite 11
Alexandria, Virginia 22314
Affiliated Relationship Code: Joint Fundraising Representative

Freshman Agricultural Republican Membe
7315 Wisconsin Avenue
Suite 310 East
Bethesda, Maryland 20814
Affiliated Relationship Code: Joint Fundraising Representative

Custodian of Records:

The Bespoke Group
140 Walnut, Suite 202
Kansas City, MO 64106
Title: Custodian
Phone # (816) 569-5435

Treasurer:

Delbert Scott
700 W 7th St
Lowry City, Missouri 64763
Title: Senator
Phone # (816) 839-0605

Designated Agent(s):

Doug Russell
1616 Arbour Dr.
Lebanon, Missouri 65536
Title: Deputy Treasurer

Banks or Depositories

Country Club Bank
P.O. Box 410889
Kansas City, Missouri 64141

Hawthorn Bank
100 Plaza Dr.
Harrisonville, Missouri 64701

BB&T
1909 K Street NW
Washington, DC 20006

Wachovia Bank, N.A.
7901 Wisconsin Avenue
# MD1010
Bethesda, Maryland 20814

Signed: Delbert Scott
Date Signed: 03/09/2011
Official Committee URL: www.vickyhartzler.com

(End FEC FORM 1)

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