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FEC FORM 2

STATEMENT OF CANDIDACY

FILING FEC-511687

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1. Theodore Edward Rokita

7643 East U.S. 36
Avon, IN 461236123

2. Identification Number: H0IN04170

3. Party: Republican Party

4. Office Sought: House of Representatives

5-6. State & District of Candidate: Indiana - 4

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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 2010 election(s).

    Hoosiers for Rokita Inc.
    FEC ID #: C00476192

    7643 East U.S. 36
    Avon, IN 461236123

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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.

    Hoosier Young Guns Victory Committee

    913 Park Avenue
    Newport, KY 410712235

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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: Theodore Edward Rokita
Signed by the candidate on: 10/25/2010

Filed: 10/25/2010

(End FEC FORM 2)

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