FEC Form 1 for Friends of Nan HayworthForm 1 for Friends of Nan Hayworth

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-441351

1. Friends of Nan Hayworth

P. O. Box 189
Mount Kisco, NY 10549
Email: nwatkins@robertwatkins.com

NOTE: Email address is different than previously reported

2. Date: 12/03/2009

3. FEC Committee ID #: C00466490 This committee is a Principal Campaign Committee. Candidate: Nan Hayworth
Party: Republican Party
Office Sought: House of Representatives
State is New York in District: 19

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Nancy H. Watkins
610 S. Boulevard
Tampa, FL 33606
Title: Treasurer
Phone # (813) 254-3369

Treasurer:

Nancy H. Watkins
610 S. Boulevard
Tampa, Florida 33606
Title: Treasurer
Phone # (813) 254-3369

Designated Agent(s):

Robert I. Watkins
610 S. Boulevard
Tampa, Florida 33606
Title: Assistant Treasurer
Phone # (813) 254-3369

Banks or Depositories

Wachovia Bank
195 N. Bedford Road
Mount Kisco, New York 10549

TD Bank
193 E. Main Street
Mount Kisco, New York 10549

Signed: Nancy H. Watkins
Date Signed: 12/04/2009
Official Committee URL: www.nanhayworth.com

(End FEC FORM 1)

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