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

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-869044

1. Friends of Nan Hayworth

P.O. Box 394
Fishkill, NY 12524

NOTE: Address is different than previously reported

Email: kevin@bsbsolutions.net

2. Date: 04/26/2013

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: 18

Affiliated Committees/Organizations

Custodian of Records:

Kevin Jahns
BSB Solutions
3538 S. Wakefield St.
Arlington, VA 22206
Title: Treasurer
Phone # (703) 798-1802

Treasurer:

Kevin Jahns
BSB Solutions
3538 S. Wakefield St.
Arlington, Virginia 22206
Title: Treasurer
Phone # (703) 798-1802

Designated Agent(s):

Banks or Depositories

Wells Fargo
P.O. Box 6995
Portland, Oregon 972286995

Signed: Kevin Jahns
Date Signed: 04/26/2013
Official Committee URL: www.nanhayworth.com

(End FEC FORM 1)

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