FEC FORM 2
STATEMENT OF CANDIDACY
FILING FEC-515533
1. Theodore Edward Rokita
7643 East U.S. 36Avon, IN 461236123
2. Identification Number: H0IN04170
3. Party: Republican Party
4. Office Sought: House of Representatives
5-6. State & District of Candidate: Indiana - 4
DESIGNATION OF PRINCIPAL CAMPAIGN COMMITTEE
7. I hereby designate the following named political committee as my Principal Campaign Committee for the 2012 election(s).
Hoosiers for Rokita Inc.
FEC ID #: C00476192
7643 East U.S. 36Avon, IN 461236123
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
FEC ID #: C00490748
913 Park AvenueNewport, KY 410712235
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, and9B. 0.00 for the general election