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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-799167

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1. VICKY PAC

    NOTE:Commmittee Name is different than previously reported

    140 WALNUT SUITE 1000
    KANSAS CITY, MO 64112
    Email: amy@bespokekc.com

2. Date: 07/18/2011

3. FEC Committee ID #: C00499798

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.
     In addition, this committee is a Leadership PAC.

Affiliated Committees/Organizations

Candidate ID# H0MO04086
VICKY HARTZLER
22804 E 299TH ST
HARRISONVILLE, Missouri 64701
Affiliated Relationship Code: Leadership PAC Sponsor

Custodian of Records:

Mr. Terry Kilroy
700 W. 47th
Suite 1000
Kansas City, MO 64112
Title: Treasurer
Phone # (816) 374-0533

Treasurer:

Mr. Terry Kilroy
700 W. 47th
Suite 1000
Kansas City, Missouri 64112
Title: Treasurer
Phone # (816) 374-0533

Designated Agent(s):

Mr. Terry Kilroy
700 W. 47th
Suite 1000
Kansas City, Missouri 64112
Title: Treasurer
Phone # (816) 374-0533

Banks or Depositories

Country Club Bank
PO Box 410889
Kansas City, Missouri 64141

Signed: Mr. Terry Kilroy
Date Signed: 07/18/2012

(End FEC FORM 1)

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