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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1190797

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1. Don Bacon for Congress

    P.O. Box 391368
    Omaha, NE 68139
    Email: markdreiling@msn.com;scott@donjbacon.com

    NOTE: Email address is different than previously reported

2. Date: 06/27/2017

3. FEC Committee ID #: C00575167 This committee is a Principal Campaign Committee. Candidate: Mr. Donald John Bacon
Party: Republican Party
Office Sought: House of Representatives
State is Nebraska in District: 02

Affiliated Committees/Organizations

Committee ID# C00647420
BOLD ACTIVE CONSERVATIVES OF NEBRASKA PAC-BACON PAC
228 S. WASHINGTON ST.
STE. 115
ALEXANDRIA, Virginia 22314
Affiliated Relationship Code: Leadership PAC Sponsor

Committee ID# C00075820
NRCC
320 FIRST STREET SE
.
WASHINGTON, DC 20003
Affiliated Relationship Code: Joint Fundraising Representative

Committee ID# C00659722
115TH FRESHMEN VICTORY
PO BOX 26141
ALEXANDRIA, Virginia 22313
Affiliated Relationship Code: Joint Fundraising Representative

Custodian of Records:

Mr. Scott L Petersen
3716 South 193rd Street
Omaha, NE 68130
Title: Campaign Director
Phone # (402) 850-3850

Treasurer:

Scott Alan Brokke
1910 S. 72nd Street
Suite 200
Omaha, Nebraska 68124
Title: Treasurer
Phone # (402) 341-9441

Designated Agent(s):

Banks or Depositories

SAC Federal Credit Union
7148 Towne Center Parkway
Papillion, Nebraska 68046

EagleBank
2001 K St NW
Washington, DC 20006

Signed: Scott Alan Brokke
Date Signed: 11/11/2017
Official Committee URL: www.donjbacon.com

(End FEC FORM 1)

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