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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1021911

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1. Rothfus for Congress

    PO Box 435
    Sewickley, PA 15143
    Email: paul@pdscompliance.com

2. Date: 12/12/2014

3. FEC Committee ID #: C00497115 This committee is a Principal Campaign Committee. Candidate: Mr. Keith Rothfus
Party: Republican Party
Office Sought: House of Representatives
State is Pennsylvania in District: 12

Affiliated Committees/Organizations

Committee ID# C00583583
Insuring Our Future
824 S Milledge Ave Ste 101
Athens, Georgia 30605
Affiliated Relationship Code: Joint Fundraising Representative

Custodian of Records:

Mr. William Haskins
3908 Ashland Court
Allison Park, PA 15101
Title: Custodian of records
Phone # (724) 602-0277

Treasurer:

Mr. William Haskins
3908 Ashland Court
Allison Park, Pennsylvania 15101
Title: Treasurer
Phone # (724) 602-0277

Designated Agent(s):

Banks or Depositories

PNC
401 Beaver Street
Sewickley, Pennsylvania 15143

SunTrust Bank
PO Box 4418
Atlanta, Georgia 30302

Signed: Mr. William Haskins
Date Signed: 08/18/2015
Official Committee URL: www.keithpa4.com

(End FEC FORM 1)

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