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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1001180

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1. Kentucky Rise PAC, Inc.

    4949 Old Brownsboro Road
    Suite 278
    Louisville, KY 40222
    Email: eric.lycan@dinsmore.com

    NOTE: Email address is different than previously reported

2. Date: 04/06/2015

3. FEC Committee ID #: C00556712

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Cathy Bailey
PO Box 187
Harrods Creek, KY 40027
Title: Chairman

Treasurer:

David Eric Lycan
250 West Main Street
Suite 1400
Lexington, Kentucky 40517
Title: Treasurer
Phone # (859) 425-1047

Designated Agent(s):

Banks or Depositories

Forcht Bank
2404 Sir Barton Way
Lexington, Kentucky 40509

Signed: David Eric Lycan
Date Signed: 04/06/2015

(End FEC FORM 1)

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