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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-761002

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1. Tulsi for Hawaii

    PO Box 75561
    Kapolei, HI 96707
    Email: carol@votetulsi.com

2. Date: 10/01/2011

3. FEC Committee ID #: C00497396 This committee is a Principal Campaign Committee. Candidate: Ms. Tulsi Gabbard
Party: Democratic Party
Office Sought: House of Representatives
State is Hawaii in District: 02

Affiliated Committees/Organizations

Custodian of Records:

Mr. Robert Owen Riggs, Jr
PO Box 3529
Honolulu, HI 96811
Title: Assistant Treasurer
Phone # (808) 779-2680

Treasurer:

Ms. Talia Khurana
PO Box 75457
Kapolei, Hawaii 96707
Title: treasurer
Phone # (808) 375-5188

Designated Agent(s):

Ms. Carol Gabbard
PO Box 75457
Kapolei, Hawaii 96707
Title: treasurer
Phone # (808) 375-5188

Banks or Depositories

First Hawaiian Bank
590 Farrington Highway
Kapolei, Hawaii 96707

Signed: Ms. Talia Tamayo Khurana
Date Signed: 01/30/2012
Official Committee URL: http://www.votetulsi.com

(End FEC FORM 1)

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