FEC Form 1 for Duckworth for CongressForm 1 for Duckworth for Congress

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-840856

1. Duckworth for Congress

PO Box 59568
Schaumburg, IL 60159
Email: Billing@tammyduckworth.com

2. Date: 12/06/2012

3. FEC Committee ID #: C00498634 This committee is a Principal Campaign Committee. Candidate: Tammy Duckworth
Party: Democratic Party
Office Sought: House of Representatives
State is Illinois in District: 08

Affiliated Committees/Organizations

Committee ID# C00521369
Off The Sidelines: IA-IL-FL
709A 8TH ST SE
WASHINGTON, DC 20003
Affiliated Relationship Code: Joint Fundraising Representative

Custodian of Records:

Leah Israel
PO Box 59568
Schaumburg, IL 60159
Title: Finance Director

Treasurer:

Nancy Chen
917 Kennebec Lane
Naperville, Illinois 60563
Title: Treasurer
Phone # (401) 454-0990

Designated Agent(s):

Brett Smiley
118 North Main Street
Suite 2
Providence, Rhode Island 02903

Banks or Depositories

Chase Bank
2555 West Golf Road
Hoffman Estates, Illinois 60194

Bank of America
1501 Pennsylvania Avenue NW
Washington, DC 20005

Signed: Nancy Chen
Date Signed: 12/06/2012

(End FEC FORM 1)

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