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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-767348

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1. John Douglass for Congress

    14249 Hume Road
    Hume, VA 22639
    Email: vwinpisinger@msn.com

    NOTE: Email address is different than previously reported

2. Date: 02/22/2012

3. FEC Committee ID #: C00496364 This committee is a Principal Campaign Committee. Candidate: John Douglass
Party: Democratic Party
Office Sought: House of Representatives
State is Virginia in District: 10

Affiliated Committees/Organizations

None
, ____

Custodian of Records:

Vickie Winpisinger
315 Inspiration Lane
Gaithersburg, MD 20878
Title: Bookkeeper
Phone # (301) 947-0278

Treasurer:

Susan Douglass
14249 Hume Road
Hume, Virginia 22639
Title: Treasurer
Phone # (703) 739-7750

Designated Agent(s):

Banks or Depositories

BB&T
2947 S. Glebe Road
Arlington, Virginia 22206

Signed: Susan Douglass
Date Signed: 02/22/2012
Official Committee URL: http://www.johndouglassforcongress.com

NOTE: URL is different than previously reported

(End FEC FORM 1)

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