FEC Form 1 for Petersen for Congress 2016Form 1 for Petersen for Congress 2016

FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1048213

1. Petersen for Congress 2016

2 Civic Center Drive
Unit 4338
San Rafael, CA 949135703
Email: petersen@politicalvisions.com

2. Date: 02/05/2016

3. FEC Committee ID #: C00608281 This committee is a Principal Campaign Committee. Candidate: Roger Petersen
Party: Republican Party
Office Sought: House of Representatives
State is California in District: 11

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Thomas E Montgomery, III
2 Civic Center Drive
Unit 4338
San Rafael, CA 949135703
Title: Treasurer
Phone # (415) 250-4036

Treasurer:

Thomas E Montgomery, III
2 Civic Center Drive
Unit 4338
San Rafael, California 949135703
Title: Treasurer
Phone # (415) 250-4036

Designated Agent(s):

Thomas E Montgomery, III
2 Civic Center Drive
Unit 4338
San Rafael, California 949135703
Title: Treasurer
Phone # (415) 250-4036

Banks or Depositories

US Bank
5800 Northgate Drive
#051
San Rafael, California 94903

Signed: Thomas E Montgomery, III
Date Signed: 02/05/2016

(End FEC FORM 1)

Generated Fri Sep 27 03:14:59 2024