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FEC Form 1 for JARED POLIS MAJORITY FUND 2012Form 1 for JARED POLIS MAJORITY FUND 2012

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-737765


1. JARED POLIS MAJORITY FUND 2012

    P.O. BOX 1174
    SPRINGFIELD, VA 22151
    Email: wwburns@earthlink.net

2. Date: 07/19/2011

3. FEC Committee ID #: C00493122

This committee is an independent expenditure-only political committee (Super PAC).

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Whitney W. Burns
P.O. BOX 1174
SPRINGFIELD, VA 22151
Title: Assistant Treasurer

Treasurer:

Lisa Kaufman
P.O. BOX 1174
SPRINGFIELD, Virginia 22151
Title: Treasurer

Designated Agent(s):

Whitney W. Burns
P.O. BOX 1174
SPRINGFIELD, Virginia 22151
Title: Assistant Treasurer

Banks or Depositories

Bank of America
1501 Pennsylvania Avenue NW
Washington, DC 20005

Signed: Lisa Kaufman
Date Signed: 07/19/2011
Official Committee URL: None

(End FEC FORM 1)


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