FEC Form 1 for Ann Marie Buerkle for CongressForm 1 for Ann Marie Buerkle for Congress

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-794509

1. Ann Marie Buerkle for Congress

PO Box 219
Syracuse, NY 132140219
Email: annbuerkle@gmail.com

2. Date: 07/10/2012

3. FEC Committee ID #: C00473751 This committee is a Principal Campaign Committee. Candidate: Ann Marie Buerkle
Party: Republican Party
Office Sought: House of Representatives
State is New York in District: 24

Affiliated Committees/Organizations

Replace Obamacare Democrats
2470 Daniells Bridge Road
Suite 121
Athens, Georgia 30606
Affiliated Relationship Code: Joint Fundraising Representative

Committee ID# C00519744
Patriot Day IV
228 S Washington Street
Suite 115
Alexandria, Virginia 223145404
Affiliated Relationship Code: Joint Fundraising Representative

Benishek Buerkle Committee
901 N Washington Street
Suite 700
Alexandria, Virginia 223141535
Affiliated Relationship Code: Joint Fundraising Representative

Custodian of Records:

Thomas J Donovan
413 W Manchester Road
Syracuse, NY 132192417
Title: Treasurer
Phone # (315) 488-6625

Treasurer:

Thomas J Donovan
413 W Manchester Road
Syracuse, New York 132192417
Title: Treasurer
Phone # (315) 488-6625

Designated Agent(s):

Theodore V. Koch
901 N Washington Street
Suite 700
Alexandria, Virginia 223141535
Title: Assistant Treasurer
Phone # (703) 299-8570

Banks or Depositories

Key Bank National Association
201 S Warren Street
Syracuse, New York 132021671

BB&T
1909 K Street NW
Washington, DC 200061152

Bank Of America
600 N Washington Street
Alexandria, Virginia 223141914

SunTrust Bank
PO Box 4418
Atlanta, Georgia 30302

Signed: Thomas J Donovan
Date Signed: 07/10/2012
Official Committee URL: www.buerkleforcongress.com

(End FEC FORM 1)

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