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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-841957

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1. Missouri Farm Bureau Federation Farm-PAC West District

    NOTE:Commmittee Name is different than previously reported

    15553 Hwy 23
    Alma, MO 64001
    Email: mfbpac@mofb.com

2. Date: 09/06/2012

3. FEC Committee ID #: C00528745 This committee is a separate segregated fund. Its connected organization is a Membership Organization

Affiliated Committees/Organizations

Missouri Farm Bureau Federation
PO Box 658
Jefferson City, Missouri 65102
Affiliated Relationship Code: Connected Organization

Committee ID# C00529990
Missouri Farm Bureau Farm-PAC East Cen
3804 Dissen Road
New Haven, Missouri 63068
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00040428
Missouri Farm Bureau Farm-PAC Northwes
506 Macadee Street
Maysville, Missouri 64469
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00089839
Missouri Farm Bureau Farm-PAC Southeas
178 David
Jackson, Missouri 63755
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00093898
Missouri Farm Bureau Farm-PAC Southwes
5863 W. State Highway 76
Anderson, Missouri 64831
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00405761
Missouri Farm Bureau Statewide Farm-PA
PO Box 658
Jefferson City, Missouri 65102
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00170944
Missouri Farm Bureau Farm-PAC St. Loui
5520 Highway 94
St. Charles, Missouri 63301
Affiliated Relationship Code: Affiliated Committee

Committee ID# C00038968
Missouri Farm Bureau Farm-PAC West Cen
32643 Highway E
Green Ridge, Missouri 65332
Affiliated Relationship Code: Affiliated Committee

Custodian of Records:

David Lueck
15553 Hwy 23
Alma, MO 64001
Title: Treasurer
Phone # (660) 674-2722

Treasurer:

David Lueck
15553 Hwy 23
Alma, Missouri 64001
Title: Treasurer
Phone # (660) 674-2722

Designated Agent(s):

Banks or Depositories

Central Bank
238 Madison Street
Jefferson City, Missouri 65101

Signed: David Lueck
Date Signed: 12/13/2012

(End FEC FORM 1)

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