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FEC FORM 2

STATEMENT OF CANDIDACY

FILING FEC-974337

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1. NAN HAYWORTH

PO BOX 394
FISHKILL, NY 12524

2. Identification Number: H0NY19139

3. Party: Republican Party

4. Office Sought: House of Representatives

5-6. State & District of Candidate: New York - 18

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DESIGNATION OF PRINCIPAL CAMPAIGN COMMITTEE

7. I hereby designate the following named political committee as my Principal Campaign Committee for the 2014 election(s).

    FRIENDS OF NAN HAYWORTH
    FEC ID #: C00466490

    P.O. BOX 511
    CHESTER, NY 10918

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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.

    YOUNG GUNS DAY III 2014
    FEC ID #: C00566075

    228 S WASHINGTON STREET
    STE 115
    ALEXANDRIA, VA 22314

    YOUNG GUNS DAY III 2014
    FEC ID #: C00566075

    228 S WASHINGTON STREET
    STE 115
    ALEXANDRIA, VA 22314

    NEW YORK MAJORITY FUND 2014
    FEC ID #: C00566216

    PO BOX 9891
    ARLINGTON, VA 22219

    REPUBLICANS INSPIRING SUCCESS & EMPOWERMENT PROJECT (RISE PROJECT)
    FEC ID #: C00567677

    PO BOX 2485
    SPRINGFIELD, VA 22152

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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, and
    9B. 0.00 for the general election

Signed as: NAN HAYWORTH
Signed by the candidate on: 11/28/2014

Filed: 11/28/2014

(End FEC FORM 2)

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