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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1047791

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1. Khary for Congress

    336 Wisconsin Ave
    Waukesha, WI 53186
    Email: kharyforcongress@gmail.com

2. Date: 02/01/2016

3. FEC Committee ID #: C00607929 This committee is a Principal Campaign Committee. Candidate: Khary Penebaker
Party: Democratic Party
Office Sought: House of Representatives
State is Wisconsin in District: 05

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Susan Hotz
20030 Freedom Ct
Brookfield, WI 53045

Treasurer:

Susan Hotz
20030 Freedom Ct
Brookfield, Wisconsin 53045

Designated Agent(s):

Banks or Depositories

Associated Bank
1400 Capitol Drive
Pewaukee, Wisconsin 53072

Signed: Susan Hotz
Date Signed: 02/02/2016

(End FEC FORM 1)

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