FEC Form 1 for Hoosiers for Rokita, Inc.Form 1 for Hoosiers for Rokita, Inc.

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-511686

1. Hoosiers for Rokita, Inc.

NOTE:Commmittee Name is different than previously reported

7643 East U.S. 36
Avon, IN 46123
Email: info@toddrokitaforcongress.com

2. Date: 10/25/2010

3. FEC Committee ID #: C00476192 This committee is a Principal Campaign Committee. Candidate: Theodore Edward Rokita
Party: Republican Party
Office Sought: House of Representatives
State is Indiana in District: 04

Affiliated Committees/Organizations

Hoosier Young Guns Victory Committee
913 Park Avenue
Newport, Kentucky 410712235
Affiliated Relationship Code: Joint Fundraising Representative

Custodian of Records:

Mr. Michael J. Erler, Sr.
11205 W Sycamore Hills Drive
Fort Wayne, IN 468149381
Title: Custodian of Records
Phone # (260) 750-3982

Treasurer:

Mr. Michael J. Erler, Sr.
11205 W Sycamore Hills Drive
Fort Wayne, Indiana 468149381
Title: Treasurer
Phone # (260) 750-3982

Designated Agent(s):

Banks or Depositories

Fifth Third Bank
5925 Illinois Road
Fort Wayne, Indiana 468041159

Signed: Mr. Michael J. Erler, Sr.
Date Signed: 10/25/2010
Official Committee URL: http://www.toddrokitaforcongress.com/

(End FEC FORM 1)

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